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Renal Artery Denervation Treatment for Refractory Arterial Hypertension

Refractory arterial hypertension (RAH) is the type that cannot be adequately controlled with the use of at least three antihypertensive agents at maximum doses (diuretics, beta blockers, ACE inhibitors and calcium reuptake inhibitors), in patients who are compliant with the medication.

Renal artery denervation makes it possible to subsequent months which, in turn, reduces the complications of arterial hypertension, which can be as serious as arrhythmia or migraine; while reducing the risk of other serious complications directly related to refractory arterial hypertension.

Benefits of the operation

Renal denervation therapy is a very innovative technique, but we already have very relevant scientific information that has been published in the best scientific medical journals.

This technique lowers blood pressure in 82% of patients and normalises it in 40%. This reduces the amount of medication these patients need to take, as well as secondary complications of refractory arterial hypertension such as neurological and cardiological problems.

It is of benefit to patients with severe arterial hypertrophy who need to take at least three drugs.

What is also important is that this technique is performed with minimal risk of complications in expert hands.

Medical-technical description

The technique consists of inserting a small, 1.5 mm diameter catheter through the femoral artery (in the abdomen or thigh) to the renal artery, until it reaches the area where the renal nerves are found. Once in place, radiofrequency is applied to suppress nerve activity. 

The equipment is guided with X-ray and contrast material.

About the operation

The patient stays awake throughout the operation, however, as the small cauterisations performed in each renal artery can be uncomfortable, an anaesthetist will be present to use strong analgesics to protect the patient from any type of pain or discomfort. 

The entire procedure takes less than eighty minutes. If the patient progresses well, the following day he will be released and will be able to go home.

Before the operation

  • When you are admitted you will have a blood test, an electrocardiogram and your vital signs will be recorded.
  • A line will be placed in the vein for delivering medication.
  • Your body hair will be shaved from the belly button to halfway down your thigh.
  • Do not take oral anticoagulants (such as Sintron or Warfarin). Your cardiologist will tell you when to stop taking them and what medicines you should take instead.
  • If you are taking medicine for your arrhythmia, your cardiologist will tell you if you should stop taking it and when.
  • You will have to understand and sign the informed consent form before the operation. This will be given to you by your cardiologist.
  • You must not eat or drink for six to eight hours before your operation.
  • Do not wear underwear or dentures. You must remove all metal objects (such as rings, bracelets, earrings, body piercings, etc).

Post-operative care

  • You will not be able to eat or drink after the operation until it is safe to do so. The nursing staff will tell you when this is.
  • The nursing staff in the unit will watch your vital signs and the catheter insertion site regularly according to the protocol established for this purpose.
  • Once the procedures are complete, all the catheters will be removed and pressure will be applied to the insertion site until it stops bleeding. A bandage will then be applied which will be removed after 12 hours. During all this time, you will lie still on the bed without bending the affected leg.
  • Sometimes the catheter insertion site in the femoral artery is sealed with an appliance. Even so, the patient must rest in bed with the affected leg stretched out, for 12 hours.
  • When the compression bandage has been removed, you will be able to sit and walk about.
  • After you have been released you will be able to lead a normal life, although strenuous exercise and efforts are not recommended for the initial two days after release.
  • On release, you will be given a medical report with guidelines to follow at home.

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