Renal Denervation: Ultrasound vs. Radiofrequency – Key Findings from a Meta-Analysis

A recent mixed treatment comparison meta-analysis of 13 randomized sham-controlled trials (N=2,285) evaluated the efficacy and safety of ultrasound renal denervation (uRDN) and radiofrequency renal denervation (rfRDN), in reference to sham and against each other, in patients with hypertension.

• Both rfRDN and uRDN significantly reduced 24-h ambulatory systolic blood pressure (SBP) compared to sham.
• uRDN demonstrated a greater reduction in ambulatory SBP across all time points 24-h (4.74 mmHg vs. 2.34 mmHg), daytime (5.40 mmHg vs. 1.32 mmHg), and nighttime (3.84 mmHg vs. -1.92 mmHg).
• Adverse Events: there was no difference in adverse events with both rfRDN and uRDN compared with sham or against each other.
• Sensitivity analysis, restricting the comparison to the Symplicity™ Spyral (rfRDN) and Paradise™ (uRDN) systems, confirmed these findings. For primary efficacy outcomes, uRDN ranked #1, followed by rfRDN and sham. These results suggest that uRDN, particularly with the Paradise system, may provide superior blood pressure reduction compared to rfRDN.
• The potential hypothesis for the superiority of uRDN Paradise System vs rfRDN Symplicity Spyral could be related to the greater tissue penetration (6–7mm) and full circumferential ablation compared to rfRDN with a penetration depth of 3–4 mm.

Future studies should aim to understand the mechanism of superiority of uRDN compared to rfRDN and assess comparative effectiveness.

ACCESS THE ARTICLE:
Journal of Hypertension: Renal denervation – radiofrequency vs. ultrasound

Source:
Bangalore, S., et al. (2025). Renal denervation – radiofrequency vs. ultrasound: Insights from a mixed treatment comparison meta-analysis of randomized sham-controlled trials. Journal of Hypertension, 43(2), 325-335