Published: September 23, 2025
A 52-year-old male with a long-standing history of poorly controlled high blood pressure despite adherence to a four-drug antihypertensive regimen (including a calcium channel blocker, ACE inhibitor, thiazide diuretic and beta-blocker).
The patient reported persistent systolic blood pressures in the range of 170–190 mmHg, confirmed by ambulatory monitoring. He had no evidence of secondary hypertension but had signs of early end-organ damage, including left ventricular hypertrophy and mild chronic kidney disease (eGFR 58 mL/min/1.73m²). He was highly motivated to reduce medication burden and improve blood pressure control due to increasing fatigue and concerns about stroke risk.
Despite maximal medical therapy, the patient’s blood pressure remained dangerously elevated. Imaging and diagnostic testing ruled out secondary causes, including renal artery stenosis, adrenal pathology and obstructive sleep apnea.
Renal artery duplex ultrasound and CT angiography showed anatomically suitable renal arteries for catheter-based intervention, with no stenoses or accessory arteries.
The patient underwent catheter-based renal denervation using a multi-electrode radiofrequency ablation system. The procedure was performed via femoral artery access under conscious sedation. Multiple ablations were delivered circumferentially to both renal arteries, targeting the sympathetic nerves in the adventitia.
The intervention was performed without complication. Total procedure time was under 60 minutes. The patient was observed and discharged the same day.
At one-month follow-up, the patient had a sustained reduction in systolic pressure with average home blood pressure reading of 152/86 mmHg, with no adverse effects or vascular complications.
Six months after the procedure, his average systolic blood pressure was 142 mmHg on two medications, with improved energy levels and no further signs of progression of organ damage. He reported improved quality of life, was able to resume hiking regularly and returned to part-time work after previously cutting back due to hypertensive symptoms.