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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...

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Autores principales: Bhatt, Nikhilesh, Long, Sarah A, Gardner, Edward A, Tay, Jonathan, Ladich, Elena, Chamberlain, David, Fogarty, Thomas J., Maguire, Patrick J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2017
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.
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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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