700 - Right Patient, Right Kidney: Optimizing Selection and Technique in Renal Denervation

Monday, April 13, 2026

4:45 PM - 4:51 PM ET

Abstract Presenter(s)

SS

Suprit Singh, MD

Interventional Radiology Resident
Temple University Hospital, United States

Author/Co-author(s)

RK

Rebecca Kalik, BS

Medical Student (MSIII)
Lewis Katz School of Medicine, Temple University, United States
IL

Ian Leopold, MD

Assistant Professor of Clinical Radiology
Temple University Hospital, United States
JC

Jeffrey Cruz, MD

Clinical Associate Professor, Vascular and Interventional Radiology
Temple University Hospital, United States
SM

Shekher Maddineni, MD,FSIR

Associate Professor of Radiology and Surgery
New York Medical College, United States
PG

Perry Gerard, MD, FACR, MBA

Professor of Clinical Radiology
Westchester Medical Center, United States
JM

Jared Meshekow, MD, MPH

Clinical Associate Professor, Vascular and Interventional Radiology
Temple University Hospital, United States

Learning Objectives: • Describe the current evidence supporting renal denervation (RDN) for medically refractory hypertension.

• Identify appropriate patients to maximize clinical benefit.

• Review technical considerations and best practices to improve the consistency, efficacy, and safety of RDN.

Background: Renal denervation (RDN) has become a potential option for patients with uncontrolled, medically refractory, hypertension. Recent studies involving RDN have demonstrated clinically meaningful blood pressure reductions. Standardizing procedures and selecting the right patient are key to reproducible results. Understanding the nuances of candidate identification, device selection, and technique optimization is key as IR gets more involved in RDN.

Clinical Findings/Procedure Details: Patient Selection:

Ideal Candidates: Adults with medically resistant hypertension (SBP > 140 mmHg) on ≥3 antihypertensive agents, including a diuretic.

Exclusion Criteria: Secondary causes of hypertension, Stage IV and V chronic kidney disease, or unsuitable renal artery anatomy.

Pre-Procedure Workup: Monitoring 24-hour BP, duplex ultrasound of the renal artery, CTA or MRA, in addition to medication adherence.

Technique Optimization:

Imaging: High-quality angiography to confirm RDN-specific renal arterial anatomy.

Energy Delivery: Ablation of the main renal arteries and branches with multi-electrode radiofrequency (RF) catheters or ultrasound based ablative systems.

Peri-Procedural Management: Sedation and post-procedure monitoring.

Patient Follow-up: BP measurement and renal function monitoring at 1, 3, and 6 months following the procedure.

Conclusion and/or Teaching Points: In the appropriate patient population, renal denervation is a promising adjunct therapy for medically refractory hypertension. Careful patient screening, multidisciplinary evaluation, and precise technique are essential to maximize clinical benefits. IR can play a pivotal role in the integration of RDN into comprehensive hypertension management pathways.

Teaching Points:

Select carefully: RDN is most effective in medically resistant hypertension with preserved renal function and suitable anatomy.

Standardized techniques technique: Consistent circumferential ablation and treatment of accessory branches improve efficacy.

Collaborate: Multidisciplinary care ensures appropriate referral and follow-up.

Outcome Measures: Systematic BP and renal function monitoring for clinical impact.