GW24-e3929 Noninvasive renal sympathetic denervation by extracorporeal high-intensity focused ultrasound in a preclinical canine model. (1st October 2013)

• Record Type: Journal Article
• Authors: Jing, Huang
• Is Part Of: Heart. Volume 99(2013)Supplement 3
• Page Start: A288
• Page End: A288
• Publication Date: 2013-10-01
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2013-304613.816
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: The feasibility of noninvasive renal sympathetic denervation (RSD) using the novel approach of extracorporeal high-intensity focused ultrasound (HIFU) was investigated in this study. Methods: Catheter-based RSD has achieved promising clinical outcomes. Methods Under the guidance of Doppler flow imaging, therapeutic ablations (250 W×2 seconds) were performed by HIFU on the bilateral renal nerves (36.3 ± 2.8 HIFU emissions in each animal) in an average 27.4-minute procedure in 18 healthy canines. The other 5 canines that were not subjected to acoustic energy treatment were used as the sham group. The animals were sacrificed on day 6 or 28. The 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, the BP and NA significantly decreased compared to the baseline values (Bp changes -15.9/-13.6 mmHg, NA change -55.4%, p < 0.005, respectively, on 28 days after ablation) and compared to the sham group on days 6 and 28. Ablation lesions around the renal artery adventitia were observed on day 6. A histologic 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 using the HIFU method in canines. Thus, noninvasive HIFU may be further explored as an important and novel strategy for RSD.