Laparoscopic Renal Denervation System for Treating Resistant Hypertension: Overcoming Limitations of Catheter-Based...

Area of Science:

• Cardiovascular medicine
• Interventional cardiology
• Nephrology

Background:

• Percutaneous renal denervation systems have shown limited efficacy in treating resistant hypertension due to limitations in ablating deeper renal nerves.
• Existing systems face challenges in effectively targeting and ablating nerves around the renal artery without causing collateral thermal damage.

Purpose of the Study:

• To introduce and evaluate a novel laparoscopic denervation system (LDS) for complete renal nerve ablation.
• To assess the safety and efficacy of LDS in achieving nerve denervation while preventing thermal arterial damage.

Main Methods:

• Developed a laparoscopic denervation system (LDS) with flexible electrodes designed to conform to the arterial wall.
• Utilized in-silico models to simulate heat distribution and an acute animal study (swine model) to demonstrate in vivo feasibility.
• Employed histological analysis to confirm arterial integrity and measured blood pressure changes post-procedure.

Main Results:

• In-silico simulations confirmed localized heat distribution, preventing damage to the outer arterial wall.
• Animal studies demonstrated maximized nerve denervation (20.78% decrease in neural density, P < 0.001) with controlled energy delivery.
• Histological analysis showed intact artery lumens, and a significant acute reduction in systolic blood pressure (9.55 mmHg, p < 0.001) was observed.

Conclusions:

• The laparoscopic denervation system (LDS) shows potential for effective and safe renal nerve ablation.
• LDS can control hypertension by targeting renal nerves, irrespective of anatomical variations.
• This novel technique offers a promising therapeutic option for resistant hypertension.