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Southampton General Hospital pioneers renal denervation to help cure high blood pressure
IT IS a groundbreaking operation that blasts kidneys with radio waves and could change the lives of millions of people suffering from high blood pressure.
The new type of surgery, completed under a local anaesthetic, can lower blood pressure in just 45 minutes.
And it is the first ever alternative treatment for patients who have been unable to control the condition using normal medicine.
Heart experts at Southampton General Hospital yesterday became the first in the region to perform the pioneering operation.
The technique is called renal denervation (RDN) and doctors use radio waves to destroy overactive nerves around patients’ kidneys.
The drug-free procedure involves burning away the nerve tissue found around the kidney arteries.
Southampton experts said the drop in blood pressure can be so dramatic the patient could reduce the number of medications they are on – or stop them all together.
Around 30 per cent of people in England – about 16 million people – suffer from high blood pressure which is known as hypertension and is often termed “the silent killer” (see panel left). The condition causes the body to pump blood too forcefully through the arteries and heart.
Complications of untreated hypertension can cause organ damage, including heart attacks, stroke or kidney disease, and lead to premature death.
Dr James Wilkinson, consultant interventional cardiologist at Southampton General Hospital, said: “High blood pressure is an enormous problem worldwide. It’s probably going to be one of the leading causes of death in the next few years.
“There are a proportion of people who are resistant to drug treatment for whom it is a great problem because they are at risk of having strokes and heart attacks and ultimately possibly dying if the blood pressure cannot be controlled with tablets.
“This treatment really is a milestone in the field, as for the first time we are able to offer treatment to a group of people who have high blood pressure who previously couldn’t be treated with medication. They are therefore sitting time bombs in terms of being at risk of potentially having a stroke or heart attack. There was no option for them until recently.”
Dr Wilkinson and Dr Allan Odurny, a consultant interventional radiologist, performed the first of two procedures together at Southampton General Hospital yesterday with three more cases due over the next month.
Previously the only way to operate was with open surgery where medics cut people’s nerves but there were a number of side effects.
Now, after a device is guided into the arteries of the kidneys through the groin using X-ray images, doctors deliver high frequency radio waves to burn off overactive nerves, increasing blood flow to the organs and reducing levels of a hormone linked to high blood pressure.
Dr Wilkinson, said: “The device allows us to gain access to the kidneys and fire short bursts of radio waves to burn overactive nerves, meaning we can bring blood pressure down to normal levels in most patients.”
Latest research into RDN, which is currently being trialled at a number of UK centres as part of an international study led by the Baker IDI Heart and Diabetes Institute in Australia, shows it is safe and effective in lowering blood pressure up to one year after with no lasting harm to the kidneys or heart.
It is predicted there will be up to 400 procedures commissioned in the next year – with between 30 and 40 at Southampton but at this time it will only be for patients who have high blood pressure but do not respond to medication.
The doctors admit they cannot look at curing high blood pressure at this stage but they hope to control it.
However they cannot rule out that one day the state-of-the-art procedure could bring an end to the use of pills to normalise blood pressure.
Dr Odurny, said: “All the evidence so far suggests people using this treatment will get control of blood pressure, not to a curative level but certainly to a safe level where the chances of heart attacks and strokes are substantially reduced.
“The main aim is to get a control of the blood pressure rather than cure. It is a relatively new treatment and there are new developments all the time. Potentially there may be a possible cure in the future.”