Research ArticleHypertension

Arterial microanatomy determines the success of energy-based renal denervation in controlling hypertension

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Science Translational Medicine  29 Apr 2015:
Vol. 7, Issue 285, pp. 285ra65
DOI: 10.1126/scitranslmed.aaa3236

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Interrupting the innervation to the kidney can ameliorate hypertension, but clinical trials have been disappointing. To better understand why, Tzafriri et al. examined the damaged tissue surrounding the heat delivery electrode in pigs. They also modeled heat transfer, including the effect of irrigation of the electrode and of the microanatomy surrounding the ablation site. They concluded that the extent of the ablation and the nerve damage varied as a result of local blood vessels, lymph nodes, and other substructures. Blood pressure decreased more in pigs that suffered damage to more nerves, indicating that microanatomy-caused variation in the effectiveness of nerve ablation could be responsible for variation in the effectiveness of renal denervation.

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