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An Open-label, Single-arm, Multicenter Feasibility Study Evaluating the Safety of Catheter-based Renal Denervation with DENEX™ in Patients with Uncontrolled Hypertension on Standard Medical Therapy

Korean Circulation Journal 2021년 51권 1호 p.43 ~ 55
김찬준, 장기육, 김병극, 박창규, 장양수,
소속 상세정보
김찬준 ( Kim Chan-Joon ) - Catholic University College of Medicine Uijeongbu St. Mary’s Hospital Department of Internal Medicine
장기육 ( Chang Ki-Yuk ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Cardiology
김병극 ( Kim Byeong-Keuk ) - Yonsei University College of Medicine Severance Cardiovascular Hospital
박창규 ( Park Chang-Gyu ) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
장양수 ( Jang Yang-Soo ) - Yonsei University College of Medicine Severance Cardiovascular Hospital

Abstract


Background and Objectives: DENEX™ is a novel renal sympathetic denervation (RDN) system that is equipped with 3 electrodes that deliver radiofrequency energy to the renal nerves along renal arteries. The purpose of this study was to evaluate the safety and efficacy of RDN with DENEX™ in resistant hypertension.

Methods: This was an open-label, single-arm, multicenter, first-in-man pilot study. Between November 2016 and May 2018, a total of 16 patients were enrolled at 4 centers in South Korea. The inclusion criteria were systolic blood pressure (SBP) ≥150 mmHg and use of 3 or more antihypertensive medications, including diuretics. The primary objective was the safety outcome of RDN with the DENEX™ system. The secondary objective was efficacy outcome based on changes of office, and 24-hour ambulatory SBP from baseline to 3 months. The patients underwent abdominal computed tomography (CT) or duplex ultrasonogram before and 6 months after RDN.

Results: No major adverse events occurred after RDN for 6 month of follow-up period. There was no vascular complication either by CT or duplex ultrasonogram. The office SBP was significantly reduced from 164.6±11.6 mmHg at baseline to 142.0±20.4 mmHg (?24.4±24.4 mmHg, p=0.003) at 3 months. The ambulatory SBP was reduced from 151.44±12.85 mmHg at baseline to 140.0±16.5 mmHg (?13.1±18.9 mmHg, p=0.056) at 3 months.

Conclusion: RDN with the DENEX™ system showed a favorable safety profile in resistant hypertension. A significant reduction in office SBP and a borderline reduction in ambulatory SBP were observed.

키워드

Hypertension; Drug resistance; Denervation; Catheter ablation

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