1659 – Catheter-based renal denervation for uncontrolled elevated systolic blood pressure

New MBS item.

Catheter-based renal denervation (RDN) is intended as a one-time treatment adjunct to existing standard of care medication therapy, in patients with confirmed uncontrolled elevated systolic blood pressure ≥150 mmHg, despite optimised treatment with three or more antihypertensive drugs, or intolerant to antihypertensive medication, and who are at high risk of cardiovascular disease based on one or more specified risk factor. RDN utilises an endovascular approach and ablative technology (e.g. radio frequency, ultrasound, local alcohol microinjection) to selectively disrupt the renal sympathetic nervous system in a localised and minimally invasive manner at the level of the kidney.

The RDN procedure is performed in the catheterisation laboratory, using standard endovascular intervention techniques similar to those used in renal angioplasty or stenting. The ablation catheter is localised via the femoral artery to the renal arteries. The efferent and afferent nerves adjacent to the artery are ablated through the arterial wall. During the procedure, both renal arteries are treated. The RDN procedure is considered to reduce blood pressure via reduction in total peripheral resistance, reduced renin release, and favourable alterations of water and salt handling.

Type: Therapeutic

Hypertension is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. In most people, hypertension typically does not cause symptoms. However, left uncontrolled, HTN is a major risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia.

For many patients, hypertension can be well managed with life-styles changes, and if these alone are not effective, the use of one or more anti-hypertensive medications. However, there is a subset of patients who have effectively exhausted therapy options, who remain with uncontrolled elevated systolic blood pressure ≥150 mmHg, despite optimised treatment with three or more antihypertensive drugs, or who are intolerant to antihypertensive medication.

• PASC consultation: Closed
• MSAC consultation: Closed Friday 6 October 2023

• PASC meeting: 15 to 16 April 2021
• ESC meeting: 5 to 6 October 2023
• MSAC meeting: 23 to 24 November 2023