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Transvenous Radiofrequency Ablation of Adrenal Gland: Experimental Study

  • Laboratory Investigation
  • Venous Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The aim was to evaluate a flexible device for transvenous adrenal gland radiofrequency ablation in vitro and in an in vivo animal model.

Materials and Methods

A flexible radiofrequency-tip catheter with an inner-cooling mechanism and a guidewire lumen was made. Then, using a polyvinyl alcohol gel model, the ablation diameter was evaluated and how much energy to deliver in vivo was determined. Finally, transvenous radiofrequency ablation of the left adrenal glands of two pigs was performed, delivering 5000 or 7000 J in a single dose to each. The ablation effects were also assessed by histological examination of hematoxylin–eosin-stained sections.

Results

The mean ablation diameters in the gel model were 20.2 and 21.9 mm in the short axis and 15 and 20 mm in the long axis for 5000 or 7000 J, respectively. The device was inserted into porcine left adrenal vein with no complications. The mean ablation diameters were 10 mm in the shorter axis (whole thickness of porcine left adrenal gland) in the porcine model for 7000 J. Transient increases in blood pressure and heart rate occurred during ablation. Histologically, the adrenal gland showed severe necrosis at ablated area. There was venous congestion upstream in a non-ablated area, and thermal damage to surrounding organs was not observed.

Conclusions

A flexible radiofrequency-tip catheter could be inserted successfully into the left adrenal vein. The left adrenal gland was entirely ablated without any thermal damage to surrounding organs. We suggest transvenous adrenal ablation has potential as a therapeutic option for primary aldosteronism.

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Abbreviations

RF:

Radiofrequency

RFA:

Radiofrequency ablation

APA:

Aldosterone-producing adenoma

AVS:

Adrenal venous sampling

LAV:

Left adrenal vein

H–E:

Hematoxylin–eosin

NADH-TR:

Nicotinamide adenine dinucleotide tetrazolium reduction

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Acknowledgements

This study was conducted with the cooperation of Research and Development Department of Japan Lifeline Co., Ltd. (Tokyo, Japan) and Hanako Medical Co. Ltd. (Saitama, Japan). We are most grateful for their excellent contribution to developing and manufacturing the devices. We thank Dr Trish Reynolds, MBBS, FRACP, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

This study was funded by the Japan Society for the Promotion of Science (KAKENHI) (Grant Number 17K10431).

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan

    Hiroyuki Sakakibara & Kei Takase

  2. Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Kazumasa Seiji, Sota Oguro & Kei Takase

  3. Research & Development Department, Japan Lifeline Co., Ltd., 6-14 Minamicho, Toda-shi, Saitama, 335-0025, Japan

    Kenji Mori, Takuya Masuda, Hisao Miyamoto, Takuya Hirao, Yuki Niwa & Yohei Suzuki

  4. Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Kei Omata, Yuta Tezuka, Yoshikiyo Ono, Ryo Morimoto & Fumitoshi Satoh

  5. Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka-shi, Saitama, 350-1298, Japan

    Yasutaka Baba

  6. Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan

    Fumitoshi Satoh

Authors
  1. Hiroyuki Sakakibara
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  2. Kazumasa Seiji
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  3. Sota Oguro
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  4. Kenji Mori
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  8. Ryo Morimoto
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  9. Takuya Masuda
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  13. Yohei Suzuki
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  14. Yasutaka Baba
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  15. Fumitoshi Satoh
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  16. Kei Takase
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Corresponding author

Correspondence to Kei Takase.

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All applicable international, national, and institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution of practice at which the studies were conducted (Interventional Technical Center, Chiba, Japan). This article does not contain any studies with human participants performed by any of authors.

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Sakakibara, H., Seiji, K., Oguro, S. et al. Transvenous Radiofrequency Ablation of Adrenal Gland: Experimental Study. Cardiovasc Intervent Radiol 45, 1178–1185 (2022). https://doi.org/10.1007/s00270-022-03155-6

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  • DOI: https://doi.org/10.1007/s00270-022-03155-6

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