Scripps Cardiologist First in Region to Perform New High Blood Pressure Procedure
Renal denervation approved for patients who don’t respond to hypertension medications
Scripps Clinic interventional cardiologist Curtiss Stinis, MD (center) performs the first renal denervation procedure in Southern California following regulatory approval of the new treatment for high blood pressure.
Renal denervation approved for patients who don’t respond to hypertension medications
What if a minimally invasive outpatient procedure could greatly reduce the need to take powerful blood pressure medications that sometimes don’t work well, or at all, and often cause bothersome side effects, like feeling tired, drowsy or dizzy?
For one Scripps Health patient, that outcome became reality recently when she underwent a newly approved procedure that uses tiny bursts of heat, known as radiofrequency ablation, to reduce the activity of nerves in the wall of kidney arteries that can worsen uncontrolled hypertension.
"Having more treatment tools to control hypertension is critical."
Curtiss Stinis, MDWhen Scripps Clinic interventional cardiologist Curtiss Stinis, MD, performed the renal denervation procedure on the patient, he became the first in Southern California to use Medtronic’s Symplicity Spyral system in a commercial procedure following the innovative technology’s approval last November by the Food and Drug Administration.
“High blood pressure is a common health problem, affecting nearly half of all adults — 120 million people — in the United States,” Stinis said. “Having more treatment tools to control hypertension is critical since blood pressure remains too high in more than three-quarters of these patients.”
Hypertension occurs when the force of blood flowing through vessels is regularly too high, measured at or above 140/90 mmHg. The condition, which becomes more common with age, is known as a “silent killer” because it typically displays no symptoms and over time can cause heart attacks, stroke, heart failure and other problems if not properly treated.
Hypertension is the primary cause of more than 670,000 deaths in the United States each year, and it costs the nation’s health system $131 billion annually, according to published research.
During the recent procedure at Scripps Clinic Anderson Medical Pavilion on the Scripps Memorial Hospital La Jolla campus, Dr. Stinis threaded a catheter through a blood vessel in the patient’s upper leg and then to renal arteries in the kidneys where radiofrequency bursts produced enough heat to disable the targeted nerves without damaging the walls of the vessels.
The procedure took about 45 minutes, and the patient went home later that day.
Dr. Stinis noted that renal denervation doesn’t eliminate the need for drug therapy in all patients, but most of them are able to take much less medication following the procedure.
Treatment limitations
While there is much interest in renal denervation, the technology is currently approved only for patients who inadequately respond to, or are intolerant to, blood pressure medications and their blood pressure remains uncontrolled despite following recommended lifestyle changes.
Another limitation is a lack of full insurance coverage for the procedure, which isn’t unusual for new medical technology.
Additionally, Scripps Health physicians are participating in an ongoing, follow-up clinical trial of the Symplicity Spyral system that is being conducted in a larger population of patients and over a longer period of time than previous studies. Positive results from that trial could expand regulatory approval to a much wider range of patients who might benefit from the technology.
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