scholarly journals Renal Denervation Using an Irrigated Radiofrequency Ablation Catheter in Patients with Resistant Hypertension

Author(s):  
Rodolfo Staico ◽  
Luciana Armaganijan ◽  
Dalmo Moreira ◽  
Marcio Sousa ◽  
Flavio Borelli ◽  
...  
2013 ◽  
Vol 34 (28) ◽  
pp. 2114-2121 ◽  
Author(s):  
Márcio Galindo Kiuchi ◽  
George Luiz Marques Maia ◽  
Maria Angela Magalhães de Queiroz Carreira ◽  
Tetsuaki Kiuchi ◽  
Shaojie Chen ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Noel Pérez ◽  
Karl Muffly ◽  
Stephen E. Saddow

Abstract Background Renal denervation with radiofrequency ablation has become an accepted treatment for drug-resistant hypertension. However, there is a continuing need to develop new catheters for high-accuracy, targeted ablation. We therefore developed a radiofrequency bipolar electrode for controlled, targeted ablation through Joule heating induction between 60 and 100 °C. The bipolar design can easily be assembled into a basket catheter for deployment inside the renal artery. Methods Finite element modeling was used to determine the optimum catheter design to deliver a minimum ablation zone of 4 mm (W) × 10 mm (L) × 4 mm (H) within 60 s with a 500 kHz, 60 Vp-p signal, and 3 W maximum. The in silico model was validated with in vitro experiments using a thermochromic phantom tissue prepared with polyacrylamide gel and a thermochromic ink additive that permanently changes from pink to magenta when heated over 60 °C. Results The in vitro ablation zone closely matched the size and shape of the simulated area. The new electrode design directs the current density towards the artery walls and tissue, reducing unwanted blood temperature increases by focusing energy on the ablation zone. In contrast, the basket catheter design does not block renal flow during renal denervation. Conclusions This computational model of radiofrequency ablation can be used to estimate renal artery ablation zones for highly targeted renal denervation in patients with resistant hypertension. Furthermore, this innovative catheter has short ablation times and is one of the lowest power requirements of existing designs to perform the ablation.


2021 ◽  
Author(s):  
Noel Pérez ◽  
Karl Muffly ◽  
Stephen E. Saddow

Abstract Background: Renal denervation with radiofrequency ablation has become an accepted treatment for drug-resistant hypertension. However, there is a continuing need to develop new catheters for high-accuracy, targeted ablation. We, therefore, developed a radiofrequency ablation device with a basket catheter and bipolar electrodes for controlled, targeted ablation through Joule heating induction between 60°C and 100°C.Methods: Finite element modeling was used to determine the optimum catheter design to deliver a minimum ablation zone of 4 mm (W) x 10 mm (L) x 4 mm (H) within 60 seconds with a 500 kHz, 60 Vp-p signal, and 0.9 W maximum. The computational model was validated using in vitro phantom tissue impregnated with a color-changing thermochromic pigment.Results: The in vitro ablation zone closely matched the size and shape of the simulated area. The new electrode design directs the current density towards the artery walls and tissue, reducing unwanted blood temperature increases by focusing energy on the ablation zone. In contrast, the basket catheter design does not block renal flow during renal denervation.Conclusions: This computational model of radiofrequency ablation can be used to estimate renal artery ablation zones for highly targeted renal denervation in patients with resistant hypertension. Furthermore, this innovative catheter has short ablation times and the lowest power requirement of existing designs to perform the ablation.


2016 ◽  
Vol 223 ◽  
pp. 31-33
Author(s):  
Dirk Prochnau ◽  
Christina Schweizer ◽  
Matthias Hoyme ◽  
Hans-Reiner Figulla ◽  
P. Christian Schulze ◽  
...  

2014 ◽  
Vol 10 (5) ◽  
pp. 640-645 ◽  
Author(s):  
Dirk Prochnau ◽  
Stefan Heymel ◽  
Sylvia Otto ◽  
Hans-Reiner Figulla ◽  
Ralf Surber

Author(s):  
Zong-Jun Liu

Objective: To assess the effectiveness of catheter-based renal denervation for reducing blood pressure in patients withresistant hypertension using a 5 F microtube-irrigated ablation catheter.Methods: Sixty patients with resistant hypertension were divided into two groups: a microtube-irrigated ablation catheter group and a general ablation catheter group. We conducted 12-month follow-up of all patients and recorded clinical blood pressure, ambulatory blood pressure, medication use, and biochemistry test results in both groups at the baseline and at the 12-month follow-up.Results: All patients underwent renal denervation. At the 6-month follow-up, ambulatory blood pressure in the microtube-irrigated ablation catheter group was significantly lower than in the general ablation catheter group (systolic blood pressure 142.0 ± 14.4 mmHg vs. 150.8 ± 17.9 mmHg, P = 0.04; diastolic blood pressure 81.2 ± 7.0 mmHg vs. 87.6 ± 8.0 mmHg, P = 0.002). At the 12-month follow-up, the between-group difference in ambulatory blood pressure was not statistically significant. At the 12-month follow-up, the number of antihypertensive drugs and diuretics used in the microtube-irrigated ablation catheter group was less than in the general ablation catheter group (P = 0.043). There was no statistical difference between the two groups in the results of biochemistry tests and echocardiography.Conclusion: The microtube-irrigated ablation catheter is more effective in treating hypertension than the generalablation catheter at the 6-month follow up and thus fewer antihypertensive drugs were used in the microtube-irrigatedablation catheter group than in the general ablation catheter group.


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