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Laparoscopic Ablation System for Complete Circumferential Renal Sympathetic Denervation
IEEE Transactions on Bio-Medical Engineering
|March 9, 2021
Summary
A new laparoscopic system for renal denervation (RDN) ensures complete nerve ablation, improving effectiveness for uncontrolled hypertension by reducing nerve injury variability.
Area of Science:
- Cardiovascular Interventions
- Nephrology
- Surgical Technology
Background:
- Catheter-based renal denervation (RDN) shows potential for lowering blood pressure (BP) but suffers from inconsistent patient response.
- Incomplete or asymmetric renal nerve ablation is a likely cause of non-response to current RDN techniques.
Purpose of the Study:
- To develop and evaluate a novel laparoscopic ablation system for complete renal denervation.
- To assess the system's effectiveness in achieving consistent nerve ablation regardless of renal artery anatomy.
Main Methods:
- A laparoscopic ablation system was designed for complete RDN, targeting the tunica externa of renal arteries.
- System effectiveness was validated through computational simulation and a 28-day survival study in pigs.
Main Results:
- Laparoscopic RDN achieved complete circumferential ablation and allowed numerical prediction of ablation patterns.
- The animal study demonstrated significant reductions in systolic BP (22.8 mmHg) and diastolic BP (14.4 mmHg).
- Immunostaining confirmed a significant reduction in sympathetic nerve markers (tyrosine hydroxylase) at treatment sites, correlating with BP reduction.
Conclusions:
- The laparoscopic ablation system effectively achieves complete circumferential RDN and can predict ablation patterns.
- This system offers a significant improvement in RDN effectiveness by minimizing variability in nerve injury, presenting a new option for treating resistant hypertension.
