Percutaneous sympathectomy of the renal arteries: the OneShot™ Renal Denervation System is not associated with significant vessel wall injury

Aims: Renal artery denervation (RADN) is an emerging technique for the treatment of resistant hypertension (RH). However, the use of the available systems has been associated with vascular injury, resulting in vasospasm and vessel wall thrombosis. The OneShot™ System (Covidien, San Jose, CA, USA) is an irrigated radiofrequency balloon designed to reduce vessel heating and injury during RADN. Methods and results: The aim of the present study was to evaluate the target vessel morphological features before and after renal ablation using the OneShot™ RADN system. In this prospective observational study, 12 renal arteries of patients underwent RADN using the OneShot™ RADN System. Pre-procedural and post-procedural optical coherence tomography (OCT) pullbacks were performed and evaluated. No evidence for vasospasm, oedema or intraluminal thrombus formation was detected. Limited arterial dissections, after RADN, occurred in three renal arteries and did not require additional treatments. A sustained reduction of office blood pressure levels was observed over six months of follow-up in all the patients. Conclusions: This study demonstrates that, in a small patient population, RADN using the OneShot™ Renal Denervation System is not associated with arterial spasm or thrombus formation on the vessel wall.