CT-guided ozone-mediated lumbar-renal sympathetic denervation for resistant hypertension treatment: A pilot single-arm clinical trial

Cardiovasc Revasc Med. 2024 Oct:67:51-57. doi: 10.1016/j.carrev.2024.04.294. Epub 2024 Apr 24.

Abstract

Background: Renal sympathetic denervation (RDN) reduces blood pressure (BP).

Methods: This single-arm open-label study enrolled patients with resistant hypertension (RH) and treat them by CT-guided ozone mediated lumbar-renal sympathetic denervation (L-RDN). The primary endpoint was to assess the changes of BP over 24-h ambulatory BP monitoring (ABPM) and to evaluate the anti-hypertensive medication burden (AHMB) at 3-month follow-up. This study was registered in Chictr.org.cn (ChiCTR2300071375).

Results: 17 patients (mean age 65.12 ± 10.77 years) with AHMB of 4.12 ± 1.11 were enrolled. After the procedure, 7 patients (46.7 %) matched the criteria for antihypertensive medication reduction. The AHMB decreased to 3.87 ± 0.96 for the whole objectives and from 3.87 ± 0.96 to 3.55 ± 0.78 for patients with normal baseline renal function. On top of the lessened AHMB, L-RDN further reduced morning systolic BP (SBP) by -8.6 ± 4.0 mmHg (p = 0.034) and diastolic BP (DBP) by -4.6 ± 2.1 mmHg (p = 0.032) for all participants and morning SBP by -13.2 ± 3.6 mmHg (p < 0.001), morning DBP by -6.2 ± 2.4 mmHg (p = 0.011) and daytime SBP by -4.1 ± 1.6 mmHg (p = 0.009) for those with normal baseline renal function at 3-month of follow-up. No adverse events were reported intra- and post operation.

Conclusions: CT-guided ozone-mediated L-RDN might be an innovative approach of RDN for treating RH. Confirmatory studies are warranted.

Keywords: Ozone; Renal denervation; Resistant hypertension.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Antihypertensive Agents* / administration & dosage
  • Antihypertensive Agents* / adverse effects
  • Antihypertensive Agents* / therapeutic use
  • Blood Pressure Monitoring, Ambulatory
  • Blood Pressure* / drug effects
  • China
  • Drug Resistance*
  • Female
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / physiopathology
  • Hypertension* / surgery
  • Kidney* / innervation
  • Male
  • Middle Aged
  • Ozone* / administration & dosage
  • Ozone* / adverse effects
  • Pilot Projects
  • Radiography, Interventional
  • Sympathectomy / adverse effects
  • Sympathectomy / methods
  • Time Factors
  • Treatment Outcome

Substances

  • Ozone
  • Antihypertensive Agents