Symplicity™ blood pressure procedure
Clinical evidence
The Symplicity Spyral™ renal denervation (RDN) system, used during the Symplicity™ procedure, is backed by extensive clinical evidence.
The Symplicity Spyral™ radiofrequency renal denervation (rfRDN) system is backed by the SPYRAL HTN Clinical program — the largest renal denervation clinical program studying more than 5,000 patients in multiple sham-controlled trials, and the largest real-world renal denervation registry.†,1–3,5–8
18.5 mmHg
mean reduction in office systolic blood pressure (SBP) at 3 years in patients taking medication.4
(N = 175)
< 0.4%
major adverse events at composite endpoint, including no new incidence of renal artery stenosis (> 70%) at 6 months.2
(N = 253)
> 5,000
patients studied in the SPYRAL HTN Clinical program.†,‡,1–3,5–8
Patients who underwent the Symplicity™ procedure continued to see additional blood pressure reductions through three years, demonstrating durable results that amplify over time following rfRDN.4 Most patients continue taking their medication after the procedure. Results may vary.
OFF MED
Scientific evidence of efficacy without meds
ON MED
Prospective evidence in the presence of meds
GSR†,3
Large dataset of multiple subgroups in real-world setting
Read on to learn more about the SPYRAL HTN clinical program, including:
SPYRAL HTN-OFF MED Trial1
Pivotal, randomized, sham-controlled trial to show safety and efficacy of the Symplicity Spyral™ system in uncontrolled hypertension patients on no antihypertensive medications (n = 331).
Results may vary.
Office SBP
Average baseline = 163 mmHg
24-hr SBP
Average baseline = 151 mmHg
Blood pressure reductions following Symplicity Spyral™ system were present throughout the day and night.
SPYRAL HTN-ON MED Trial2
Randomized, sham-controlled trial to show long-term efficacy and safety of the Symplicity Spyral™ system in uncontrolled hypertension patients on one to three antihypertensive medications (n = 337).
At three years, 74% of patients treated in the sham arm elected to undergo the Symplicity™ procedure.
Results may vary.
Office SBP
Average baseline =
163 mmHg
24-hr SBP
Average baseline =
150 mmHg
Average baseline =
149 mmHg
Blood pressure reductions following Symplicity Spyral™ system were present throughout the day and night.
P-values are ANCOVA adjusted for baseline BP.
GSR-DEFINE3
Enrolled over 3,900 patients‡:
Real-world results for the Symplicity™ rfRDN system3
Baseline BP 164 ± 25 mmHg
Symplicity Spyral™ and Flex renal denervation catheters safely reduced blood pressure through 36 months, independent of the number and type of baseline antihypertensive medication classes.†,‡,3
The change in AH medications to 36 months was –0.15 ± –1.34 (p < 0.0001; n = 1,984).
Results may vary.
GSR-DEFINE showed stable kidney function in real-world patients at three-year follow up.10
Enrollment is complete for this post-approval study. Study follow-up is ongoing.
Learn more about the turning point in hypertension care and how it can help enhance treatment strategies.
Learn about Symplicity Spyral™ RDN system’s components and their role in the Symplicity™ blood pressure procedure.
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† Includes Symplicity Spyral™ and Flex RDN catheters.
‡ Study follow-up is ongoing. Data does not represent follow-up for all patients.
0. Based on accepted publications through April 2026. Medtronic data on file.
1. Böhm M, Kario K, Kandzari DE, et al. Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. Lancet. 2020;395(10234):1444–1451. doi:10.1016/S0140-6736(20)30554-7.
2. Kandzari D, Townsend R, Kario K, et al. Safety and efficacy of renal denervation in patients taking antihypertensive medications. J Am Coll Cardiol. 2023;82(19):1809–1823. doi:10.1016/j.jacc.2023.08.045.
3. Mahfoud F, Schlaich M, Schmieder RE, et al. Long-term outcomes in ESC guideline-recommended patients for RDN from Global SYMPLICITY Registry DEFINE. Presented at: EuroPCR 2025; May 20–23, 2025; Paris, France.
4. Kandzari D, Mahfoud F, Townsend R, et al. Durable safety and efficacy of renal denervation using the Symplicity Spyral catheter in patients taking antihypertensive drugs: final, 3-year results from the SPYRAL HTN-ON MED randomized study. Presented at: TCT 2025; October 25–28, 2025; San Francisco, CA.
5. Kario K, Ogawa H, Okumura K, et al. SYMPLICITY HTN-Japan – First randomized controlled trial of catheter-based renal denervation in Asian patients. Circ J. 2015;79(6):1222–1229. doi:10.1253/circj.CJ-15-0150.
6. Bhatt DL, Kandzari DE, O’Neill WW, et al. A controlled trial renal denervation for resistant hypertension. N Engl J Med. 2014;370(15):1393–1401. doi:10.1056/NEJMoa1402670.
7. Esler MD, Böhm M, Sievert H, et al. Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 month results from the SYMPLICITY HTN-2 randomized clinical trial. Eur Heart J. 2014;35(26):1752–1759. doi:10.1093/eurheartj/ehu209.
8. Krum H, Schlaich MP, Sobotka PA, et al. Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the Symplicity HTN-1 study. Lancet. 2014;383(9917):622–629. doi:10.1016/S0140-6736(13)62192-3.
9. Kandzari DE, Mahfoud F, Townsend RR, et al. Long-term safety and efficacy of renal denervation: 24-month results from the SPYRAL HTN-ON MED trial. Circ Cardiovasc Interv. 2025;18(7):e015194. doi:10.1161/CIRCINTERVENTIONS.125.015194.
10. Schlaich MP, Mahfoud F, Williams B. Long-term safety and efficacy of renal denervation with the Symplicity Spyral catheter in the Global SYMPLICITY Registry. Presented at: American Society of Nephrology Kidney Week; November 4–7, 2021; San Diego, CA.
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