In the late 1940s, subdiaphragmatic splanchnicectomy was used for the treatment of severe hypertension. Surgical sympathectomy was effective but carried a high price: prolonged hospitalisation, postural hypotension, syncope, impotence, and even difficulty in walking. However, this approach was justified at that time, in view of the lack of antihypertensive drugs and the poor outcome of malignant hypertension. The many effective drugs we have nowadays make an interventional therapeutic approach for hypertension strange and unattractive. The control of hypertension, however, remains disappointingly low, leaving uncontrolled patients at increased cardiovascular risk. Thus the need for new therapeutic strategies to address this problem permits the use of interventional techniques. A device that activates carotid baroreceptors is currently in phase III studies in resistant hypertension.
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