经“子母”导管行去肾交感神经治疗顽固性高血压二例

Dual catheter-based renal sympathetic denervation in two patients with resistant hypertension

目的探讨经"子母"导管行肾动脉交感神经治疗顽固性高血压的方法及疗效。方法 2例顽固性高血压患者,于局麻下使用7F肾动脉指引导管套5F消融导管对其行经导管去肾交感神经术,螺旋式消融肾动脉内膜4～6个点,术中消融指标:每点消融时间累积120 s,消融功率8 W,消融阻抗150～250Ω,消融温度45℃。结果 2例血压由术前170/100,175/98 mmHg降至术后出院时的130/82,134/84 mm Hg,术后4个月随访期间平均血压分别为130/82,134/84 mm Hg。2例患者术后降压药的用量和种类减少。结论使用"子母"导管行经导管去肾交感神经术治疗顽固性高血压安全、有效。

Objective To assess the method and effect of dual catheter-based renal sympathetic denervation for resistant hypertension patient. Method Two cases with resistant hypertension were enrolled to receive the radiofrequency Sym- plicity dual catheter-based treatment in local anesthesia. Four to six points at the renal artery intima were ablated spirally. Ablation indexes of each point included ablation time of 120 seconds, energy of 8 watts, impedance of 150-250 ohm and tem- perature of 45~C. Results After the short-term follow-up,blood pressure in two patients were well controlled. In case 1, the preoperative blood pressure was 170/100 mmHg and then declined gradually to 125/78 mmHg in the discharge day af- ter the procedure. Along with the reduction of the dosage and sorts of antihypertensive drugs,the mean blood pressure was 130/82mmHg 4 month after the operation. In case 2 ,the preoperative blood pressure was 175/98 mmHg and then declined gradually to 134/76 mmHg in the discharge day after the procedure. Along with the reduction of the sorts of antihypertens- ive drugs,the mean blood pressure was 134/84 mmHg 4 month later after the operation. Conclusion Using the dual catheter for renal sympathetic denervation is a new effective method for treating patients with resistant hypertension.