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Freyhardt, Patrick; Schütze, Josephine; Donners, Ricardo; Schnorr, Jörg; Stolzenburg, Nicola; Rinnenthal, Jan L.; Penzkofer, Tobias; Hamm, Bernd; Günther, Rolf W. und Streitparth, Florian (2018): Renal Denervation by Transaortic Periarterial Ethanol Injection: An Experimental Study in Porcines. In: Cardiovascular and Interventional Radiology, Bd. 41, Nr. 12: S. 1943-1951

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Abstract

AimsTo evaluate the feasibility, safety and efficacy of renal sympathetic denervation via endoluminal transaortic periarterial ethanol injection.Methods and Results: In 11 normotensive pigs transaortic puncture was performed with a 90-cm 21G needle with subsequent unilateral ethanol injection to the periarterial space. Needle placement was achieved using a 7F steerable sheath fluoroscopically positioned slightly above the renal artery origin. Blood pressure measurements and abdominal CT scans were performed immediately pre- and postintervention and 4weeks later. After euthanasia norepinephrine concentration of both kidneys (RTNEC) was determined and renal arteries and surrounding tissues histologically examined to assess induced nerve fibre degeneration.Results: All but one procedure were technically successful. One major complication with accidental ethanol injection into the renal artery and subsequent infarction occurred. One pig died from no intervention-related cardiac arrest. The 4-week follow-up was uneventful in the remaining 10 animals. RTNEC was significantly lower on the treated side in eight of ten pigs (mean decrease 36.6%) with correlating histopathological signs of nerve degeneration.Conclusion: sRenal sympathicolysis by transaortic periarterial ethanol injection was feasible and effective in a porcine model. This approach may be an alternative to catheter-based RFA or other methods of renal denervation.

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