An in vivo apparatus includes a flexible shaft having a proximal end, a distal end, and a length sufficient to access a patient's renal artery relative to a percutaneous access location. An energy guide apparatus is provided at the distal end of the shaft and dimensioned for deployment within the renal artery. An ex vivo apparatus includes an arrangement configured to localize the energy guide apparatus within the renal artery, and an energy source configured to direct ablative energy to target tissue located a predetermined distance from the localized energy guide apparatus. The target tissue includes perivascular renal nerve tissue adjacent the renal artery.