Catheter-Based Radiofrequency Renal Denervation: Location Effects on Renal Norepinephrine
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BACKGROUND: Clinical studies indicate that blood pressure (BP)-lowering effects of radiofrequency (RF) renal denervation (RD) are sustained for up to 2 years, although a recent clinical trial failed to find a major effect compared to sham treatment. In most previous studies, the efficacy of RD has not been assessed. The current study determined whether RD in different regions of the renal artery causes different degrees of RD as assessed with renal norepinephrine (NE) levels. METHODS AND RESULTS: Unilateral RD was performed on 14 pigs divided into 3 groups: RD near the ostium, in the main renal artery near the bifurcation, and in extrarenal branches of the renal artery. After 2 weeks post-RD, the pigs were euthanized, renal cortex tissue was collected for NE measurement, and renal arteries were prepared for histological analysis. Renal NE decreased by 12% with RD at the ostium, 45% with RD near the bifurcation in the main renal artery, and 74% when RD was performed in extrarenal artery branches. The number of renal nerves was greatest in extrarenal branches and in the main artery compared to the ostium and the average distance from the lumen was greatest for nerves at the ostium and least at the branches. CONCLUSIONS: RF RD lowers renal NE more significantly when performed in branches of the renal artery closer to the kidney. Increased efficacy of RF RD in extrarenal arterial branches may be due to the greater number of nerves in close proximity to the artery lumen in the branches.
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Even under optimal conditions, catheter-based renal denervation methods ablate only 40-50% of renal nerves unless nerves running along the renal segmental arteries are also ablated.
“Even under optimal conditions, catheter-based RDN methods ablate only 40–50% of renal nerves unless nerves running along the renal segmental arteries are also ablated167.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [167]
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Effects of different ablation points of renal denervation on the efficacy of resistant hypertension
Zhang, H., Li, L., Xiao, R.-X., Zhang, T.-C., Liu, Z., & Gao, J. (2020) · PeerJ · doi:10.7717/peerj.9842 · Cited by 1 · see citing works
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Tsioufis, C. (2020) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.736196796.793578606
Role of renal sympathetic denervation in non‑pharmacological treatment of cardiovascular diseases
Bulava, A. (2022) · Intervenční a akutní kardiologie · doi:10.36290/kar.2022.024
Hering, D., Heuser, R. R., & Esler, M. (2023) · Springer eBooks · doi:10.1007/978-3-031-38934-4_2
Renal Denervation Lowers Blood Pressure in Sham Controlled Studies: Meta-Analysis
Papademetriou, V., Tatakis, F., Tsioufis, P., & Tsioufis, K. P. (2023) · Springer eBooks · doi:10.1007/978-3-031-38934-4_5
Hering, D., & Heuser, R. R. (2023) · Springer eBooks · doi:10.1007/978-3-031-38934-4_17
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Renal denervation for hypertension management: past, current evidence, and future directions
Hassan, S., Rendon, I. H., Spilias, N., Bredel, L., Chatzizisis, Y. S., & Delgado-Lelievre, M. C. (2026) · American Journal of Hypertension · doi:10.1093/ajh/hpag112
Development of Renal Denervation Catheter Based on Piezoelectric Ultrasonic Transducer
Li, Q., Zhou, T., 秦丹, Wu, Y., Li, X., Li, S., Chen, X., & Wu, Z. (2026) · Micromachines · doi:10.3390/mi17101207
- Authors
- Henegar, J. R., Zhang, Y., Hata, C., Narciso, I., Hall, M. E., & Hall, J. E.
- Affiliations
- University of Missouri (US)
- Center for Innovation and Strategic Collaboration, St. Jude Medical, Inc. 2 , Irvine, California , ;
- University of Mississippi Medical Center (US)
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-01-08
- Volume
- 28
- Issue
- 7
- Pages
- 909-914
- ISSN
- 0895-7061 (ISSN-L)
- 1941-7225
- PMC
- PMC4804121
- OpenAlex
- W2002349269
- Cited by
- 83
- References
- 15
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 9 · 2022: 3 · 2021: 9 · 2020: 6 · 2019: 16 · 2018: 4 · 2017: 10 · 2016: 13 · 2015: 9
- FWCI
- 8.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Hypertension (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (P01HL051971)
- National Institute of General Medical Sciences (P20GM104357)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- renal denervation, radiofrequency ablation, renal artery branches, hypertension, blood pressure reduction, catheter ablation, renal cortex, animal models
- MeSH terms
- Animals, Kidney, Norepinephrine, Radiography, Renal Artery, Swine, Sympathectomy, Time Factors, Down-Regulation, Catheter Ablation, Models, Animal
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