Симпатическая денервация почечный артерий: патофизиологические особенности совершенствования методики

Чепурной А.Г., Шугушев З.Х., Максимкин Д.А.

Представлен анализ современных исследований, посвященных денервации почечных артерий у больных артериальной гипертензией. Освещаются патофизиологические особенности повышения эффективности процедуры, согласно которым целесообразно выполнять пролонгированные абляции в стволе почечной артерии, ветвях второго и третьего порядка и в добавочных ветвях диаметром более 3 мм. Кроме того, показано, что увеличение числа точек абляции повышает вероятность попадания радиочастотного воздействия на участок афферентных и эфферентных нервных волокон. Представлены современные технологические разработки, которые позволяют провести интраоперационное картирование расположения нервных волокон в адвентиции почечных артерий. Благодаря этому появляется возможность проведения селективной денервации почечных артерий, тем самым, за счет снижения количества неэффективных точек абляции, можно увеличить восприимчивость к оперативному лечению артериальной гипертензии и повысить частоту эффективных вмешательств.

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