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Radiosurgical Ablation of the Renal Nerve in a Porcine Model: A Minimally Invasive Therapeutic Approach to Treat
Nikhilesh Bhatt1, Sarah A Long1, Edward A Gardner2
1Fogarty Institute for Innovation.
Insights
Minimally invasive radiosurgery effectively ablated renal nerves in a porcine model, reducing norepinephrine levels. This novel approach shows promise for treating refractory hypertension when conventional methods fail.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Minimally Invasive Surgery
Background:
- Hypertension is a significant risk factor for cardiovascular diseases, including heart attack, stroke, and kidney disease.
- Current hypertension treatments are often inadequate, with over half of patients not achieving blood pressure control.
Purpose of the Study:
- To assess the feasibility, safety, and efficacy of using radiosurgery to ablate renal nerves for treating refractory hypertension.
- To explore a novel minimally invasive treatment option for uncontrolled high blood pressure.
Main Methods:
- A Hanford porcine model (N=6) was utilized to test the CyberHeart radiosurgical platform for renal nerve ablation.
- Norepinephrine (NE) levels were measured pre- and post-procedure.
- Renal nerve and arterial histology were examined to evaluate treatment effects.
Main Results:
- Plasma norepinephrine levels decreased significantly over a six-month period.
- Histology confirmed renal nerve ablation with no significant arterial injury.
- Kidney function markers (urea, nitrogen, creatinine) remained unchanged.
Conclusions:
- CyberHeart radiosurgery is a feasible method for ablating renal nerves.
- The procedure led to a reduction in norepinephrine and demonstrated targeted renal nerve injury.
- This technique presents a potentially safe and effective treatment for 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 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.