Renal Sympathetic Denervation

Renal sympathetic denervation is a minimally invasive, endovascular catheter based procedure using radiofrequency ablation or ultrasound ablation aimed at treating resistant hypertension, meaning high blood pressure not controlled by medication. Nerves in the wall of the renal artery are ablated by applying radiofrequency pulses or ultrasound to the renal arteries, reducing sympathetic nerve activity to the kidney and allowing blood pressure to decrease. Early data from international clinical trials without sham controls was promising, demonstrating large blood pressure reductions in patients with treatment resistant hypertension, but a 2014 prospective, single blind, randomized, sham controlled clinical trial failed to confirm a beneficial effect on blood pressure, and a 2014 consensus statement from the Joint UK Societies did not recommend the procedure on the evidence then available; more recent sham controlled trials suggest renal denervation can lead to lower systolic blood pressure.