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Short-term Safety and Efficiency of Cryoablation for Rena Sympathetic Denervation in a Swine Model

Chinese Medical Journal 2015年第6期128卷 790-794页

作者： Meng Ji Li Shen Yi-ZheWu Zhi-Feng Yao Jia-Sheng Yin Jia-Hui Chen Jian-Guo Jia Ling-Juan Qiao Peng LiD Jun-Bo Ge Institutes of Biomedical Science Fudan University Shanghai 200032 China Department of Cardiology Zhongshan Hospital Fudan University Shanghai 200032 China cyrofocus medtech corporation Shanghai 200120 China

Background:Renal sympathetic nerves are involved in the reflective activation of the sympathetic nervous system in circulatory control.Catheter-based renal denervation (RDN) ameliorated treatment-resistant hypertension safely,but 10％-20％ of treated patients are nonresponders to radiofrequency denervation.The purpose of this study was to investigate the safety and efficiency of cryoablation for sympathetic denervation in a swine model and to explore a new way of RDN.Methods:Seven swines randomly assigned to two groups:Renal cryoablation (CR) group and control group.The control group underwent renal angiogram only.The CR group underwent renal angiogram plus bilateral renal cryoablation.Renal angiograms via femoral were performed before denervation,after denervation and prior to the sacrifice to access the diameter of renal arterial and the pressure of aorta abdominalis.Euthanasia of the swine was performed on 28-day to access norepinephrine (NE) changes of the renal cortex and the changes of renal nerves.Results:Cryoablation did not induce severe complications at any time point.There was no significant change in diameter of renal artery.CR reduced systolic blood pressure (BP) from 145.50 ± 9.95 mmHg at baseline to 119.00 ± 14.09 mmHg.There was a slight but insignificant decrease in diastolic BP.The main nerve changes at 28-day consisted of necrosis with perineurial fibrosis at the site of CR exposure in conjunction with the nerve vacuolation.Compared with the control group,renal tissue NE of CR group decreased by 89.85％.Conclusions:Percutaneous catheter-based cryoablation of the renal artery is safe.CR could effectively reduce NE storing in the renal cortex,and the efficiency could be maintained 28-day at least.

关键词： Cryoablation Renal Sympathetic Denervation Sympathetic Nerve System

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