How are you taking part in this consultation?

You will not be able to change how you comment later.

You must be signed in to answer questions

    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Percutaneous transluminal renal sympathetic denervation for resistant hypertension

    Closed for comments This consultation ended on at   Request commenting lead permission

    2 The condition, current treatments and procedure

    The condition

    2.1 Hypertension is a major risk factor for cardiovascular disease and chronic kidney disease. Hypertension can be primary or secondary. Primary hypertension does not have a single known cause, whereas secondary hypertension develops because of an underlying medical condition or disease. Hypertension is considered resistant if it is not controlled after treatment with at least 3 antihypertensive medications from different classes.

    Current treatments

    2.2 NICE's guideline on hypertension in adults describes diagnosing and managing hypertension, including resistant hypertension. Current treatments for hypertension include lifestyle modifications and antihypertensive medications. Blood pressure and treatment are regularly monitored and treatment is adjusted as needed. For resistant hypertension, additional medications and device-based antihypertensive therapies (for example renal denervation and carotid baroreceptor stimulation) can be considered.

    The procedure

    2.3 This procedure is usually done using local anaesthesia, with sedation and anticoagulation. A catheter is introduced through the femoral artery and advanced into each renal artery under fluoroscopic guidance. The catheter is connected to a generator which delivers radiofrequency or ultrasound energy (depending on the type of system used) from the distal to proximal end of each renal artery. This ablates the renal nerves leading to the kidney, with the aim of disrupting neurogenic reflexes involved in blood pressure control. There are different systems with different technologies in use for renal sympathetic denervation.