Transcatheter non-contact microwave ablation may enable circumferential renal artery denervation while sparing the vessel intima and media

Pierre C. Qian, Michael A. Barry, Sara Al-Raisi, Pramesh Kovoor, Jim Pouliopoulos, Chrishan J. Nalliah, Abhishek Bhaskaran, William Chik, Rahul Kurup, Virginia James, Winny Varikatt, Alistair McEwan, Aravinda Thiagalingam, Stuart P. Thomas

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Aims: Trials of transcatheter renal artery denervation (RDN) have failed to show consistent antihypertensive efficacy. Procedural factors and limitations of radiofrequency ablation can lead to incomplete denervation. The aim of the study was to show that non-contact microwave catheter ablation could produce deep circumferential perivascular heating while avoiding injury to the renal artery intima and media.

Methods and results: A novel microwave catheter was designed and tested in a renal artery model consisting of layers of phantom materials embedded with a thermochromic liquid crystal sheet, colour range 50-78°C. Ablations were performed at 140 W for 180 sec and 120 W for 210 sec, delivering 25,200 J with renal arterial flow at 0.5 L/min and 0.1 L/min. Transcatheter microwave ablations 100-160 W for 180 sec were then performed in the renal arteries of five sheep. In vitro, ablations at 140 W and 0.5 L/min flow produced circumferential lesions 5.9±0.2 mm deep and 19.2±1.5 mm long with subendothelial sparing depth of 1.0±0.1 mm. In vivo, transcatheter microwave ablation was feasible with no collateral visceral thermal injury. There was histological evidence of preferential outer media and adventitial ablation.

Conclusions: Transcatheter microwave ablation for RDN appears feasible and provides a heating pattern that may enable more complete denervation while sparing the renal arterial intima and media.

Original languageEnglish
Pages (from-to)e1907-e1915
Number of pages9
JournalEuroIntervention
Volume12
Issue number15
DOIs
Publication statusPublished - 3 Feb 2017
Externally publishedYes

Keywords

  • catheter ablation
  • innovation
  • preclinical research
  • renal sympathetic denervation
  • Interventions for hypertension
  • Renal denervation
  • Tools, devices and techniques

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