Abstract 12942: Beta Radiation for Renal Nerve Denervation: Initial Feasibility and Safety
BACKGROUND: Sympathetic renal denervation shows promise in treating resistant hypertension. Current approach using percutaneous radio frequencyablation is currently undergoing evaluation, but has several limitations. Vascular brachytherapy has the potential to damage nerves. The purpose of the present study is to assess the safety and feasibility of renal artery brachytherapy for sympathetic renal denervation.
METHODS: A total of 10 normotensive domestic swine underwent vascular brachytherapy to left and right renal arteries using the Beta-Cath™3.5F System with doses of 25 Gy and 50 Gy at 2 mm from the source center. Each treated group had 8 arteries; 4 arteries not treated served as a control. Follow up obtained at 1 or 2 months included angiogram, intravascular ultrasound, norepinephrine levels, and histopathology.
RESULTS: Overall, the vascular brachytherapy procedure was safe with no apparent angiographic or ultrasound injuries to the vessel. Histology demonstrated a varied degree of thermal injury, which was more pronounced in the 50 Gy group. The majority of the examined nerves showed some degree of injury. (Figure) There was dose-related effect on the severity of the nerve injury. There was variable degree of arteriolar changes in the examined sections, most showing a varied degree of endothelial cell loss of approximately 2% to 20%.
CONCLUSIONS: This initial feasibility and safety study of renal nerve denervation mediated by low and intermediate β-radiation dosages indicates that this approach can cause substatntial nerve damage while avoiding a significant damage to the renal artery.
- © 2012 by American Heart Association, Inc.