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基于患者特定模型的导管射频消融肾去神经支配的计算建模。

Computational Modeling of Catheter-based Radiofrequency Renal Denervation with Patient-specific Model.

出版信息

Annu Int Conf IEEE Eng Med Biol Soc. 2021 Nov;2021:4289-4292. doi: 10.1109/EMBC46164.2021.9630677.

Abstract

Renal sympathetic denervation (RDN) is an effective approach for uncontrolled hypertension. Although several studies have compared the ablation characteristics at various locations, there is no direct comparative study on the effect of ablation in main and branch renal artery (RAs) and different electrode materials. The study aims to investigate the effect of different electrode materials (copper, gold, and platinum) and positions (proximal, middle, or distal site) on ablation. A 3D patient-specific renal artery model and a unipolar model (470 kHz) were constructed to mimic RDN. Two therapeutic strategies, including main (site 1 and 2) and branch (site 3) ablations were simulated with three electrode materials. The finite element method was used to calculate the coupled electric-thermal-flow field. Maximum lesion depth, width, area, and lesion angle were analyzed. The results showed that the difference in lesion width and depth was no mere than 0.5 mm, and the maximum difference value in lesion area is 0.683 mm among three electrode materials. The lesion angle of proximal site 1 versus middle site 2 was 58.39 ° and 52.23 °, but the difference between distal site 3 and site 1, or site 2 was 29.19 ° and 35.35 ° respectively. There is no significant difference in the use of the three electrode materials, and ablation at the distal site of the artery is more effective.Clinical Relevance-This provides a reference for the selection of RF electrode materials and ablation locations.

摘要

肾脏去交感神经术(RDN)是治疗未控制高血压的有效方法。尽管已有多项研究比较了不同部位的消融特性,但对于主肾动脉和分支肾动脉(RAs)以及不同电极材料的消融效果,尚无直接的对比研究。本研究旨在探讨不同电极材料(铜、金和铂)和位置(近段、中段或远段)对消融的影响。构建了一个 3D 患者特定的肾动脉模型和一个单极模型(470 kHz)来模拟 RDN。使用三种电极材料模拟了两种治疗策略,包括主(部位 1 和 2)和分支(部位 3)消融。采用有限元法计算了耦合的电热流场。分析了最大病变深度、宽度、面积和病变角度。结果表明,病变宽度和深度的差异不超过 0.5mm,三种电极材料的病变面积最大差异值为 0.683mm。近段部位 1 与中段部位 2 的病变角度为 58.39°和 52.23°,而远段部位 3 与部位 1 或部位 2 的病变角度分别为 29.19°和 35.35°。三种电极材料的使用没有显著差异,动脉远段的消融效果更明显。临床意义-为射频电极材料和消融部位的选择提供了参考。

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