Comparison of Saline-Irrigated Catheter vs. Temperature-Controlled Catheter for Renal Denervation in a Canine Model

BACKGROUND The effectiveness of catheter-based renal denervation (RDN) remains controversial. Although the reasons for this have not yet been elucidated, ineffective denervation appears to be an important factor. The present study aimed to investigate the difference in RDN between a saline-irrigated...

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Veröffentlicht in:American journal of hypertension 2015-12, Vol.28 (12), p.1434-1443
Hauptverfasser: Wang, Zhenglong, Chen, Shaojie, Zhou, Tingquan, Su, Li, Ling, Zhiyu, Fan, Jinqi, Chen, Weijie, Du, Huaan, Lu, Jiayi, Xu, Yanping, Tan, Zhen, Yang, Hanxuan, Hu, Xinyu, Li, Chengzhi, Yan, Xue, Hu, Guangxin, Liu, Chang, Yin, Yuehui
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Sprache:eng
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Zusammenfassung:BACKGROUND The effectiveness of catheter-based renal denervation (RDN) remains controversial. Although the reasons for this have not yet been elucidated, ineffective denervation appears to be an important factor. The present study aimed to investigate the difference in RDN between a saline-irrigated catheter (SIC) and a temperature-controlled catheter (TCC). METHODS Dogs (n = 6) from the Kunming province in Chinese were ablated; the SIC was introduced into the right renal artery, while the TCC was introduced into the left renal artery. After 6 months, histopathology and renal angiography were performed, and the change in neural density was evaluated using morphometric software. The average values of heart rate (HR), blood pressure (BP), and catecholamine metabolites were assessed at baseline and follow-up. RESULTS Histopathology showed nerve demyelination and denaturation, as well as interstitial hyperplasia, although these changes were more pronounced when the SIC was used. The change in neural density was greater and ablation was deeper when the SIC was used. Intimal hyperplasia was greater when the TCC was used, whereas medial hyperplasia was greater when the SIC was used. A trend toward a decrease in HR, BP, metanephrine, and normetanephrine between baseline and follow-up was observed. CONCLUSIONS Our findings suggest that SIC ablation results in more extensive neural degeneration, deeper penetration, and less extensive intimal hyperplasia than TCC ablation for RDN.
ISSN:0895-7061
1941-7225
DOI:10.1093/ajh/hpv051