A novel non-vascular system to treat resistant hypertension

Heuser, Richard R.; Mhatre, Ajay U.; Buelna, Terrence J.; Berci, Winton L.; Hubbard, Brad

doi:10.4244/eijv9i1a19

Cited by 20 publications

(8 citation statements)

References 9 publications

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“…However, the reduction of renal norepinephrine concentration was less at 90 days than at 7 and 30 days. This result is in line with previous studies using healthy swine . Although the recovery mechanism has not yet been elucidated, previous animal studies suggest contribution of nerve regeneration .…”

Section: Discussionsupporting

confidence: 92%

“…This result is in line with previous studies using healthy swine. 24,36 Although the recovery mechanism has not yet been elucidated, previous animal studies suggest contribution of nerve regeneration. 26,37 Considering the long-lasting effects of RDN in humans, 38 recovery of renal norepinephrine concentration as early as 3 months after RDN seems to be specific to healthy animals.…”

Section: Renal Norepinephrine Concentrationmentioning

confidence: 99%

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Safety of catheter‐based radiofrequency renal denervation on branch renal arteries in a porcine model

Sakaoka

Rousselle²,

Hagiwara

et al. 2018

Cathet Cardio Intervent

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Objectives We aimed to investigate the safety of radiofrequency (RF)‐renal denervation (RDN) on branch renal arteries (RAs) in a porcine model. Background The efficacy of RF‐RDN was enhanced by treatment of the branch RA, in addition to the main RA. However, there are concerns regarding the safety of RF‐RDN on branch RA because of their smaller diameter and proximity to the kidney. Methods RF was delivered to 24 RA from 12 swine. A total of 8 RA from 4 swine were untreated. Treated RA were examined by angiography and histopathology at 7, 30, and 90 days. Serum creatinine concentration, biophysical parameters during RF delivery, and renal norepinephrine concentration were also assessed. Results Angiography revealed minimal late lumen loss and diameter stenosis in the main and branch RA at any time point. There was no change in serum creatinine after RF‐RDN. Histopathologically, no augmentation of medial damage or neointimal formation was found in branch RA compared with main RA. No or minimal damage to surrounding tissues including the kidneys, ureters, lymph nodes, and muscles was observed at any time point in both the main and branch RA. Equivalent electrode temperature in the main and branch RA was achieved by automatic adjustment of output power by the generator. The renal norepinephrine concentration was significantly lower in the treated group compared with the untreated group. Conclusions RF‐RDN on branch RA was safe in a porcine model, with stenosis‐free healing of treated arteries and negligible kidney damage at 7, 30, and 90 days.

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Section: Discussionsupporting

confidence: 92%

Section: Renal Norepinephrine Concentrationmentioning

confidence: 99%

Safety of catheter‐based radiofrequency renal denervation on branch renal arteries in a porcine model

Sakaoka

Rousselle²,

Hagiwara

et al. 2018

Cathet Cardio Intervent

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“…Histopathologic analysis also confirmed nerve ablation in the treated zones. 20 We next took this proof-of-concept and applied it in a human study. At a urologic center in India, nine patients who had renal disease, and in whom nephrectomy was planned, underwent RDN with the NephroBlate™, followed by nephrectomy 1 month later.…”

Section: A S C U L a R B I O L O G Ymentioning

confidence: 99%

It's what's inside that matters: Getting to the source in renal denervation

Patel

Mhatre

Heuser

2019

Cathet Cardio Intervent

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“…30 Separately, a non-vascular catheter-based technology deploys a transurethral approach to ablate the renal pelvis which is richly innervated with afferent fibres and could be an alternative for patients with bleeding disorders or renal artery anatomy that is unsuitable for current endovascular ablation catheters. 31 A wholly non-invasive US platform (Surround Sound™, Kona Medical) that targets the distal renal artery and bifurcation using advanced Doppler imaging is currently in clinical trials in Europe with a US pivotal study planned to start recruiting in 2016.…”

Section: Renal Sympathetic Denervationmentioning

confidence: 99%

Interventional procedures and future drug therapy for hypertension

2016

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Hypertension management poses a major challenge to clinicians globally once non-drug (lifestyle) measures have failed to control blood pressure (BP). Although drug treatment strategies to lower BP are well described, poor control rates of hypertension, even in the first world, suggest that more needs to be done to surmount the problem. A major issue is non-adherence to antihypertensive drugs, which is caused in part by drug intolerance due to side effects. More effective antihypertensive drugs are therefore required which have excellent tolerability and safety profiles in addition to being efficacious. For those patients who either do not tolerate or wish to take medication for hypertension or in whom BP control is not attained despite multiple antihypertensives, a novel class of interventional procedures to manage hypertension has emerged. While most of these target various aspects of the sympathetic nervous system regulation of BP, an additional procedure is now available, which addresses mechanical aspects of the circulation. Most of these new devices are supported by early and encouraging evidence for both safety and efficacy, although it is clear that more rigorous randomized controlled trial data will be essential before any of the technologies can be adopted as a standard of care.

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A novel non-vascular system to treat resistant hypertension

Abstract: In this small, preclinical study, we introduce a new non-vascular system to treat resistant hypertension. If the current clinical experience confirms efficacy and safety, this approach may be one way to treat patients who cannot be treated with the standard percutaneous arterial devices.

Cited by 20 publications

References 9 publications

Safety of catheter‐based radiofrequency renal denervation on branch renal arteries in a porcine model

Safety of catheter‐based radiofrequency renal denervation on branch renal arteries in a porcine model

It's what's inside that matters: Getting to the source in renal denervation

Interventional procedures and future drug therapy for hypertension

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