CPT® Code 0339T

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; bilateral

Transcatheter renal sympathetic denervation is a minimally invasive procedure aimed at treating conditions such as hypertension, heart failure, renal dysfunction, 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 from the renal plexus, this procedure effectively reduces sympathetic nervous system activity, thereby lowering blood pressure. The transcatheter approach allows for the delivery of low-level radiofrequency energy directly through the renal artery wall to target the sympathetic nerves associated with the kidney. This technique 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 procedure includes the use of fluoroscopy and contrast injections to visualize the renal vasculature, ensuring accurate catheter placement and effective treatment delivery. Ultimately, this innovative procedure represents a significant advancement in the management of resistant hypertension and related conditions.