For the first time in Israel, doctors at Hadassah’s Heart Institute used an innovative catheterization tool to successfully perform a new procedure on a 72 years old woman suffering from severe and uncontrolled chronic hypertension (high blood pressure). The minimally invasive outpatient procedure, which takes only 40 minutes to perform, blocks the over functioning nerves and permanently lowers blood pressure.

 

The procedure, called renal denervation, is based on research showing that overactive kidney nerves are a major contributor to the progression of high blood pressure. Renal denervation involves selectively disabling renal nerves within the sympathetic nervous system. Ardian Inc., a subsidiary of Medtronic Inc., developed the special catheterization tool to cauterize specific nerves in the kidneys.

 

In a straight-forward endovascular procedure similar to angioplasty, Prof. Chaim Lotan, Head of the Heart Institute at Hadassah, together with Prof. Allan Bloom, Director of the vascular and interventional radiology center, and Prof. Haim Danenberg, director of the cardiovascular research center at the heart institute, inserted a small, flexible catheter with an electrode on its tip into the patient’s femoral artery in the upper thigh and threaded it into the renal artery. Once in place, controlled amounts of low-power electrical energy are applied to deactivate the surrounding renal sympathetic nerves, reducing the hyperactivity of the sympathetic nervous system.

 

The standard treatment for hypertension is based on a combination of medications and a healthy lifestyle that includes a balanced diet and exercise. The side effects of the medications, which must be taken daily, often impact the patient’s quality of life.

 

"This revolutionary procedure opens a window of opportunity for treating patients with hypertension who have not responded well to medication,” said Prof. Chaim Lotan, Head of Hadassah Heart Institute. "The treatment is still in its initial stages,” he added, pointing out that the procedure was only devised two years ago. "At this stage, it is intended for patients whose blood pressure remains uncontrolled even after taking large amounts of medication. Renal denervation can reduce the required dosage for some patients and completely eliminate the need for medication in others. So far we have seen improvement in the levels of hypertension, but it is too early to measure the long term results.”

 

Though it has no symptoms, hypertension is of the main causes of heart failure, kidney failure and strokes in Israel and worldwide. Nearly one billion people suffer from hypertension worldwide; in Israel approximately one million people are affected. The treatment is not covered by Israel's national health insurance system.

 

source: Hadassah University Medical Center