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Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat Refractory Hypertension
BACKGROUND: Hypertension 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 t...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364090/ https://www.ncbi.nlm.nih.gov/pubmed/28367392 http://dx.doi.org/10.7759/cureus.1055 |
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author | Bhatt, Nikhilesh Long, Sarah A Gardner, Edward A Tay, Jonathan Ladich, Elena Chamberlain, David Fogarty, Thomas J. Maguire, Patrick J |
author_facet | Bhatt, Nikhilesh Long, Sarah A Gardner, Edward A Tay, Jonathan Ladich, Elena Chamberlain, David Fogarty, Thomas J. Maguire, Patrick J |
author_sort | Bhatt, Nikhilesh |
collection | PubMed |
description | BACKGROUND: Hypertension 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. OBJECTIVE: To 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. METHODS: A 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. RESULTS: Plasma 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. CONCLUSION: CyberHeart radiosurgery of the renal nerve is feasible and resulted in norepinephrine reduction and renal nerve injury consistent with radiosurgical targeted ablation. |
format | Online Article Text |
id | pubmed-5364090 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-53640902017-03-31 Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat Refractory Hypertension Bhatt, Nikhilesh Long, Sarah A Gardner, Edward A Tay, Jonathan Ladich, Elena Chamberlain, David Fogarty, Thomas J. Maguire, Patrick J Cureus Medical Physics BACKGROUND: Hypertension 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. OBJECTIVE: To 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. METHODS: A 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. RESULTS: Plasma 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. CONCLUSION: CyberHeart radiosurgery of the renal nerve is feasible and resulted in norepinephrine reduction and renal nerve injury consistent with radiosurgical targeted ablation. Cureus 2017-02-26 /pmc/articles/PMC5364090/ /pubmed/28367392 http://dx.doi.org/10.7759/cureus.1055 Text en Copyright © 2017, Bhatt et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Medical Physics Bhatt, Nikhilesh Long, Sarah A Gardner, Edward A Tay, Jonathan Ladich, Elena Chamberlain, David Fogarty, Thomas J. Maguire, Patrick J Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat Refractory Hypertension |
title | Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat Refractory Hypertension |
title_full | Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat Refractory Hypertension |
title_fullStr | Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat Refractory Hypertension |
title_full_unstemmed | Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat Refractory Hypertension |
title_short | Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat Refractory Hypertension |
title_sort | radiosurgical ablation of the renal nerve in a porcine model: a minimally invasive therapeutic approach to treat refractory hypertension |
topic | Medical Physics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364090/ https://www.ncbi.nlm.nih.gov/pubmed/28367392 http://dx.doi.org/10.7759/cureus.1055 |
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