Renal Denervation

This extensively revised edition examines renal pathophysiology and the rationale for renal denervation for the management of hypertension, as well as possible long-term benefits and risks of this therapy. Renal denervation is a minimally invasive, endovascular catheter-based procedure that makes use of radiofrequency ablation to treat resistant hypertension, with studies showing a high degree of effectiveness. The devices involved in the continued evolution of this therapy are discussed and the book incorporates analyses of the development of the technique while evaluating its cost effectiveness and future applications.

Renal Denervation: A New Approach to Treatment of Resistant Hypertension describes the technique in detail, its advances and its pitfalls. While it has been estimated that 50% of Western civilization has hypertension and approximately 20% of patients have resistant hypertension, hypertension remains the leading cause of cardiovascular morbidity and mortality thus strengthening arguments to consider a wider range of potential solutions to manage these patients.

Pathophysiology: The Target for Renal Denervation.- Physiological Rationale for Renal Denervation Therapy in Hypertension.- Preclinical Model and Histopathology Translational Medicine and Renal Denervation.-Appraisal of the Clinical Trial Data on Renal Denervation for the Management of Resistant Hypertension.- Catheter-Based Technology Alternatives for Renal Denervation: An Overview.- Vincristine Local Delivery for Renal Artery Denervation.- Renal Denervation: Potential Future Implications Beyond Resistant Hypertension.- Renal Denervation for Congestive Heart Failure.- The Potential Role of Catheter-Based Renal Sympathetic Denervation in Chronic and End-Stage Kidney Disease.- Diabetes and Metabolic Syndrome.- Obstructive Sleep Apnea.- Future of Renal Denervation Studies and Clinical Implementation.- Transcatheter Carotid Body Denervation (Cibiem): First-in-Man Results and Future Directions.- Mobius for Hypertension: Results to Date and Pivotal Trial.-Sensing Renal Nerve ActivityBefore, During and After Denervation: Autonomix.- Sensing Renal Nerve Activity Before, During and After Denervation: SyMap.- Patient Selection for Renal Denervation Therapy - From Mild Hypertension in the Young .- Is There an Unmet Need for Device Treatment for Moderate Hypertension?.- What are the FDA Parameters for Pivotal Successful Study Design for Device Approval for Hypertension Therapy?.- What are the FDA Parameters for Pivotal Successful Study Design for Device Approval for Hypertension Therapy?.- US Preventive Services Task Force Recommendation on ABPM Rationale/Potential Implications: How Much Reduction of Blood Pressure is Enough?.- Renal Denervation Cost Analysis and Consideration.- What Needs to Be Shown Before Renal Denervation Can Be Used in Clinical Practice?.- How to Screen Patients for Renal Denervation Trials? Why Is There US Apathy Toward ABPM: Low Reimbursement or Cognitive Dissonance?.- Renal Denervation: New Data From the Latest Feasibility Trials.- Evaluation ofthe Renal Nerve: Anatomy, Renal Nerve Distribution and Animal Models.- Renal Denervation Lowers BP in Sham-Controlled Studies:  Meta-Analysis.- Renal Denervation May Lower Treatment Burden, as Well as Blood Pressure:  Radiance-Htn Solo.- Coping With CABANA: Despite Trial Flaws, A-fib Experts Say Lessons Have been Learned.- Chemical Renal Denervation with Alcohol:  The Post-Market Study Data and The Target BP Program.- Renal Denervation With Alcohol Infusions Appears Safe, but Clinical Impact Remain Unproven.