Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat Refractory Hypertension

Abstract

BackgroundHypertension is strongly associated with cardiovascular diseases such as heart failure, stroke, kidney disease, and has been correlated with an increased risk for heart attack. Current treatment regimens for hypertension are highly inadequate, with reports indicating that only 50.1% of the clinical population with the disease has their blood pressure under control.ObjectiveTo study the feasibility of using minimally invasive radiosurgery to ablate the renal nerves as a novel treatment for refractory hypertension, and to assess the safety and efficacy of such an approach.MethodsA Hanford porcine (miniswine) model (N = 6) was used to investigate the feasibility of using the CyberHeart radiosurgical platform (CyberHeart Inc., Mountain View, CA, USA) to create safe renal nerve ablations. Norepinephrine (NE) levels were measured pre and post treatment. Additionally, renal nerve and arterial histology were studied to examine effect.ResultsPlasma norepinephrine levels showed a decrease over the six-month time point. Urea, nitrogen, and creatinine levels showed no changes post procedure. Histology documented no significant arterial injury in targeted areas. Renal nerves documented histologic change consistent with nerve ablation.ConclusionCyberHeart radiosurgery of the renal nerve is feasible and resulted in norepinephrine reduction and renal nerve injury consistent with radiosurgical targeted ablation.

Ablative Radiotherapy as a Noninvasive Alternative to Catheter Ablation for Cardiac Arrhythmias

“…Additionally, ablative radiotherapy is used in non-oncologic indications, such as trigeminal neuralgia, arteriovenous malformations, seizures, and psychiatric disorders in the brain, and has been explored for renal artery hypertension, back pain, and cardiac arrhythmias, termed stereotactic arrhythmia radioablation (STAR) [ 8 , 9 ••].…”

Non-invasive Stereotactic Radioablation: A New Option for the Treatment of Ventricular Arrhythmias

“…26,27 Non-malignant diseases that may benefit from the therapy are being investigated, including hypertension treated via renal arterial denervation. 28…”

Determination of the psychometric properties of the Patients’ Self-Efficacy Scale in blood pressure patients

“…High blood pressure is a risky factor for kidney disease, stroke, premature birth, and cardiovascular disease [ 2, 3 ]. High blood pressure is associated with sympathetic nervous system, because increased levels of sympathetic system activity lead to high blood pressure and therapeutic treatments are effective on controlling the sympathetic nervous system and had little success in controlling and treating hypertension [ 4 ]. Researchers have found that the number of adults with high blood pressure has doubled between 1995 and 2005 [ 5 ].…”

“…Therefore, high blood pressure control is considered as an important indicator in assessing the impact of health services [ 2 ]. Studies have shown that only 50.1% of the population with high blood pressure can control their disease (with a level below 140/90 mmHg) [ 4 ]. Factors, such as overweight and obesity, low exercise activities, high alcohol consumption, and the use of drugs and drugs, increase the risk of hypertension in individuals [ 7 ].…”

“…The chance of high blood pressure is similar in population, but the distribution of the disease varies according to these risk factors in the population of patients [ 6 ]. For example, about 30% of people over the age of 18 are hypertensive, which, given the increasing prevalence of obesity, is expected to increase the number of this young population in the future, and in spite of increasing efforts to increasing awareness for controlling and treating high blood pressure is a poor diet [ 4 ]. Although blood pressure control is difficult, one can predict hypertension by examining metabolic syndrome in a person.…”