Pulmonary artery denervation using catheter-based ultrasonic energy

Area of Science:

• Cardiovascular Research
• Pulmonary Hypertension
• Medical Device Technology

Background:

• Pulmonary arterial hypertension (PAH) involves vascular remodeling and right heart failure.
• Radio-frequency pulmonary artery denervation (PDN) shows promise but has limited denervation depth.
• High-frequency ultrasound can target deeper tissues, sparing vessel intima and media.

Purpose of the Study:

• To assess the feasibility, safety, and efficacy of ultrasound pulmonary artery denervation (PDN).
• To investigate ultrasound energy delivery for targeting pulmonary sympathetic nerves.
• To evaluate ultrasound PDN in a preclinical model of pulmonary hypertension.

Main Methods:

• Histological analysis of human pulmonary artery innervation.
• Finite element analysis of ultrasound energy distribution.
• Ex vivo and in vivo (swine) studies of ultrasound PDN efficacy and safety.

Main Results:

• Human pulmonary arteries show predominantly sympathetic innervation (>40% of nerves >4 mm deep).
• Ultrasound achieved temperatures >47°C to a depth of 10 mm.
• Ultrasound PDN reduced pulmonary artery pressure in swine, with no adverse events up to 95 days.
• Histology confirmed nerve alteration and sparing of intima/media in treated animals.

Conclusions:

• Ultrasound PDN is a safe and effective preclinical treatment for pulmonary hypertension.
• The technology allows for deep energy delivery to target sympathetic nerves in the pulmonary artery.
• This approach holds potential for treating human pulmonary arterial hypertension.