Literature DB >> 25349043

Controlled circumferential renal sympathetic denervation with preservation of the renal arterial wall using intraluminal ultrasound: a next-generation approach for treating sympathetic overactivity.

Kenichi Sakakura1, Austin Roth, Elena Ladich, Kai Shen, Leslie Coleman, Michael Joner, Renu Virmani.   

Abstract

AIMS: The Paradise Ultrasound Renal Denervation System is a next-generation catheter-based device which was used to investigate whether the target ablation area can be controlled by changing ultrasound energy and duration to optimise nerve injury while preventing damage to the arterial wall. METHODS AND
RESULTS: Five ultrasound doses were tested in a thermal gel model. Catheter-based ultrasound denervation was performed in 15 swine (29 renal arteries) to evaluate five different doses in vivo, and animals were euthanised at seven days for histopathologic assessment. In the gel model, the peak temperature was highest in the low power-long duration (LP-LD) dose, followed by the mid-low power-mid duration (MLP-MD) dose and the mid-high power-short duration (MHP-SD) dose, and lowest in the mid power-short duration (MP-SD) dose and the high power-ultra short duration (HP-USD) dose. In the animal study, total ablation area was significantly greater in the LP-LD group, followed by the MLP-MD group, and it was least in the HP-USD, MP-SD and MHP-SD groups (p=0.02). Maximum distance was significantly greater in the LP-LD group, followed by the MLP-MD group, the MHP-SD group, and the HP-USD group, and shortest in the MP-SD group (p=0.007). The short spare distance was not different among the five groups (p=0.38). Renal artery damage was minimal, while preserving significant nerve damage in all groups.
CONCLUSIONS: The Paradise Ultrasound Renal Denervation System is a controllable system where total ablation area and depth of ablation can be optimised by changing ultrasound power and duration while sparing renal arterial tissue damage but allowing sufficient peri-arterial nerve damage.

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Year:  2015        PMID: 25349043     DOI: 10.4244/EIJY14M10_14

Source DB:  PubMed          Journal:  EuroIntervention        ISSN: 1774-024X            Impact factor:   6.534


  16 in total

1.  Anticipated expansion of a new approach to treating hypertension without medication by catheter-based renal denervation.

Authors:  Keisuke Okamura; Hidenori Urata
Journal:  J Thorac Dis       Date:  2018-09       Impact factor: 2.895

2.  Renal denervation with ultrasound therapy (paradise device) is an effective therapy for systemic hypertension.

Authors:  Sho Torii; Hiroyoshi Mori; Hiroyuki Jinnouchi; Atsushi Sakamoto; Aloke Finn; Renu Virmani
Journal:  J Thorac Dis       Date:  2018-09       Impact factor: 2.895

Review 3.  Catheter-based ultrasound technology for image-guided thermal therapy: current technology and applications.

Authors:  Vasant A Salgaonkar; Chris J Diederich
Journal:  Int J Hyperthermia       Date:  2015-03-23       Impact factor: 3.914

Review 4.  Renal Denervation: Is It Ready for Prime Time?

Authors:  Lucas Lauder; Milan A Wolf; Sean S Scholz; Mathias Hohl; Felix Mahfoud; Michael Böhm
Journal:  Curr Cardiol Rep       Date:  2019-07-05       Impact factor: 2.931

Review 5.  Renal denervation in resistant hypertension: a review of clinical trials and future perspectives.

Authors:  Eiichiro Yamamoto; Daisuke Sueta; Kenichi Tsujita
Journal:  Cardiovasc Interv Ther       Date:  2022-04-26

Review 6.  Renal sympathetic denervation in therapy resistant hypertension - pathophysiological aspects and predictors for treatment success.

Authors:  Karl Fengler; Karl Philipp Rommel; Thomas Okon; Gerhard Schuler; Philipp Lurz
Journal:  World J Cardiol       Date:  2016-08-26

Review 7.  Resistant Hypertension Updated Guidelines.

Authors:  Irene Chernova; Namrata Krishnan
Journal:  Curr Cardiol Rep       Date:  2019-08-30       Impact factor: 2.931

Review 8.  Neuroscientific therapies for atrial fibrillation.

Authors:  Peter Hanna; Eric Buch; Stavros Stavrakis; Christian Meyer; John D Tompkins; Jeffrey L Ardell; Kalyanam Shivkumar
Journal:  Cardiovasc Res       Date:  2021-06-16       Impact factor: 10.787

9.  The Prevalence of Japanese Outpatients with Hypertension Who Meet the Definition of Treatment Resistant Hypertension and Are Eligible for Enrolment in Clinical Trials of Endovascular Ultrasound Renal Denervation.

Authors:  Keisuke Okamura; Kazuyuki Shirai; Tetsu Okuda; Hidenori Urata
Journal:  Intern Med       Date:  2017-10-16       Impact factor: 1.271

10.  Accurate Depth of Radiofrequency-Induced Lesions in Renal Sympathetic Denervation Based on a Fine Histological Sectioning Approach in a Porcine Model.

Authors:  Atsushi Sakaoka; Hisako Terao; Shintaro Nakamura; Hitomi Hagiwara; Toshihito Furukawa; Kiyoshi Matsumura; Kenichi Sakakura
Journal:  Circ Cardiovasc Interv       Date:  2018-02       Impact factor: 6.546

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