 Pulmonary arterial hypertension PAH is characterized by premature death mainly because of progressive and severe right ventricular failure. Target drugs are reported to be associated with significant improvement of clinical outcome for PAH patients. However, previous studies using those target drugs focused on the change of 6-minute walk distance 6MWD and or hemodynamic responses. As 6MWD has weak correlation with clinical outcome time to clinical worsening, TTCW, benefits from target drugs for PAH patients are not clear. We previously reported the safety and efficacy of pulmonary artery denervation PADN for treatment of PAH patients who were unresponsive to target drugs. Hence, we design the randomized study to identify the effect of PADN on PAH. 