Allegheny Health Network’s Cardiovascular Institute Sees Positive Outcomes from Groundbreaking Therapy for Treatment-Resistant Hypertension

PITTSBURGH- Interventional cardiologists across Allegheny Health Network's (AHN) Cardiovascular Institute have realized positive health outcomes in patients who have exhibited severe, medication-resistant hypertension after performing a groundbreaking surgical therapy called renal denervation.

Currently, AHN Allegheny General Hospital (AGH), AHN Saint Vincent in Erie and AHN Wexford hospitals perform the minimally invasive procedure. AHN Saint Vincent, under the clinical leadership of Orestis Pappas, MD, leads the region in most procedures completed.

The American Heart Association estimates that nearly 47% of the U.S. population lives with hypertension (high blood pressure), and of the adults who are aware of their hypertension, about 80% do not have it under control.

There weren't many options for this patient population - until renal denervation systems were approved by the FDA in late 2023. The systems were more widely introduced in clinical practices after the U.S. Centers for Medicare & Medicaid Services announced it would cover the procedure for all eligible in 2025.

Blood pressure is the driving force of blood flow from the heart to the body. However, too high of a blood pressure (hypertension) is associated with cardiovascular morbidities such as stroke, heart attack and heart failure.

Beyond the heart, however, the brain also influences blood pressure by controlling the autonomic nervous system. Specifically, the autonomic nervous system near the kidneys and renal arteries plays a crucial role in controlling blood pressure.

When these nerves are overactive, they can signal the brain to increase heart rate and contractility (pumping), and constrict arteries and veins, ultimately raising a person's blood pressure, explained Dr. Ramzi Khalil, interventional cardiologist at AHN AGH.

"It's only been within the last decade that interventional cardiology has focused on how we can better manipulate the nervous system via renal arteries to improve hypertension in patients," said Dr. Khalil. "This innovative approach is exciting because it provides the first non-pharmacological therapy for these patients, who previously would have been on three, sometimes more, blood pressure medications without noticeable relief."

During the procedure, an interventional cardiologist inserts a small, flexible catheter into the groin and accesses the bilateral renal arteries through the femoral vein. Once the catheter reaches the precise location, the renal nerves are ablated - similar to an ablation procedure for atrial fibrillation - with heat via radiofrequency or ultrasound energy.

"Renal arteries are lined with efferent nerves that signal the brain and help regulate blood pressure," said Dr. Khalil. "Ablating these nerves reduces brain-kidney signaling, lowering specific hormones and enzymes, which in turn decreases blood pressure and improves blood flow to the kidneys."

Previous clinical studies have demonstrated notable improvements in hypertension by ablating the sympathetic nervous system.

In fact, AHN's quaternary medical facility, Allegheny General Hospital, was the first in western Pennsylvania to participate in early clinical trials looking at a renal denervation system, Simplicity Spyral by Medtronic, in the SPYRAL AFFIRM study.

In October 2025, presented at the Transcatheter Cardiovascular Therapeutics (TCT) conference, researchers demonstrated that high-risk cardiac patients who participated in the study showed significant blood pressure reductions, without reports of major safety events at the 6-month mark. In addition, participants who underwent the renal denervation procedure did not increase the dosage amount or number of hypertensive medications currently being prescribed.

"This is once again a testament to Allegheny Health Network's longstanding reputation of participating in some of the world's leading clinical trials that aim to improve the portfolio of effective therapies and options for cardiac patients," said Samer Azouz, MD, interventional cardiologist at AHN Wexford. "In addition to this latest finding, some clinical studies have shown a lowered risk of heart attack and stroke by roughly 20 percent with improved blood pressure readings being maintained for more than a decade."

Patients are often able to return home after the procedure, same day, with minimal discomfort, Dr. Azouz continued.

There is a rigorous screening process prior to renal denervation eligibility. Patients must have uncontrolled hypertension (≥ 140/90 mm Hg) despite active management by a clinician for more than a 6-month period, among other qualifying factors. In most cases, patients are typically on at least 3 prescriptions to manage hypertension or are intolerant to medications.

For more information or to get your blood pressure checked, call 412-DOCTORS.

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Media Contact:
Nikki Buccina
Allegheny Health Network
[email protected]