Bhatt Nikhilesh, Long Sarah A, Gardner Edward A, Tay Jonathan, Ladich Elena, Chamberlain David, Fogarty Thomas J, Maguire Patrick J
Fogarty Institute for Innovation.
CyberHeart Inc.
Cureus. 2017 Feb 26;9(2):e1055. doi: 10.7759/cureus.1055.
Hypertension is strongly associated with cardiovascular diseases such as heart failure, stroke, kidney disease, and has been correlated with an increased risk for heart attack. Current treatment regimens for hypertension are highly inadequate, with reports indicating that only 50.1% of the clinical population with the disease has their blood pressure under control.
To study the feasibility of using minimally invasive radiosurgery to ablate the renal nerves as a novel treatment for refractory hypertension, and to assess the safety and efficacy of such an approach.
A Hanford porcine (miniswine) model (N = 6) was used to investigate the feasibility of using the CyberHeart radiosurgical platform (CyberHeart Inc., Mountain View, CA, USA) to create safe renal nerve ablations. Norepinephrine (NE) levels were measured pre and post treatment. Additionally, renal nerve and arterial histology were studied to examine effect.
Plasma norepinephrine levels showed a decrease over the six-month time point. Urea, nitrogen, and creatinine levels showed no changes post procedure. Histology documented no significant arterial injury in targeted areas. Renal nerves documented histologic change consistent with nerve ablation.
CyberHeart radiosurgery of the renal nerve is feasible and resulted in norepinephrine reduction and renal nerve injury consistent with radiosurgical targeted ablation.
高血压与心力衰竭、中风、肾病等心血管疾病密切相关，并且与心脏病发作风险增加有关。目前的高血压治疗方案严重不足，报告显示，患有该疾病的临床患者中只有50.1%的人的血压得到控制。
研究使用微创放射外科手术消融肾神经作为难治性高血压新治疗方法的可行性，并评估这种方法的安全性和有效性。
使用汉福德猪（小型猪）模型（N = 6）来研究使用CyberHeart放射外科平台（美国加利福尼亚州山景城的CyberHeart公司）进行安全肾神经消融的可行性。在治疗前后测量去甲肾上腺素（NE）水平。此外，研究肾神经和动脉组织学以检查效果。
血浆去甲肾上腺素水平在六个月时间点显示下降。尿素、氮和肌酐水平在手术后没有变化。组织学记录显示目标区域没有明显的动脉损伤。肾神经记录显示组织学变化与神经消融一致。
肾神经的CyberHeart放射外科手术是可行的，并且导致去甲肾上腺素减少和与放射外科靶向消融一致的肾神经损伤。
