CPT® Code 0338T

Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural roadmapping and radiological supervision and interpretation, including pressure gradient measurements, flush aortogram and diagnostic renal angiography when performed; unilateral

Transcatheter renal sympathetic denervation is a minimally invasive procedure aimed at treating conditions such as hypertension, heart failure, renal dysfunction, and issues related to glucose control and sleep apnea, particularly when traditional lifestyle modifications and pharmacological treatments have proven ineffective. The underlying principle of this procedure is based on the understanding that heightened activity of the sympathetic nervous system, originating from the renal plexus, significantly contributes to the development of hypertension. By disrupting the nerve impulses that are transmitted from the renal plexus, this procedure effectively reduces sympathetic nervous system activity, thereby leading to a decrease in blood pressure levels. The technique employs a transcatheter endovascular approach, utilizing low-level radiofrequency energy that is precisely delivered through the renal artery wall to target the sympathetic nerves associated with the kidney. The procedure begins with the preparation of the skin over the access artery, typically one of the femoral arteries, followed by arterial puncture and the placement of a sheath. Heparin is administered to prevent clotting during the procedure. A guide wire is then navigated from the access artery into the aorta, positioning it appropriately for subsequent imaging and interventions. The use of fluoroscopy and contrast injections allows for detailed visualization of the renal vasculature, facilitating the accurate delivery of radiofrequency energy to interrupt nerve impulses. This innovative approach represents a significant advancement in the management of resistant hypertension and related conditions.