Renal Artery Sympathetic Denervation (RDN) can lower blood pressure. Different ablation catheters (single electrode, multi-electrode) have different scopes of ablation (renal artery main stem and branches). Few studies have compared the advantages and disadvantages of different ablation catheters and different procedures in terms of antihypertensive efficacy. To compare the efficacy and safety of 3D reconstruction radiofrequency ablation (3DRA) and basket multi-electrode radiofrequency ablation (BMRA) in Renal Artery Sympathetic Denervation. Fifty-three patients with Refractory hypertension (RHT) were divided into BMRA, (n = 28) and 3DRA(n = 25). BMRA group used a stereobasket multi-electrode ablation catheter with a controlled ablation temperature of 60°C and an ablation time of 120 s per site. 3DRA group used a NavStar pressure-monitored perfusion monopolar ablation catheter with a controlled ablation temperature of 40°C, an ablation time of 40 s per site, and an ablation energy of 12 W. Baseline and RDN parameters and complications were compared in both groups. Home and 24 h ambulatory blood pressure, type of anti-hypertensive medication taken, and serum creatinine were followed up at 1, 3, 6, 12, and 24 months after the RDN. There were no differences in baseline characteristics between the two groups. (23.14 ± 2.00)months of follow-up in the BMRA group resulted in a total of (25.86 ± 8.61) loci ablation. (19.28 ± 7.40)months of follow-up in the 3DRA group resulted in a total of (21.04 ± 6.47)loci ablation. Home SBP was significantly lower in both groups at 1 month after RDN treatment compared to baseline(H-SBP/mmHg: BMRA 149.9 ± 10.59 vs. baseline 168.36 ± 12.76; 3DRA 152.6 ± 14.91 vs. 164.89 ± 12.96, both p < .05). The proportion of people with 24 h ambulatory SBP attainment was significantly higher in both groups and was maintained for 24 months. At each follow-up time point, there were no differences in home and 24-h flow SBP, DBP, or Scr between the two groups. There were two cases of severe renal artery complications from implanted vascular stents and one case of femoral artery pseudoaneurysm in the 3DRA group. At follow-up, 1 (1.9%) patient in the 3DRA group died of unexplained death and 1 (1.9%) patient developed heart failure, and 1 (1.9%) patient in the BMRA group died of unexplained death. Basket multi-electrode radiofrequency ablation and 3D reconstruction radiofrequency ablation of the renal artery applied to RDN have comparable efficacy in reducing systolic blood pressure.

中文翻译：

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3D重建和篮式多电极肾去神经术（RDN）治疗难治性高血压合并慢性肾脏病的疗效和安全性

肾动脉交感神经去神经术（RDN）可以降低血压。不同的消融导管（单电极、多电极）的消融范围（肾动脉主干和分支）不同。很少有研究比较不同消融导管和不同手术方式在降压疗效方面的优缺点。比较 3D 重建射频消融 (3DRA) 和篮式多电极射频消融 (BMRA) 在肾动脉交感神经去神经术中的疗效和安全性。 53 例难治性高血压（RHT）患者分为 BMRA（n  = 28）和 3DRA（n  = 25）。 BMRA 组使用 Stereobasket 多电极消融导管，控制消融温度为 60°C，每个部位的消融时间为 120 s。 3DRA组使用NavStar压力监测灌注单极消融导管，控制消融温度为40℃，每个部位消融时间为40 s，消融能量为12 W。比较两组基线和RDN参数及并发症。 RDN 后 1、3、6、12 和 24 个月对家庭血压和 24 小时动态血压、服用的抗高血压药物类型以及血清肌酐进行随访。两组之间的基线特征没有差异。 BMRA组的(23.14±2.00)个月随访导致总共(25.86±8.61)个位点消融。 3DRA组的(19.28±7.40)个月随访导致总共(21.04±6.47)个位点消融。 RDN 治疗后 1 个月时，两组家庭 SBP 均显着低于基线（H-SBP/mmHg：BMRA 149.9 ± 10.59 对比基线 168.36 ± 12.76；3DRA 152.6 ± 14.91 对比 164.89 ± 12.96，均p  < .05 ）。两组中 24 小时动态 SBP 达到的人数比例均显着较高，并维持了 24 个月。在每个随访时间点，两组之间的家庭和 24 小时血流 SBP、DBP 或 Scr 没有差异。 3DRA组中有2例因植入血管支架而出现严重肾动脉并发症，1例出现股动脉假性动脉瘤。随访时，3DRA 组中有 1 名患者（1.9%）死于不明原因死亡，1 名患者（1.9%）出现心力衰竭，BMRA 组中有 1 名患者（1.9%）死于不明原因死亡。篮式多电极射频消融术和肾动脉3D重建射频消融术应用于RDN在降低收缩压方面具有相当的疗效。