Objectives The feasibility of noninvasive renal sympathetic denervation (RSD) using the novel approach of extracorporeal high-intensity focused ultrasound (HIFU) was investigated in this study.
Methods Catheter-based RSD has achieved promising clinical outcomes. Methods Under the guidance of Doppler flow imaging, therapeutic ablations (250 W×2 seconds) were performed by HIFU on the bilateral renal nerves (36.3 ± 2.8 HIFU emissions in each animal) in an average 27.4-minute procedure in 18 healthy canines. The other 5 canines that were not subjected to acoustic energy treatment were used as the sham group. The animals were sacrificed on day 6 or 28. The blood pressure (BP), plasma noradrenaline (NA) level and renal function were determined on days 0, 6 and 28. Pathological examinations were performed on all retrieved samples.
Results All of the animals survived the treatment. After ablation, the BP and NA significantly decreased compared to the baseline values (Bp changes -15.9/-13.6 mmHg, NA change -55.4%, p < 0.005, respectively, on 28 days after ablation) and compared to the sham group on days 6 and 28. Ablation lesions around the renal artery adventitia were observed on day 6. A histologic examination revealed the disruption of nerve fibers, necrosis of Schwann cells and neurons, and apparent denervation on day 28. No procedure-related complications were observed.
Conclusions Effective RSD was successfully achieved using the HIFU method in canines. Thus, noninvasive HIFU may be further explored as an important and novel strategy for RSD.
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