顽固性高血压的介入治疗肾神经消融课件.ppt

尽管当代降压药物有长足开展，但仍有部

分标准服药的患者血压不能达标此外：交感神经抑制剂、直接肾素抑制剂、非特异性血管扩张剂、抗高血压疫苗…高血压是全球公共卫生的难题，难治性高血压约占10%-20%，有更高心血管事件风险Resistanthypertension:Circulation2021;117:e510–26

理论根底的启示：寻找解决方法Sympatheticnervoussystemandthekidneyinhypertension.Carotidbaroreflexandhypertension肾交感神经阻断？颈动脉体迷走神经兴奋？

SymplicityHTN-1ThreeYearand

SymplicityHTN-2OneYearSummarySustainedBPReductionstoThreeYearsFirstSymplicityHTN-1patienttreatedJune2007ThreeyearreportingshowsnodiminishmentofeffectandimpressivelongtermsafetyForpatientsthathavecompleted3yearfollowup,100%havebeenclassifiedasresponders(10mmHgreduction),whileat6months71%ofpatientswereclassifiedasresponders.SuperiorResultsConfirmedinRandomisedStudySymplicityHTN-2treatmentpopulationshowssustainedtreatmenteffectat12monthfollow-upControlcross-overpatientsalsoshowsignificantBPreductionOnlytheSymplicity?renaldenervationsystemhasprovensafe,superiorandsustainedBPreductions

Significant,SustainedBloodPressureReductionstoatLeast3YearsExpandedresultspresentedattheAmericanCollegeofCardiologyAnnualMeeting2021(Krum,H.)p0.01for?frombaselineforalltimepoints

ImpressiveSafetyRecordContinuesinLongTermFollow-up81patientswith6-monthrenalCTA,MRAorduplexNovascularabnormalitiesatanysiteofRFdeliveryOneprogressionofapre-existingstenosisunrelatedtoRFtreatment(stentedwithoutfurthersequelae)Onenewmoderatestenosiswhichwasnothemodynamicallyrelevantandnottreated3deathswithinthefollow-upperiod;allunrelatedtothedeviceortherapyNohypotensiveeventsthatrequiredhospitalizationTherewerenoobservedchangesinmeanelectrolytesoreGFRExpandedresultspresentedattheAmericanCollegeofCardiologyAnnualMeeting2021(Krum,H.)

PercentageRespondersIncreasesOverTimeResponderwasdefinedasanofficeSBPreduction≥10mmHg(n=143)(n=148)(n=144)(n=130)(n=107)(n=59)(n=24)(n