Modified Ozone-Mediated Neurolysis for Resistant Hypertension in a Patient With Bilateral Renal Artery Stenosis.

BACKGROUND

Catheter-based renal denervation (RDN) has been proven to be an effective treatment for resistant hypertension (RH). However, patients with concomitant renal artery stenosis are considered contraindicated.

CASE SUMMARY: A 75-year-old woman with bilateral renal artery stenosis and RH unresponsive to 5 antihypertensives combined with intravenous high-dose nitroprusside, underwent computed tomography-guided percutaneous ozone injection around the left lumbar sympathetic ganglion at the left renal artery level. The procedure led to immediate discontinuation of intravenous antihypertensives and sustained blood pressure reduction for up to 6 months.

DISCUSSION: This novel approach avoids intravascular procedures and contrast agents and achieved outcomes comparable to RDN for the patient.

NOVELTY: Ozone-mediated neurolysis, a traditional pain-relief technique, can be modified to produce blood pressure-lowering effects comparable to RDN.

TAKE-HOME MESSAGE: Computed tomography-guided ozone-mediated neurolysis may be a promising option for RH associated with renal artery stenosis.