Endovascular neuromodulation is evolving rapidly, with growing evidence that sympathetic overactivity contributes to several cardiovascular and metabolic diseases. Beyond renal denervation, multiple organs — including the liver, pancreas, duodenum, the splanchnic vascular bed, and the pulmonary arteries — represent promising targets for catheter-based denervation.
Prof. Dr. Horst Sievert has been directly involved in early clinical development of these approaches and has personally performed first-in-human procedures in several multiorgan-denervation programs. These include combined renal and hepatic denervation as well as splanchnic nerve denervation, conducted in high-volume research centers in Georgia with extensive procedural experience. This provides practical insights relevant for device design, procedural workflow, safety assessment, and clinical trial planning.
Key areas of clinical experience:
- Renal + hepatic denervation (MODUS feasibility program): Early reductions in blood pressure and HbA1c at 90 days.
- Multiorgan Denervation (MDN) technology: Balloon-based systems with micro-needle ethanol injections enabling targeted perivascular nerve ablation.
- NECTAR IV: Improvements in 24-hour ambulatory blood pressure and HbA1c in patients with hypertension and type 2 diabetes.
- Greater splanchnic nerve denervation: Early clinical data showing improved hemodynamics and functional capacity in HFpEF.
- Pulmonary artery denervation: Consistently positive findings across multiple FIM and randomized clinical trials.
Relevance for industry partners
The growing field of multiorgan denervation raises important questions regarding target selection, energy delivery, procedural access, catheter stability, and safety endpoints. Early hands-on clinical experience helps inform these aspects in real-world settings. Insights from multiorgan procedures performed in Georgia provide additional understanding of patient selection, vessel anatomy, imaging guidance, and post-procedure follow-up.
Conclusion
Multiorgan denervation is emerging as a versatile therapeutic approach that may benefit multiple disease areas driven by sympathetic overactivity. As technologies mature, collaboration between industry and experienced clinical centers will be key to advancing this field and designing effective next-generation devices and studies.
Contact for scientific exchange and industry collaboration:
Prof. Dr. Horst Sievert
CVC Frankfurt – CardioVasculäres Centrum Frankfurt
HorstSievertMD@aol.com