Abstract
Renal denervation through catheter-based ablation of renal nerves appears to be a promising therapy to treat resistant hypertension. Currently, there are several approaches in development to achieve ablation. These include energy-based approaches using radiofrequency (RF), ultrasound (intravascular and extra-vascular), beta-radiation and cryoablation [1–8]. All energy-based approaches are untargeted and have the potential to damage the vascular wall and surrounding tissue. Moreover, OCT findings have shown that RF probes damage the endothelial layer and cause thrombus formation on the intraluminal side [9]. Late stenosis in renal arteries have also been reported in a limited number of cases with RF ablation [10, 11]. In addition, energy-based approaches are not suitable for treating stented areas of the renal arteries [12].
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Acknowledgements
The authors would like to thank Drs. Jorge Garcia, Félix Vega and Michelle Kelly (ISIS Services) for conducting preclinical studies and Drs. Narayan Raju (Pathology Research Laboratories) and Dr. Renu Virmani (CVPath Institute) for conducting histopathology and preparing immunohistochemical stains and pathology reports.
In addition, the authors thank the clinical investigators Drs. Konstantine Kipiani, Vakhtang Kipiani and Tea Mukhuradze (The Center for Vascular and Heart Diseases of Georgia, Tbilisi, Georgia); Dr. Horst Sievert (CardioVasculares Centrum, St. Katharinen-Krankenhaus, Frankfurt, Germany); Dr. Nicholas Kipshidze (Lenox Hill Hospital, New York, NY and General Director and Physician-in-Chief, Kipshidze University Hospital, Tbilisi, Georgia); and Dr. Michael Wholey for conducting the study and providing the clinical data for this manuscript. The Investigators plan to publish the results once follow-up data from all patients become available.
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Wholey, M.H., Stein, E., Evans, M., Venkateswara Rao, K.T. (2015). Targeted Renal Nerve Deactivation by Neurotropic Agents. In: Heuser, R., Schlaich, M., Sievert, H. (eds) Renal Denervation. Springer, London. https://doi.org/10.1007/978-1-4471-5223-1_16
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DOI: https://doi.org/10.1007/978-1-4471-5223-1_16
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