Renal Denervation at the Georges-Pompidou European Hospital in Paris: The Transition From Research to Standard Care in Hypertensive Patients

Objective: Renal Denervation (RDN) is a minimally invasive intervention for resistant primary hypertension or medication-intolerant patients, transitioning from research to standard care. This prompts our forward-thinking initiative to facilitate this shift. Design and method: The approach undertaken in this project is comprehensive and multidimensional, encompassing the definition, assessment, and analysis of various pivotal dimensions in hypertensive patients’ management, focusing on patient’s pathway, legal considerations, RDN techniques and expertise, internal visibility, and cost analysis. Results: The patient pathway involves eligibility criteria-based selection, with an interventional radiologist assessing renal artery anatomy. A multidisciplinary meeting validates the procedure’s indication, and with patient consent, the 3-days hospitalization for the procedure is followed by a rigorous 5-years follow-up. Legally, healthcare professionals consider good clinical practice and liability, implementing proactive measures for compliance and safety. Patient-related legal considerations focus on obtaining informed consent and protecting personal data. In human resources (HR), a strategy adapts to Generations Y and Z, addressing upcoming changes. Training initiatives encourage professional involvement and reveal potentials. HR management during shortages focuses on optimizing existing staff for quality care. Stakeholders express satisfaction with the training, demonstrating its effectiveness in strengthening skills and confidence in managing RDN patients. In the marketing aspect, an observational study targeted potentially eligible RDN patients in our Hypertension Unit. Efforts aim to emphasize the uniqueness of the RDN implementation approach to strengthen internal recognition. Due to the lack of social security coverage, limited availability of RDN probes, and logistical constraints, external recruitment remains restricted. Financially, annual hypertensive patient treatment costs are 422 EUR, with uncomplicated follow-up at 135 EUR per patient. Managing cardio-neurovascular complications costs at least 12,647 EUR per patient in the first year. While the financial benefit of RDN for complicated hypertension is evident, the comparison with uncomplicated cases is subtle and considers the reduction in cardiovascular events and improvement in quality of life. Our registry supports RDN probe reimbursement requests. Conclusions: This managerial approach reinforces the belief in the effectiveness of a strategic and systematic method to successfully implement RDN into standard care highlighting the inherent complementarity between management and medicine.