Concierge interventional cardiology · UK
Renal artery denervation - the catheter procedure, done in a proper cath lab.
Radiofrequency and ultrasound catheter-based renal denervation for patients with true treatment-resistant hypertension. NICE-compliant selection, MDT, procedure and structured follow-up in one place.
Why patients choose us
- 01
NICE-compliant patient selection
RDN sits under NICE IPG754. We only book patients who genuinely meet the criteria - true resistance to three drugs including a diuretic, confirmed on ambulatory monitoring, secondary causes excluded.
- 02
An interventional cardiologist with RDN volume
Both radiofrequency (Symplicity Spyral) and ultrasound (Paradise) systems in centres that run RDN as a regular list - not a once-a-year novelty.
- 03
Structured 24-month follow-up
Office and ambulatory blood pressure at 1, 3, 6, 12 and 24 months. Medication rationalised by a hypertension consultant, not left to the GP.
Indicative pricing
What private renal artery denervation costs in the UK.
Indicative ranges from our interventional network. Firm figures across radiofrequency and ultrasound platforms inside one working day, with cover checked.
In short
Radiofrequency RDN in our network: £16,000–£24,000, home day-case or one night.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Radiofrequency renal artery denervation (Symplicity Spyral) | £16,000–£24,000 | 60–90 min | Day-case or 1 night |
| Ultrasound renal artery denervation (Paradise) | £17,500–£26,000 | 60–90 min | Day-case or 1 night |
| Pre-procedure hypertension MDT and workup | £1,200–£2,200 | 1–2 weeks | Outpatient |
| Ambulatory 24-hour BP monitoring | £220–£380 | 24 hours | 48 hours |
| Renal artery CT or MR angiography | £650–£1,100 | 20–40 min | 3–5 days |
| Post-procedure follow-up package (12 months) | £950–£1,600 | 4 visits | Structured |
| Interventional cardiology consultation | £300–£500 | 30–45 min | Same visit |
Prices vary by device (radiofrequency versus ultrasound), by hospital and by whether the pre-procedure workup and follow-up package are bundled. Firm quotes always include the MDT, procedure, imaging and structured follow-up.
The problem
RDN is a procedure, not a first line - but for the right patient it earns its place.
The commonest RDN mistake is offering it to the wrong patient. Selection under IPG754, an honest expected effect size, and structured follow-up are the three things that separate a well-run RDN programme from marketing.
IPG754 selection, not marketing
Three drugs including a diuretic, ambulatory confirmation, secondary causes excluded. Anything less is not RDN territory.
Realistic effect size
6–10 mmHg office SBP on average. We say this before you consent, not after.
Follow-up is the procedure
Ambulatory BP at 1, 3, 6, 12 and 24 months. Medication rationalised by a hypertension consultant.
The journey
From BP diary to 24-month review - what happens, in order.
One hypertension MDT from screening through cath lab and ambulatory follow-up.
Phase 1 · Before
Workup, MDT, ambulatory BP
Phase 2 · On the day
Cath lab and observation
Phase 3 · After
Structured follow-up and titration
- 01
Before
You send your BP readings and drug list
Home BP diary, ambulatory 24-hour data if you have it, current medications and doses, and any renal or endocrine bloods done so far.
- 02
Before
We come back with a plan
Within one working day: whether the case likely fits IPG754, which centre, an indicative price and cover check.
- 03
Before
Secondary causes screen
Aldosterone-renin ratio, plasma metanephrines, renal artery imaging (Doppler or CT/MR angiography), sleep study if apnoea is suspected.
- 04
Before
Hypertension MDT and consent
A joint hypertension and interventional MDT confirms suitability. Consent covers access-site bleeding, renal artery injury and the real-world blood pressure fall you can expect (roughly 6–10 mmHg office SBP).
- 05
On the day
Cath lab procedure
Local anaesthetic and sedation. Femoral or radial access, catheter passed into each main renal artery and its branches, radiofrequency or ultrasound energy delivered. Typically 60–90 minutes.
- 06
On the day
Ward recovery and discharge
Bed rest for 4–6 hours after femoral access, less for radial. Most patients home the same evening or the next morning.
- 07
After
Structured hypertension follow-up
Ambulatory BP at 1, 3, 6, 12 and 24 months. Antihypertensive rationalisation, adherence check, and repeat imaging only if a complication is suspected.
Typical end-to-end: 4–6 weeks from enquiry to procedure. Full effect is judged at 6 months.
When it helps
When renal artery denervation earns its place.
The situations where RDN genuinely helps, plus the red flag that means A&E today, not an RDN referral.
-
True treatment-resistant hypertension
Office BP ≥140/90 despite three antihypertensives at maximally tolerated doses, one being a diuretic - confirmed by 24-hour ambulatory monitoring.
-
Intolerance of multiple antihypertensives
Side-effect-limited titration where combinations cannot be pushed further - RDN can substitute for one or two agents.
-
Poor adherence, actively addressed
Adherence checked (drug-level testing where available), addressed and still resistant - not ignored and offered a procedure instead.
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Hypertension with cardiovascular target-organ damage
LVH, microalbuminuria or hypertensive nephrosclerosis - where lowering pressure matters most.
-
Secondary causes excluded
Primary aldosteronism, phaeochromocytoma, renal artery stenosis, obstructive sleep apnoea and Cushing’s all excluded before RDN is offered.
-
Sympathetic-driven physiology
High heart rate and features suggesting sympathetic overdrive can predict a larger BP fall - an evolving selection signal.
-
Patient preference for a procedural option
Some patients, fully informed, prefer a one-off procedure and one fewer tablet to lifelong quadruple therapy - a legitimate consideration under IPG754.
-
Red flag: accelerated or malignant hypertension
BP ≥180/120 with retinal haemorrhages, papilloedema, chest pain or acute kidney injury is a hypertensive emergency - A&E the same day, not an RDN referral.
Procedure options
Two devices, one artery - and honest choice about both.
Radiofrequency, ultrasound, access route, bilateral treatment and where combined medical optimisation earns its place.
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Radiofrequency RDN (Symplicity Spyral)
A multi-electrode catheter delivers RF energy in a spiral pattern along the main renal artery and its branches. The most-studied system with the largest published dataset.
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Ultrasound RDN (Paradise system)
A balloon-mounted ultrasound transducer delivers circumferential energy through the artery wall. Faster energy delivery per artery in some hands.
-
Access route - femoral versus radial
Femoral access is standard for RDN catheters. A small number of centres use radial with dedicated devices. Radial has lower access-site bleeding risk.
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Bilateral treatment
Both renal arteries are treated in the same sitting. Bilateral treatment is essential for a meaningful blood pressure effect.
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Branch-vessel ablation
Current radiofrequency catheters treat both main and accessory branches, targeting sympathetic nerves that run in the adventitia further downstream.
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Combined with medical optimisation
RDN is never a substitute for medication rationalisation, salt restriction and sleep apnoea treatment - it works alongside them.
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Re-do RDN
Repeat procedure is uncommon but occasionally offered to non-responders after full re-workup, in high-volume centres only.
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Not RDN - sham medical arm
For patients whose BP responds to observed medication or salt restriction alone, RDN is not offered. Sham-controlled trials remind us the effect is real but modest.
Our vetted UK network
A small panel of RDN interventional cardiologists, we picked them.
NICE-compliant centres in London and the major UK cities running regular RDN lists on both platforms.
Selection criteria
How we choose every RDN centre in our network.
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Interventional cardiologists on the GMC specialist register with regular RDN volume
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NICE IPG754-compliant selection process with a hypertension MDT
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Both radiofrequency and ultrasound platforms available
-
Structured 24-month follow-up in the same hypertension clinic
Safety and recovery
What to expect afterwards - honestly.
RDN is a low-risk day-case procedure with modest blood pressure benefit. Understanding both is the honest starting point.
Sedation and local anaesthetic
Femoral or radial access under local anaesthetic with conscious sedation. A consultant anaesthetist is available but general anaesthesia is not routine.
Access-site bleeding and haematoma
The commonest early problem - 2–4% at the femoral puncture site. Radial access carries much lower access-site risk.
Renal artery injury
Dissection, spasm or pseudoaneurysm are all rare (well under 1% in expert centres). Repeat imaging is only done if a complication is suspected.
Renal function
Small, transient rises in creatinine are described. Meaningful long-term decline in renal function has not been shown in the pivotal trials.
Back and flank discomfort
During and immediately after the procedure - well controlled with sedation and simple analgesics.
The blood pressure fall is modest
Realistic average office SBP fall is 6–10 mmHg at six months in sham-controlled data, with ambulatory readings typically lower. Some patients get more, some less.
You will still be on medication
RDN reduces, not replaces, drug burden. Rationalisation is done by a hypertension consultant, not by stopping tablets on your own.
Long-term durability
Trial data now stretch to three years with sustained effect. Longer-term data continue to accumulate.
Red flags after the procedure
Expanding groin lump, severe flank pain, gross haematuria, breathlessness or new leg pain - same-day contact with the interventional team or A&E.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever device was used, the note the interventional cardiologist sends you keeps to the same shape.
A quiet reminder
Medical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the angiogram and the follow-up plan before your review, just ask.
- 01Header
Access route, device and vessels treated
Femoral or radial, radiofrequency or ultrasound, and which renal arteries and branches were ablated.
- 02Technique
Ablation pattern and burns delivered
Number and location of RF ablations or ultrasound emissions, with attention to spiral coverage in main and branch vessels.
- 03Findings
Renal angiography before and after
Baseline anatomy, any accessory arteries, and confirmation of no dissection, spasm or thrombus on the final images.
- 04Impression
Medication and follow-up plan
Read this first: which antihypertensive will be titrated at which visit, ambulatory BP schedule and the trigger points for review.
Recognised by major UK insurers
RDN is often covered under specialist cardiology when NICE IPG754 criteria are met. We confirm cover, excess and any pre-authorisation before booking.
Frequently asked
Everything we get asked about renal artery denervation.
Quick answers on selection, device choice, expected BP fall and cost.
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Am I a candidate for renal artery denervation?
Under NICE IPG754, RDN is for adults with treatment-resistant hypertension - office BP ≥140/90 despite three antihypertensives at maximally tolerated doses (one being a diuretic), confirmed on ambulatory monitoring, with secondary causes excluded and adherence addressed. A hypertension MDT confirms suitability in every case.
-
How much will my blood pressure fall after RDN?
Realistic average office systolic BP reduction is 6–10 mmHg at six months in sham-controlled trials, with ambulatory measurements typically 4–7 mmHg lower. Some patients respond much more, some barely at all - RDN is a shift in the curve, not a cure.
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Will I be able to stop my blood pressure tablets?
Usually not stop them altogether, but often reduce the number or the dose. Medication rationalisation is done under a hypertension consultant using ambulatory BP data, not by patients stopping tablets on their own.
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Radiofrequency or ultrasound - which system is better?
Both radiofrequency (Symplicity Spyral) and ultrasound (Paradise) have positive sham-controlled trials. Head-to-head data are limited. In practice we match device to anatomy and centre experience - the operator matters more than the badge.
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How much does private RDN cost in the UK?
Roughly £16,000–£24,000 for radiofrequency RDN, £17,500–£26,000 for ultrasound RDN. Pre-procedure workup runs £1,200–£2,200 and a 12-month follow-up package is £950–£1,600. Firm quotes are back within one working day.
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Is RDN available on the NHS?
Yes - NICE IPG754 supports its use in the NHS with special arrangements, and a small number of tertiary centres offer it. Waiting lists and stringent selection mean many suitable patients look privately for faster access to the same MDT process.
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