This week, Medtronic led a $100 million investment in Pulnovo Medical, marking the first mega-round in over a month. While much of the early coverage frames this as a pulmonary hypertension play or a precursor to acquisition, the more important signal is how pulmonary artery denervation is being positioned within a broader platform strategy.
To understand the context, it helps to revisit March 2025. When Boston Scientific acquired SoniVie for $540 million, attention focused on competitive positioning. Less discussed was SoniVie’s pipeline, which included pulmonary applications alongside renal denervation through its TIVUS ultrasound platform. That acquisition gave Boston Scientific immediate access to a multi-indication denervation platform.
Medtronic’s investment in Pulnovo now looks like a move to close the platform gap before Boston Scientific can open it.
Medtronic has spent years building its denervation franchise, anchored by Symplicity Spyral and supported by extensive clinical and commercial infrastructure. The company is now advancing its next-generation Spyral+ transradial system, expected to launch in late 2026 or early 2027.
That investment has established both clinical credibility and a scalable delivery model. Through its investment and commercial partnership, Pulnovo allows Medtronic to extend that foundation into a second anatomical target without starting from scratch.

Pulnovo focuses on pulmonary arterial hypertension, a rare and progressive disease affecting about 50,000 patients in the U.S. Left untreated, it leads to right heart failure and death. While pharmacological treatments remain standard, options were limited until Merck’s WINREVAIR was approved in 2024. Beyond Group 1 PAH, a larger Group 2 PH population still lacks approved therapies.
From a technical perspective, renal and pulmonary denervation share the same core mechanism of radiofrequency ablation of sympathetic nerves, along with similar physician workflows and infrastructure. What differs is the indication, the payor conversation, or the competitive set.
Pulnovo effectively becomes an adjacent application layered onto a commercial engine Medtronic has already built.
Boston Scientific has taken a similar approach through SoniVie. SoniVie’s TIVUS is an ultrasound-based platform (like Recor) with Breakthrough Device Designations in both renal and pulmonary denervation. Recent developments, such as the CMS RAPID pathway, further support this category.
Another key element is geographic strategy. Pulnovo is a China-based company, founded in 2013 and spun out of research at Nanjing Medical University, with NMPA approval and access to China’s innovative device green channel, which exempts qualifying products from China’s Volume-Based Procurement (VBP) pricing system.
This is significant for Medtronic, which generates about 7% of its revenue in China and has seen more than 80% of its Chinese product portfolio impacted by VBP. The environment has become increasingly challenging for imported medical devices.
One response is to invest in domestically developed Chinese devices, rather than trying to export American ones. A similar approach was seen when Johnson & Johnson backed Ronovo Surgical alongside a China commercialization agreement.
Through this partnership, Medtronic gains access to the Chinese cardiovascular intervention market without navigating those barriers alone, while Pulnovo gains global commercial reach through Medtronic’s infrastructure.
Competition in pulmonary artery hypertension is not just device-based. Drug therapy is a major factor.
WINREVAIR has quickly become a leading treatment, generating $1.4 billion in revenue in 2025 and seeing rapid adoption. It is increasingly used before interventional approaches, creating a more challenging baseline than renal denervation.
Pulnovo’s path will likely depend on positioning its therapy for patients who do not respond to drug treatment and for populations not addressed by current options.
Beyond the headline investment, this deal highlights a broader shift. Sympathetic nerve ablation is increasingly being treated as a scalable platform that can extend across multiple indications. With both Medtronic and Boston Scientific building in this direction, the focus is shifting beyond any single procedure and toward how far the denervation model can expand.
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