Abstract
BACKGROUND: This study aimed to explore the clinical application of renal denervation (RDN) in patients with refractory hypertension complicated by acute aortic syndrome. CASE SUMMARY: We present a case of a 54-year-old woman with refractory hypertension treated with quadruple antihypertensive therapy, including nifedipine, metoprolol, hydrochlorothiazide, and sacubitril-valsartan. Five months ago, she underwent emergent thoracic aortic endovascular stent-graft repair for acute aortic type B dissection. Successful bilateral RDN (Netrod system) was performed without complications. Postprocedure 24-hour average blood pressure decreased to 119/73 mm Hg at 3-month follow-up from 136/82 mm Hg preoperatively, with hydrochlorothiazide discontinued and the rest medications halved. DISCUSSION: This case suggests that RDN may offer an effective approach for blood pressure control in acute aortic syndrome. Careful preprocedure evaluation and multidisciplinary decision-making are crucial. TAKE-HOME MESSAGE: This case shows that RDN combined with definitive thoracic aortic endovascular stent-graft repair potentially becomes a new treatment modality for acute aortic syndrome.