Renal Denervation: A New Therapy for Resistant Hypertension

Abstract

The Food and Drug Administration (FDA) recently approved renal denervation to treat resistant hypertension. This procedure is a minimally invasive procedure that starts by placing a catheter in the renal artery. This catheter is used to send either radiofrequency heat or ultrasound waves to burn the superficial nerves surrounding the renal arteries while making certain no damage happens to the renal arteries themselves. This procedure is done after a renal angiogram to ensure patency of the renal artery. Each radiofrequency ablation will take 1-2 minutes, depending on the device used. The radiofrequency balloon generator requires one single application of the radiofrequency pulse. The radiofrequency generator that uses a catheter tube will need more than one pulse. The second approved option uses ultrasound to generate an electrical signal that is converted into ultrasound vibration, that occurs at the distal end of the catheter. This vibration heats the system around the nerves, disrupting the superficial nerves that communicate with the central nervous system. This will result in lowering the blood pressure. We will review the studies that led to FDA approval, and the current guidelines for use. The FDA now approves both devices.