Key result
Renal denervation lowers ambulatory systolic blood pressure by ~19 mmHg in resistant hypertension.
Why the study?
The effects of the SPYRAL™ catheter system on blood pressure and the association of ablation points with BP reduction in a real-world setting were not well characterized.
Does catheter-based renal denervation reduce ambulatory blood pressure in adults with resistant hypertension?
Cohort (n=11)
No
Does catheter-based renal denervation reduce ambulatory blood pressure in adults with resistant hypertension?
Mean Difference: -19.4 (95% CI -29.7–-9.2)
p-value: p=0.002
SPYRAL renal denervation safely reduces ambulatory blood pressure in patients with resistant hypertension, with greater reductions potentially associated with more ablation points.
Background Catheter-based renal denervation (RDN) is an interventional therapy for patients with resistant or uncontrolled arterial hypertension after the exclusion of secondary causes. This study aimed to evaluate the effects of the SPYRAL™ catheter system on systolic (SBP) and diastolic blood pressure (DBP) in a real-world clinical setting. Additionally, we explored whether the number of ablation points was associated with the magnitude of blood pressure (BP) reduction. Methods We conducted a retrospective, single-center study including patients aged ≥18 years with predominantly resistant hypertension with preserved renal function (eGFR ≥40 mL/min/1.73 m2) and no evidence of secondary hypertension. Ambulatory blood pressure monitoring (ABPM) and renal function were assessed at baseline and three months after RDN. Patients were stratified into subgroups based on the number of ablation points (≤20 vs. >20). A two-tailed p -value <0.05 was considered statistically significant. Results Data from eleven patients (mean age 64.4 ± 8.1, 45.5% were male) were analyzed. At three months, eGFR remained stable (mean decrease −4.6 mL/min/1.73 m 2 , CI 95% −15.8–6.6, p = 0.37). Mean ambulatory SBP and DBP decreased significantly following RDN ( Δ −19.4mmHg, CI 95% −9.2 to −29.7, p = 0.002; Δ −8.6 mmHg, CI 95% −3.9 to −13.3, p = 0.002; for SBP and DBP respectively). Subgroup analysis revealed that patients with more ablation points experienced a greater reduction in SBP ( Δ −17.7 mmHg, CI 95% 0.1–35.3, p = 0.04) and a numerically greater reduction in DBP ( Δ −4.8 mmHg, CI 95% 4.5–12, p = 0.27) than those with fewer abation points. Conclusion In this small retrospective cohort, reductions in SBP and DBP were observed following RDN using the SPYRAL™ multi-electrode system, with no excess of adverse renal events. These preliminary findings require confirmation in larger, adequately powered patient cohorts before firm conclusions can be established.
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Stanisavljevikj et al. (2026) conducted a cohort in Resistant or uncontrolled arterial hypertension (n=11). Catheter-based renal denervation (RDN) was evaluated on Mean ambulatory systolic blood pressure at 3 months (MD -19.4 mmHg, 95% CI -9.2 to -29.7, p=0.002). Catheter-based renal denervation using the SPYRAL™ system significantly reduced mean ambulatory systolic blood pressure by 19.4 mmHg at three months in patients with resistant hypertension.
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