Advantages and limitations of antihypertensive procedures
| Type of procedural therapy | Advantages | Limitations |
|---|---|---|
| Arteriovenous coupling | Improves measures of arterial stiffness Reduces overall systemic vascular resistance Increases cardiac output and arterial blood oxygen content | Development of venous iliac stenosis proximal to the anastomosis Potential risk of restenosis, and need for antithrombotic therapies Compression stockings need to be used after device insertion Potential for high-output cardiac failure |
| Renal denervation therapy | Potential reduction of increased sympathetic activity Percutaneous ambulatory procedure | Lacks a procedural end point Variable effects on blood pressure due to variability in degree of denervation achieved |
| Baroreflex activation therapy | Attenuates overall sympathetic activation Potential for neurohormonal modulation | Need for subcutaneous internal pulse generator with some systems Heterogeneity in the response to carotid sinus stimulation Requirement of surgical neck dissection Potential of nerve injury with residual deficit |
| Renal artery stenting | Potential to avoid surgery to treat stenosis Rapid improvement of global renal ischemia with bilateral lesions Potential to lessen sudden cardiac disturbance syndromes | Discordance between procedural success and clinical improvement Risk of contrast-induced nephropathy Need for surveillance for stent restenosis Complications related to femoral access |