Noninvasive Renal Sympathetic Denervation by Extracorporeal High-Intensity Focused Ultrasound in a Pre-Clinical Canine Model

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:61

Article

Wang, Qifeng¹  Guo, Rui²  Rong, Shunkang^1,3,4,5  Yang, Gang¹  Zhu, Que¹  Jiang, Yonghong¹  Deng, Changming¹  Liu, Dichuan¹  Zhou, Qi¹  Wu, Qi¹  Wang, Shunhe⁶  Qian, Jun¹  Wang, Qi^3,4,5  Lei, Han²  He, Tong-Chuan⁷  Wang, Zhibiao^3,4,5  Huang, Jing^1,3,4,5 

[1] Chongqing Med Univ, Affiliated Hosp 2, Chongqing 400010, Peoples R China

[2] Chongqing Med Univ, Affiliated Hosp 1, Chongqing 400010, Peoples R China

[3] State Key Lab Ultrasound Engn Med Co Founded Chon, Chongqing, Peoples R China

[4] Minist Sci & Technol, Chongqing, Peoples R China

[5] Natl Engn Res Ctr Ultrasound Med, Chongqing, Peoples R China

[6] Chongqing Med Univ, Chongqing 400010, Peoples R China

[7] Univ Chicago, Med Ctr, Dept Surg, Mol Oncol Lab, Chicago, IL 60637 USA

关键词: ablation;    extracorporeal high-intensity focused ultrasound;    hypertension;    noninvasive;    renal sympathetic denervation;   

DOI  :  10.1016/j.jacc.2013.02.050

来源: Elsevier

【 摘 要 】

Objectives This study investigated the feasibility of noninvasive renal sympathetic denervation (RSD) by using the novel approach of extracorporeal high-intensity focused ultrasound (HIFU). Background Catheter-based RSD has achieved promising clinical outcomes. Methods Under the guidance of Doppler flow imaging, therapeutic ablations (250 W x 2 s) were performed by using extracorporeal HIFU on the bilateral renal nerves (36.3 +/- 2.8 HIFU emissions in each animal) in a mean 27.4-min procedure in 18 healthy canines of the ablation group. Similar procedures without acoustic energy treatment were conducted in 5 canines of the sham group. The animals were killed on day 6 or 28. Blood pressure (BP), plasma noradrenaline (NA) level, and renal function were determined on days 0, 6, and 28. Pathological examinations were performed on all retrieved samples. Results All of the animals survived the treatment. After ablation, BP and NA significantly decreased compared with the baseline values (BP changed -15.9/-13.6 mmHg, NA changed -55.4% [p < 0.001] 28 days after ablation]) and compared with the sham group on days 6 and 28. Ablation lesions around the renal artery adventitia were observed on day 6. A histological examination revealed the disruption of nerve fibers, necrosis of Schwann cells and neurons, and apparent denervation on day 28. No procedure-related complications were observed. Conclusions Effective RSD was successfully achieved by using the extracorporeal HIFU method in canines. Thus, noninvasive HIFU may be further explored as an important and novel strategy for RSD. (C) 2013 by the American College of Cardiology Foundation

【 授权许可】

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