Percutaneous transluminal renal sympathetic denervation for resistant hypertension

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 10 sources, which was discussed by the committee. The evidence included 1 Cochrane review, 1 meta-analysis, 3 randomised controlled trials, 1 three‑arm randomised trial and 4 case series (registries). It is presented in the summary of key evidence section in the overview. The committee also considered additional confidential documentation provided by a company.

The professional experts and the committee considered the key efficacy outcomes to be: reduction in blood pressure, reduction in use of antihypertensive medication and reduction in end-organ damage.

The professional experts and the committee considered the key safety outcomes to be: pain and renal artery damage.

Patient commentary was sought but none was received.

The committee noted that the technology has evolved and there are different methods for doing this procedure. Different devices may have different efficacy and safety profiles.

The committee noted that most of the evidence that the committee reviewed for this procedure is for resistant hypertension.

The committee was informed that the concept of 'resistant hypertension' is evolving and that this procedure may have a role in the treatment of 'uncontrolled hypertension'.