Renal denervation procedure
Vessix™ Renal Denervation, W.
RENAL, ACUTE KIDNEY INJURY, CONTRAST-INDUCED NEPHROPATHY
All patients underwent renal angiography via Seldinger technique followed by bilateral RDN. Three specialized endovascular ablation systems were used: Symplicity flex™ (Medtronic Inc, Mountain View, Canada) in 22 patients, Vessix™ Renal Denervation System (Boston Scientific, USA) in 27 patients, and Symplicity Spyral™ Renal Denervation system (Medtronic, USA) in 21 patients.By the Symplicity flex™ (Medtronic Inc, Mountain View, Canada) radiofrequency ablations were applied from distant to proximal part of the renal arteries under electrode temperature control (40–75°С), with the maximal output power of 8 W. The maximum of 8 applications were performed at > 5 mm distance in a spiral pattern, each lasting for about 120 s with the total duration of the procedure up to 35-45-minutes.In the Vessix™ Renal Denervation System, balloon catheters with 4-, 5- and 6-mm diameter depending on the diameter of renal artery were used. Radiofrequency generator monitored impedance, and in case of the inadequate electrode contact, the electrode switched off automatically. Each application lasted for 30 s, temperature 65–68 °С, power 1 W.The Symplicity Spyral™ device monitors temperature and impedance and regulates power (6 W), duration of applications is 60 s. All procedures were performed by well experienced and properly trained operators (DZ, EM).Upon completion of the procedure, femoral artery was compressed. For 12 h the patients were monitored at the intense care unit followed by 2-5-day stay at the cardiology department. Two-month dual antiplatelet therapy (aspirin 100 mg and clopidogrel 75 mg OD) was prescribed to all patients.Acute kidney injury (contrast-induced nephropathy) was diagnosed according to KDIGO criteria [