Renal Denervation: A New Option for Refractory High Blood Pressure

James Devries, MD, Michael Young, MD, Henry Tannous, MD, and Nathan Crain, PA-C, in the Cardiac Catheterization Laboratory at DHMC
James Devries, MD, Michael Young, MD, Henry Tannous, MD, and Nathan Crain, PA-C, in the Cardiac Catheterization Laboratory at DHMC.

In January 2025, Dartmouth Health's Heart and Vascular Center at Dartmouth Hitchcock Medical Center began offering renal denervation, a new, minimally invasive procedure for treating high blood pressure that has not responded to medication or lifestyle changes.

"We know that untreated high blood pressure comes with a significant risk of stroke, heart disease, and kidney disease—but for some people, medications cause side effects, or the combination of medication and lifestyle changes isn't enough to provide adequate control," said interventional cardiologist James DeVries, MD.

During the procedure, an interventional cardiologist inserts a catheter into a blood vessel in the leg and uses radiofrequency or ultrasound energy to destroy overactive nerves surrounding the renal arteries. This prevents the transmission of nerve signals to the brain that raise blood pressure.

"Before renal denervation, there weren't a lot of options for people with difficult-to-control high blood pressure," said Dr. DeVries. "We take a team approach with our interventional cardiology, nephrology and vascular surgery experts to select the patients who will benefit most from renal denervation."

According to Dr. DeVries, research shows that even a minimal drop in blood pressure has a dramatic effect on cardiac risk. So far, the team has seen a high treatment response rate, with most patients successfully reducing their medications.

However, because renal denervation is a new procedure that only recently received FDA approval, it isn't always covered by insurance. To connect more patients with this potentially life-saving treatment option, Dartmouth Health has been selected to participate in the SPYRAL AFFIRM clinical trial—providing an additional treatment pathway for patients who could benefit from renal denervation, but don't have insurance coverage for the procedure.

"Having both the commercial and clinical trial treatment avenues is unique to our center, and we're proud to be able to offer the full range of treatment options to our patients," said Dr. DeVries.