An innovative procedure for treating elevated blood pressure is administered to the 50th patient at GUH

Donegal patient Francis Hegarty became the 50th patient to undergo the Renal Denervation (RDN) procedure at Galway University Hospitals; a minimally invasive procedure to help treat high blood pressure in patients who have not responded to medications and lifestyle changes.

Galway University Hospitals were the first hospital in the country to carry out the RDN procedure, and the first internationally to offer RDN as a day-case surgery. This means that patients arrive at the hospital in the morning, have their procedure, and then return home the same day.

Following a number of successful clinical trials at GUH, the RDN procedure went mainstream in 2021. And just recently, on 30 August, the European Society of Cardiology (ESC) updated its guidelines for the management of elevated blood pressure and hypertension incorporating recommendations for the first time on the use of renal denervation to treat various types of hypertension. These ESC guidelines state that RDN may be considered, after a shared decision with the patient about risks and benefits and only in hospitals like GUH that undertake medium to high volumes of this procedure, among patients with resistant hypertension (not responsive to 3 or more medications) or among patients with very high risk of cardiovascular disease who have uncontrolled hypertension.

“Approximately 35% of the adult population in Ireland have high blood pressure and around one third of these patients are taking medication but their blood pressure is still uncontrolled. If we are able to control blood pressure adequately overtime than we can reduce the risk of end-organ damage. Even a small reduction in blood pressure can lead to a significant reduction of the risk of stroke or heart attack,” explains Prof Faisal Sharif, Consultant Interventional Cardiologist at GUH and University of Galway.

“Renal denervation is indicated for very high-risk patients with uncontrolled blood pressure or resistant hypertension. First line of treatment is lifestyle changes and adherence to blood pressure medications. If these measures are insufficient to control the blood pressure or patient has intolerance to blood pressure medications, then RDN may be considered. The treatment is optional and is offered to patients who fit the criteria.

“It’s a minimally invasive procedure involving catheterisation through the femoral artery in the thigh, to deliver radiofrequency or ultrasound waves to the nerves surrounding the renal arteries. This process disrupts the overactive sympathetic nerve activity, leading to a reduction in blood pressure. Following the procedure, patients are monitored with a 24-hour blood pressure monitor every three months for the first year, and then annually for the next five year.  

“Providing this approach as day case procedure has significant benefits for patients in terms of reduced disruption to their lives, recovery at home and we are not dependent on the availability of beds for an overnight stay which can be a challenge with the current demands on inpatient care, added Prof Sharif.

Prof Bill McEvoy, a Consultant Cardiologist at University Hospital Galway, Professor of Preventive Cardiology at University of Galway and co-Chair of the ESC guidelines for the management of elevated blood pressure and hypertension said, "The ESC guidelines include evidence-based recommendations that provide guidance for clinicians and their patients on the use of this important new technology. However, it must be stressed that this RDN procedure needs to be undertaken in a centre where there is expertise and experience.”

Karen Brennan who underwent the RND procedure during the initial clinical trial five years ago, stated, "This procedure has been a life changer for me; it saved my life. I didn't realise I had severe hypertension until I went to my doctor with a headache and was informed my blood pressure was 220 over 120 and that I was on the verge of having a stroke.

“I was on all the medications I could be on, but nothing was working for me. I heard about the clinical trial and after some persuasion from my family, I went for it and was lucky enough to be just within the parameters to be treated for the procedure. 

“Five years on and I’ve never felt as good.  My blood pressure remains normal, and I cannot thank Prof Sharif and his team enough for all they have done for me.”

For further information on the Renal Denervation Procedure at Galway University Hospitals, including the eligibility criteria, email eileen.coen@universityofgalway.ie

Photo captions:

Francis Hegarty from Teelin in County Donegal and Prof Faisal Sharif, Consultant Interventional Cardiologist at GUH and University of Galway.

Karen Brennan from Moylough in County Galway and Prof Faisal Sharif, Consultant Interventional Cardiologist at GUH and University of Galway.