Percutaneous Computer Tomography-Guided Ethanol Sympathicolysis for the Treatment of Resistant Arterial Hypertension

Purpose As an alternative to catheter-based radiofrequency (RF) ablation, renal sympathicolysis can also be achieved by image-guided percutaneous injection of ethanol around the renal artery. Materials and Methods We report the case of a 50-year-old man with refractory hypertension and end-stage renal failure of unclear etiology who was treated with computed tomography-guided percutaneous periarterial ethanol sympathicolysis. Results The procedure was painless. The patient’s BP decreased within 6 days from a baseline value of 172/84 mm Hg (1 week before treatment) to a sustained decreased value of 143/70 mm Hg 1 month after intervention, i.e. , a decrease by 29/14 mm Hg. The patient’s hypertension-related headache resolved. Conclusion Image-guided periarterial ethanol injection for renal sympathetic denervation in a patient with drug-resistant hypertension is feasible. We provide a detailed description of this new interventional procedure and discuss its potential advantages compared with catheter-based RF ablation.