Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

16 May 2018 : Case report  Japan

Reduction of Blood Pressure Following After Renal Artery Adventitia Stripping During Total Nephroureterectomy: Potential Effect of Renal Sympathetic Denervation

Unusual or unexpected effect of treatment

Keisuke Okamura1DEF*, Shunsuke Satou12DEF, Keita Setojima2DE, Shinjiro Shono3DE, Shigero Miyajima4DE, Tatsu Ishii4DE, Kazuyuki Shirai1DE, Hidenori Urata1DE

DOI: 10.12659/AJCR.908891

Am J Case Rep 2018; 19:567-572

Abstract

BACKGROUND: Catheter-based renal sympathetic denervation has been reported to be effective for treatment resistance hypertension in Australia and Europe. However, in the blinded SYMPLICITY HTN-3 trial, renal denervation did not achieve a significant decrease in blood pressure (BP) in comparison to sham controls. There have been various discussions on the factors that influenced this result.

CASE REPORT: Two men on antihypertensive therapy underwent unilateral radical nephroureterectomy for cancer of the renal pelvis. When the renal artery adventitia was stripped and cauterized just before renal artery ligation, the measured BP of the 2 men increased after stripping adventitia and decreased gradually after cauterization of the renal artery. This was presumably due to removal of renal artery sympathetic nerves, similar to the mechanism of catheter-based renal sympathetic denervation, although anesthesia, fluid infusion, and/or mesenteric traction may have had an influence.

CONCLUSIONS: A similar strategy involving thoracolumbar sympathectomy was reported about 50 years ago. The clinically significant blood pressure reduction in these patients suggests renal denervation is effective.

Keywords: Hypertension, Nephrectomy, Sympathectomy

Add Comment 0 Comments

620 2

In Press

25 May 2023 : Case report  Latvia

Neuroendocrine Carcinoma of the Extrahepatic Bile Ducts: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.939239  

24 May 2023 : Case report  South Africa

An Initially Missed Diagnosis of Venous Thromboembolic Phenomenon in Adult-Onset Still’s Disease: A Case Re...

Am J Case Rep In Press; DOI: 10.12659/AJCR.939520  

24 May 2023 : Case report  Italy

Successful Surgical Removal of a Giant Serous Ovarian Cyst in a 52-Year-Old Woman with Presurgical Body Mas...

Am J Case Rep In Press; DOI: 10.12659/AJCR.939697  

23 May 2023 : Case report  Japan

Successful Noninvasive Respiratory Management of an Infant with Bilateral Choanal Atresia and a Supernumera...

Am J Case Rep In Press; DOI: 10.12659/AJCR.939642  

Most Viewed Current Articles

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

07 Dec 2021 : Case report  USA

Edwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...

DOI :10.12659/AJCR.934347

Am J Case Rep 2021; 22:e934347

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923