Benjamin Honton comments on the article from EuroIntervention Journal: First report of transradial renal denervation with the dedicated radiofrequency Iberis™ catheter published ahead of print on October 25, 2013.
We describe the first use of transradial access renal denervation in a patient with resistant hypertension using a dedicated radiofrequency catheter (Iberis™; Terumo Medical Corporation, Tokyo, Japan). The system includes a generator and a 4 Fr single-use radiofrequency (RF) device which has to be introduced via a 6 Fr guiding catheter. Radiofrequency energy is delivered at the tip of the catheter. The system was CE approved in March 2013.
Review by Benjamin Honton
What is known:
Renal denervation is a new tool for management of resistant hypertension. Despite improvement of the first-generation devices, all the procedures are actually approached by femoral access with potential severe complications.
Indeed, numbers of publications suggest the safety of a radial approach with a reduction of morbi-mortality in the field of coronary percutaneous intervention.
This article reports the first use of radial approach for renal denervation with the IBERIS catheter, from Terumo Corporation. Using a 6 French sheath introducer, a 6 Fr guiding MP shape catheter is placed in the renal artery.
The Iberis™ system is a unipolar electrode catheter with a 155 cm long shaft and a flexible tip of 12 mm. As described in the Symplicity study, the pattern of denervation was helicoïdal with a distance of 5 mm between two points of ablation. There is no cooling mechanism during the procedure and the electrode generates a temperature of up to 60° Celsius with an 8-watt energy delivery level, for a two-minute ablation point. Eight points in the right renal artery and five in the left renal artery trunk of renal denervation were performed. Final angiogram did not show any renal artery dissection or spasm.
This case underlines the availability of a dedicated radial radiofrequency renal denervation catheter, expanding the possibilities to treat patients with similar efficacy to a femoral catheter, but probably with fewer expected complications. Moreover, it allows sympathetic renal denervation for patients with an acute origin of renal artery, which could be technically challenging by femoral approach.
Read more about Iberis® Renal Sympathetic Denervation System by Terumo in our Material Catalogue.
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