Renal Denervation in Hypertensive Patients: Back to Anatomy?

A decade ago, when endovascular renal sympathetic denervation (RDN) using radiofrequency energy was first proposed as a treatment of resistant hypertension,1 the strategy of renal nerve ablation, by that time using the mono-electrode Simplicity catheter, was almost purely empirical, based on porcine model. It was advised to distribute a few ablation points along a spiral path to increase RDN efficacy, while avoiding both circumferential nerve destruction and side branch approach, considered as potentially dangerous. [...