Article Dans Une Revue Eur Radiol Année : 2018

MRI-based detection of renal artery abnormalities related to renal denervation by catheter-based radiofrequency ablation in drug resistant hypertensive patients.

Résumé

OBJECTIVES: Endovascular renal denervation (RDN) using catheter-based radiofrequency (RF) ablation has emerged as a potential treatment option for drug-resistant hypertension. Its efficacy is currently under debate. We aimed to evaluate the capability of contrast-enhanced magnetic resonance imaging (MRI) to assess the effects of RDN on the renal arterial wall in patients presenting with drug-resistant hypertension.

METHODS: Patients were included prospectively following institutional review board approval and written informed consent. Renal arteries were imaged using a two-dimensional T1-weighted TSE sequence pre- and post-administration of a gadolinium-based contrast agent, before (D0), 2 days (D2) and 6 months (M6) after RDN. Mean enhancement of the wall (mENH) and mean wall thickness (mWT) were compared across time using an ANOVA with repeated measures and post-hoc paired t-test.

RESULTS: Follow-up was completed for 23 patients (median age, 57 years; 16 men). The mENH at D2 (96.3 \textpm 36.0 %) was significantly higher than at D0 (61.1 \textpm 26.3%, p < 0.001) and M6 (66.1\textpm22.7%, p < 0.001). Similarly, mWT was significantly higher at D2 (3.1 \textpm 0.4 m) than at D0 (2.7 \textpm 0.4mm, p < 0.001) and M6 (2.9 \textpm 0. 5 mm, p = 0.002).

CONCLUSIONS: MRI demonstrated abnormalities of the arterial wall 2 days after RDN that had resolved at 6 months.

KEY POINTS: \textbullet Contrast-enhanced MRI provides anatomic evidence of renal artery RF ablation \textbullet Temperature increase related to RF ablation induces transient arterial wall inflammation \textbullet Morphological effects observed 2 days post RF ablation are not visible after 6 months.

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Dates et versions

hal-01960473 , version 1 (19-12-2018)

Identifiants

Citer

M. Sigovan, S. Si-Mohamed, P.Y. Courand, B. Harbaoui, Marc Sapoval, et al.. MRI-based detection of renal artery abnormalities related to renal denervation by catheter-based radiofrequency ablation in drug resistant hypertensive patients.. Eur Radiol, 2018, 28 (8), pp.3355-3361. ⟨10.1007/s00330-017-5272-3⟩. ⟨hal-01960473⟩
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