“High blood pressure is one of the leading causes of heart disease and stroke worldwide, and many patients struggle to control it, despite medication. This landmark procedure positions University Hospital Limerick (UHL) at the forefront of innovative cardiovascular care, while giving patients access to safer, more convenient treatment options,” according to Dr Cormac O’Connor, consultant interventional cardiologist, UHL, who, along with fellow consultant interventional cardiologist, Dr Samer Arnous, recently introduced a pioneering medical procedure for patients with high blood pressure.
Renal arterial denervation is an emerging treatment for patients with resistant hypertension, or high blood pressure that is difficult to control with medication. The procedure has been available at UHL since the opening of the hospital’s new €2m catheterisation laboratories in 2024. RAD involves passing a catheter through the circulatory system to access the renal arteries and using radio-frequency waves or ultrasound to target the excessive nerve activity around the renal arteries that can contribute to high blood pressure.
Even when accessing the arterial system via the groin, RAD is regarded as minimally invasive. The transradial procedure, completed by a multidisciplinary cardiology team led by Drs Arnous and O’Connor in April this year, is an even less invasive option for people struggling to contain hypertension, where the arteries are accessed through the wrist. In a further development for patient safety, the Limerick team successfully delivered this procedure using a tiny 5 French catheter. The French scale is used internationally to measure the diameter of catheters used in healthcare.
For patients, the benefits of RAD are significant. They include a potential reduced reliance on daily medication - the procedure may help patients who do not respond well to multiple blood pressure drugs. It helps lower the risk of heart attack and stroke as better blood pressure control can significantly reduce the risk of serious cardiovascular events. It also preserves normal kidney function as the treatment targets nerve activity without harming the kidneys.
The Limerick team’s wrist-based approach offers several additional advantages, as Dr Arnous explained: “Renal denervation can be performed via either the radial artery in the wrist or the femoral artery in the groin, but radial access offers several practical advantages that are increasingly appealing to both patients and clinicians. Entering through the wrist is generally more comfortable, less invasive and allows patients to sit up and walk almost immediately after the procedure, avoiding the prolonged bed rest often required with femoral access. It also carries a lower risk of significant bleeding or vascular complications.”