Renal Denervation for Refractory Hypertension Complicated by Acute Aortic Syndrome.

BACKGROUND

This study aimed to explore the clinical application of renal denervation (RDN) in patients with refractory hypertension complicated by acute aortic syndrome.

CASE SUMMARY: We present a case of a 54-year-old woman with refractory hypertension treated with quadruple antihypertensive therapy, including nifedipine, metoprolol, hydrochlorothiazide, and sacubitril-valsartan. Five months ago, she underwent emergent thoracic aortic endovascular stent-graft repair for acute aortic type B dissection. Successful bilateral RDN (Netrod system) was performed without complications. Postprocedure 24-hour average blood pressure decreased to 119/73 mm Hg at 3-month follow-up from 136/82 mm Hg preoperatively, with hydrochlorothiazide discontinued and the rest medications halved.

DISCUSSION: This case suggests that RDN may offer an effective approach for blood pressure control in acute aortic syndrome. Careful preprocedure evaluation and multidisciplinary decision-making are crucial.

TAKE-HOME MESSAGE: This case shows that RDN combined with definitive thoracic aortic endovascular stent-graft repair potentially becomes a new treatment modality for acute aortic syndrome.