Advantages and limitations of antihypertensive procedures

Type of procedural therapyAdvantagesLimitations
Arteriovenous couplingImproves 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 therapyPotential 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 therapyAttenuates 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 stentingPotential 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