Skip to main navigation menu Skip to main content Skip to site footer

Review article: Biomedical intelligence

Vol. 144 No. 1112 (2014)

Transcatheter renal denervation for the treatment of resistant arterial hypertension: the Swiss expert consensus

  • Gregoire Wuerzner
  • Olivier Muller
  • Paul Erne
  • Isabella Sudano
  • Stéphane Cook
  • Georg Noll
  • Urs Kaufmann
  • Hans Rickli
  • Bernard Waeber
  • Christophe Kaiser
  • Christian Sticherling
  • Antoinette Pechère-Bertschi
  • Iris Baumgartner
  • Augustinus Jacob
  • Thomas Lüscher
  • Michel Burnier
  • Salah Qanadli
Cite this as:
Swiss Med Wkly. 2014;144:w13913


Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practice. The eligibility of patients for trancatheter renal denervation needs (1.) confirmation of truly resistant hypertension, (2.) exclusion of secondary forms of hypertension, (3.) a multidisciplinary decision confirming the eligibility, (4.) facilities that guarantee procedural safety and (5.) a long-term follow-up of the patients, if possible in cooperation with a hypertension specialist. These steps are essential until long-term data on safety and efficacy are available.


  1. Chappuis A, Bochud M, Glatz N, Vuistiner P, Paccaud F, Burnier M. Swiss survey on salt intake: main results. 2011. Available from:
  2. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007;28(12):1462–536.
  3. Gu YM, Asayama K, Liu YP, Staessen JA. Renal denervation: time to open Pandora’s box. Swiss Med Wkly. 2012;142:w13638.
  4. Daugherty SL, Powers JD, Magid DJ, Tavel HM, Masoudi FA, Margolis KL, et al. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation. 2012;125(13):1635–42.
  5. Symplicity HTNI, Esler MD, Krum H, Sobotka PA, Schlaich MP, Schmieder RE, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet. 2010;376(9756):1903–9.
  6. Mahfoud F, Luscher TF, Andersson B, Baumgartner I, Cifkova R, Dimario C, et al. Expert consensus document from the European Society of Cardiology on catheter-based renal denervation. Eur Heart J. 2013 Apr 25.
  7. Schmieder RE, Redon J, Grassi G, Kjeldsen SE, Mancia G, Narkiewicz K, et al. ESH Position Paper: Renal denervation – an interventional therapy of resistant hypertension. J Hypertens. 2012;30(5):837–41.
  8. Schlaich MP, Schmieder RE, Bakris G, Blankestijn PJ, Bohm M, Campese VM, et al. International Expert Consensus Statement: Percutaneous Transluminal Renal Denervation for the Treatment of Resistant Hypertension. J Am Coll Cardiol. 2013 Dec 3;62(22):2031-45. Epub 2013 Sep 6.
  9. Krum H, Sobotka P, Mahfoud F, Bohm M, Esler M, Schlaich M. Device-based antihypertensive therapy: therapeutic modulation of the autonomic nervous system. Circulation. 2011;123(2):209–15.
  10. DiBona GF, Kopp UC. Neural control of renal function. Physiol Rev. 1997;77(1):75–197.
  11. Templin C, Jaguszewski M, Ghadri JR, Sudano I, Gaehwiler R, Hellermann JP, et al. Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography: pre- and post-procedural comparison with the Simplicity(R) catheter system and the EnligHTN multi-electrode renal denervation catheter. Eur Heart J. 2013;34(28):2141–8. Epub 2013 Apr 25.
  12. Krum H, Schlaich M, Whitbourn R, Sobotka PA, Sadowski J, Bartus K, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet. 2009;373(9671):1275–81.
  13. Gosain P, Garimella PS, Hart PD, Agarwal R. Renal sympathetic denervation for treatment of resistant hypertension: a systematic review. J Clin Hypertens. 2013;15(1):75–84.
  14. Doumas M, Anyfanti P, Bakris G. Should ambulatory blood pressure monitoring be mandatory for future studies in resistant hypertension: a perspective. J Hypertens. 2012;30(5):874–6.
  15. Mahfoud F, Ukena C, Schmieder RE, Cremers B, Rump LC, Vonend O, et al. Ambulatory blood pressure changes after renal sympathetic denervation in patients with resistant hypertension. Circulation. 2013;128(2):132–40.
  16. Persu A, Jin Y, Azizi M, Baelen M, Volz S, Elvan A, et al. Blood pressure changes after renal denervation at 10 European expert centers. J Hum Hypertens. 2013.
  17. Esler MD, Krum H, Schlaich M, Schmieder RE, Bohm M, Sobotka PA, et al. Renal sympathetic denervation for treatment of drug-resistant hypertension: one-year results from the Symplicity HTN-2 randomized, controlled trial. Circulation. 2012;126(25):2976–82.
  18. Symplicity HTNI. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension. 2011;57(5):911–7.
  19. Papademetriou V, Worthley S, Tsioufis C, Worthley M, Chew D, Sinhal A, et al. Catheter-Based Renal Denervation for the Treatment of Patients with Drug-Resistant Hypertension: EnligHTN I: Three-Month Data of a First in Man Study Using a Multi-Electrode Radiofrequency Ablation Catheter. Circulation. 2012;A19523(126).
  20. Kandzari DE, Bhatt DL, Sobotka PA, O’Neill WW, Esler M, Flack JM, et al. Catheter-based renal denervation for resistant hypertension: rationale and design of the SYMPLICITY HTN-3 Trial. Clinical cardiology. 2012;35(9):528–35.
  21. Mahfoud F, Schlaich M, Kindermann I, Ukena C, Cremers B, Brandt MC, et al. Effect of renal sympathetic denervation on glucose metabolism in patients with resistant hypertension: a pilot study. Circulation. 2011;123(18):1940–6.
  22. Brandt MC, Mahfoud F, Reda S, Schirmer SH, Erdmann E, Bohm M, et al. Renal sympathetic denervation reduces left ventricular hypertrophy and improves cardiac function in patients with resistant hypertension. J Am Coll Cardiol. 2012;59(10):901–9.
  23. Brandt MC, Reda S, Mahfoud F, Lenski M, Bohm M, Hoppe UC. Effects of renal sympathetic denervation on arterial stiffness and central hemodynamics in patients with resistant hypertension. J Am Coll Cardiol. 2012;60(19):1956–65.
  24. Vonend O, Antoch G, Rump LC, Blondin D. Secondary rise in blood pressure after renal denervation. Lancet. 2012;380(9843):778.
  25. Kaltenbach B, Id D, Franke JC, Sievert H, Hennersdorf M, Maier J, et al. Renal Artery Stenosis After Renal Sympathetic Denervation. J Am Coll Cardiol. 2012;60(25):2694–5.
  26. Mahfoud F, Cremers B, Janker J, Link B, Vonend O, Ukena C, et al. Renal hemodynamics and renal function after catheter-based renal sympathetic denervation in patients with resistant hypertension. Hypertension. 2012;60(2):419–24.
  27. Dieterle T. Blood pressure measurement – an overview. Swiss Med Wkly. 2012;142:w13517.
  28. de la Sierra A, Segura J, Banegas JR, Gorostidi M, de la Cruz JJ, Armario P, et al. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension. 2011;57(5):898–902.
  29. Burnier M, Wuerzner G, Struijker-Boudier H, Urquhart J. Measuring, analyzing, and managing drug adherence in resistant hypertension. Hypertension. 2013;62(2):218–25.
  30. Burnier M, Schneider MP, Chiolero A, Stubi CL, Brunner HR. Electronic compliance monitoring in resistant hypertension: the basis for rational therapeutic decisions. J Hypertens. 2001;19(2):335–41.
  31. Yakovlevitch M, Black HR. Resistant hypertension in a tertiary care clinic. Arch Intern Med. 1991;151(9):1786–92.
  32. Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation. 2008;117(25):e510–26.
  33. Verloop WL, Vink EE, Voskuil M, Vonken EJ, Rookmaaker MB, Bots ML, et al. Eligibility for percutaneous renal denervation: the importance of a systematic screening. J Hypertens. 2013 Jun 5.
  34. Savard S, Frank M, Bobrie G, Plouin PF, Sapoval M, Azizi M. Eligibility for renal denervation in patients with resistant hypertension: when enthusiasm meets reality in real-life patients. J Am Coll Cardiol. 2012;60(23):2422–4.

Most read articles by the same author(s)

1 2 3 4 5 6 7 > >>