Efficacy and safety of extracorporeal high-intensity focused ultrasound with color Doppler ultrasonic location in renal sympathetic denervation

JIN Can; ZHANG Xiao-zhong

doi:10.3969/j.1674-4055.2014.06.19

Abstract：Objective To study the efficacy and safety of extracorporeal high-intensity focused ultrasound (HIFU) through color Doppler ultrasonic locating in renal sympathetic denervation.Methods Male Bama minipigs (aged 8 months old,n=18) were randomly divided into ablation group 1 (HIFU=280 W×2 s), ablation group 2 (320 W×2 s) and control group (only CDFI, eachn=6). The blood pressure was detected, blood samples were collected and blood indexes [including norepinephrine (NE) and renal function] were reviewed in all minipigs before operation, immediately after operation, and 7 d and 28 d after operation. After operation for 28 d the minipigs were euthanatized and the changes of histopathology were observed.Results After operation for 7 d, systolic blood pressure (SBP) decreased [(132.67±6.86) mmHgvs. (122.33±6.15) mmHg,P<0.05], and after 28 d, SBP decreased [(132.67±6.86) mmHgvs. (117.83±6.49) mmHg,P<0.01] in ablation group 2. Compared with control group, SBP decreased after 7 d and 28 d in ablation group 2 (allP<0.05). After operation for 7 d and 28 d, the concentration of plasma NE decreased in control group, ablation group 1 and ablation group 2 (allP<0.05). Compared with control group and ablation group 1, the concentration of plasma NE decreased in ablation group 2 (allP<0.01) 7 d and 28 d after operation. The comparisons in serum creatinine, blood urea nitrogen and uric acid showed difference had no statistical significance (allP>0.05) in 3 groups before and after operation and among 3 groups. The observation of light microscope showed that vascular wall membrane structure was completed without injury, degeration and necrosis, but in ablation group 2, neurocyte edema and degeration, and mild demyelination were observed. Conclusion HIFU through color Doppler ultrasonic locating is feasible in renal sympathetic denervation, which can remove renal syspathetic nerve without invasion, inhibit NE release and reduce blood pressure.