A 50-year-old woman with resistant hypertension presents for consideration of renal denervation. She is compliant with HCTZ 50 mg daily, amlodipine 10 mg daily, and losartan 100 mg daily. Renal CTA shows normal renal arteries bilaterally. On the right there is an accessory renal artery measuring 3.5 mm in diameter. On the left, there is an early branching main renal artery. She is referred for ultrasound renal denervation.
The correct answer is: A. After confirming renal anatomy by renal angiogram, treat the right main and accessory renal arteries and the left main renal artery.
Treatment of accessory renal arteries measuring 3.5-8.0 mm is recommended. Adequate balloon apposition is required to achieve adequate treatment. Treatment beyond the bifurcation in the renal hilum is not recommended.
This patient case quiz is part of the larger Overcoming Challenges in Hypertension Management grant. Educational grant support is provided by Medtronic. To visit the Overcoming Challenges in Hypertension Management grant page and access additional educational activities on this topic, click here.
References
- Swaminathan RV, East CA, Feldman DN, et al. SCAI Position Statement on Renal Denervation for Hypertension: Patient Selection, Operator Competence, Training and Techniques, and Organizational Recommendations. JSCAI. 2023;2(6):101121. doi: https://doi.org/10.1016/j.jscai.2023.101121.
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