1417Evaluation of later morphologic alterations in renal artery wall and nerves in response to catheter-based renal denervation in sheep: comparison of the single-point and multiple-point RDN catheters

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
M Taborsky ◽  
L Cervenka ◽  
L Kopkan ◽  
Z Tonar ◽  
D Richter ◽  
...  
2018 ◽  
pp. 891-901 ◽  
Author(s):  
M. TÁBORSKÝ ◽  
D. RICHTER ◽  
Z. TONAR ◽  
T. KUBÍKOVÁ ◽  
A. HERMAN ◽  
...  

This study evaluated the subacute morphologic alterations in renal artery wall and renal nerves in response to catheter-based renal denervation (RDN) in sheep and also compared the efficiency of single-point and multiple-point ablation catheters. Effect of each ablation catheter approved for the clinical use (Symplicity FlexTM, Medtronic, Inc., or EnligHTNTM, St. Jude Medical, INC.) was compared to intact contralateral renal artery in 12 sheep by histopathology and immunohistochemistry evaluation after a 10-day period post-RDN procedure. The safety was verified by extensive evaluation of kidney morphology. Vascular wall lesions and nerve injuries were more pronounced in those animals treated with multi-point EnligHTN catheter when compared with animals treated with single-point Symplicity Flex catheter. However, neither RDN procedure led to complete renal nerve ablation. Both systems, tested in the present study, provided only incomplete renal nerve ablation in sheep. Moreover, no appreciable progression of the nerve disintegration in subacute phase post-RDN procedure was observed. This study further supports the notion that the effectiveness remains fully dependent on anatomical inter-individual variability of the sympathetic nerve plexus accompanying the renal artery. Therefore, new systems providing deeper penetrance to targeted perivascular structure would be more efficient.


2017 ◽  
pp. 601-614 ◽  
Author(s):  
M. TÁBORSKÝ ◽  
D. RICHTER ◽  
Z. TONAR ◽  
T. KUBÍKOVÁ ◽  
A. HERMAN ◽  
...  

Renal sympathetic hyperactivity is critically involved in hypertension pathophysiology; renal denervation (RDN) presents a novel strategy for treatment of resistant hypertension cases. This study assessed effects of two RDN systems to detect acute intravascular, vascular and peri-vascular changes in the renal artery, and renal nerve alterations, in the sheep. The procedures using a single-point or multi-point ablation catheters, Symplicity FlexTM, Medtronic versus EnligHTNTM, St. Jude Medical were compared; the intact contralateral kidneys served as controls. Histopathological and immunohistochemical assessments were performed 48 h after RDN procedures; the kidney and suprarenal gland morphology was also evaluated. Special staining methods were applied for histologic analysis, to adequately score the injury of renal artery and adjacent renal nerves. These were more pronounced in the animals treated with the multi-point compared with the single-point catheter. However, neither RDN procedure led to complete renal nerve ablation. Forty-eight hours after the procedure no significant changes in plasma and renal tissue catecholamines were detected. The morphologic changes elicited by application of both RDN systems appeared to be dependent on individual anatomical variability of renal nerves in the sheep. Similar variability in humans may limit the therapeutic effectiveness of RDN procedures used in patients with resistant hypertension.


Cardiology ◽  
2015 ◽  
Vol 131 (3) ◽  
pp. 189-196 ◽  
Author(s):  
Minfu Bai ◽  
Chaokuan Yang ◽  
Chuanyu Gao ◽  
Xianpei Wang ◽  
Hongzhi Liu ◽  
...  

Objectives: This study was designed to observe the efficacy and safety of renal denervation from the inside and outside of renal arteries. Methods: Fourteen beagles were randomly divided into a control group (n = 4) and treatment group (n = 10). One renal artery in every beagle of the treatment group was randomly assigned to an intimal group (10 renal arteries) which underwent percutaneous renal denervation from the inside, and another renal artery was assigned to an adventitial group (10 renal arteries) which underwent renal denervation from the outside by laparotomy. Results: Compared with the intimal group, the renal norepinephrine (NE) concentration in the adventitial group had significantly decreased (p = 0.003) at 3 months postsurgery. Renal artery HE staining showed that the perineurium from the adventitial group appeared thickened. Western blotting showed that renal tissue tyrosine hydroxylase (TH) protein expression in the adventitial group was significantly lower than that in the intimal group (p < 0.01) at 3 months postsurgery. There was a renal artery stenosis and a renal atrophy in the intimal group after 1 month of follow-up. Conclusion: The inhibitory effect on renal sympathetic nerve activity was more effective in the adventitial group than the intimal group, and renal denervation in the former group was safe.


2014 ◽  
Vol 57 (3) ◽  
Author(s):  
Andrea Bizzarri

<p>The focus on the present study is on the point-source approximation of a seismic source. First, we compare the synthetic motions on the free surface resulting from different analytical evolutions of the seismic source (the Gabor signal (G), the Bouchon ramp (B), the Cotton and Campillo ramp (CC), the Yoffe function (Y) and the Liu and Archuleta function (LA)). Our numerical experiments indicate that the CC and the Y functions produce synthetics with larger oscillations and correspondingly they have a higher frequency content. Moreover, the CC and the Y functions tend to produce higher peaks in the ground velocity (roughly of a factor of two). We have also found that the falloff at high frequencies is quite different: it roughly follows ω<span><sup>−2</sup></span> in the case of G and LA functions, it decays more faster than ω<span><sup>−2</sup></span> for the B function, while it is slow than ω<span><sup>−1</sup></span> for both the CC and the Y solutions. Then we perform a comparison of seismic waves resulting from 3-D extended ruptures (both supershear and subshear) obeying to different governing laws against those from a single point-source having the same features. It is shown that the point-source models tend to overestimate the ground motions and that they completely miss the Mach fronts emerging from the supershear transition process. When we compare the extended fault solutions against a multiple point-sources model the agreement becomes more significant, although relevant discrepancies still persist. Our results confirm that, and more importantly quantify how, the point-source approximation is unable to adequately describe the radiation emitted during a real world earthquake, even in the most idealized case of planar fault with homogeneous properties and embedded in a homogeneous, perfectly elastic medium.</p>


PLoS ONE ◽  
2016 ◽  
Vol 11 (3) ◽  
pp. e0150662 ◽  
Author(s):  
Adelina Doltra ◽  
Arthur Hartmann ◽  
Philipp Stawowy ◽  
Leonid Goubergrits ◽  
Titus Kuehne ◽  
...  

2018 ◽  
Vol 28 (8) ◽  
pp. 3355-3361 ◽  
Author(s):  
Monica Sigovan ◽  
Salim Si-Mohamed ◽  
Pierre-Yves Courand ◽  
Brahim Harbaoui ◽  
Marc Sapoval ◽  
...  

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 491
Author(s):  
Thuy Thi Bich Phung ◽  
Son Van Chu ◽  
Son Thien Vu ◽  
Hanh Thi Pham ◽  
Hang Minh Nguyen ◽  
...  

We investigated Nucleos(t)ide-analogue (NA)-resistance mutations (mt) in 142 treatment-naive children with Chronic Hepatitis B (CHB), using a sensitive co-amplification at lower denaturation temperature (COLD)-PCR with Sanger DNA sequencing. An NA resistance-associated mt in the hepatitis B virus (HBV) reverse transcriptase (RT) was found in 66.2% of the patients, with nonclassical mt contributing the most (64.8%). Significantly higher frequencies of Lamivudine (LMV) and Adefovir dipivoxil (ADF) resistance-associated mt were found in genotypes B and C, respectively (ORLMV/ADF: 1495.000; 95% CI: 89.800–24,889.032; p < 0.001). Single-point mt associated to LMV and ADF resistance were detected in 59.9% of the tested children with rtV207M (38.0%) and rtN238T (9.9%) being the most frequent. Multiple-point mt were found only in 8 cases (5.6%): 6 children carried double mt (rtV207M + rtL229V; rtV207M + rtI233V; rtV207I + rtV207M × 2 cases; rtV207M + rtS213T; rtN238A + rtS256G) relating to LMV or/and ADF resistance and 3 children carried triple mt (rtL180M + rtM204I + rtN238T; rtV207M + rtS213T + rtS256G) or quadruple mt (rtL180M + rtM204V + rtV207I/M) for LMV-ADF resistance and Entecavir-reduced susceptibility. Our data indicate that significantly higher frequencies of LMV and ADF-associated mutations were found in treatment-naïve children infected with HBV genotypes B and C, respectively. The developed COLD-PCR method and obtained data may contribute to the development of suitable treatments for children with CHB.


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