Percutaneous transperitoneal renal sympathetic denervation by radiofrequency ablation - a new method for the treatment of hypertension

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K08234
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Osaka City University
• Principal Investigator: Yamamoto Akira 大阪市立大学, 大学院医学研究科, 准教授 (60419695)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 腎交感神経除神経術 / 経皮的ラジオ波焼灼術

Outline of Final Research Achievements

Experiments were conducted on a method of radiofrequency ablation (RFA) from outside the renal artery.
Safety: (1) Hemorrhage was observed after 1 side puncture (1/14 (7%)) for n=14 number of kidneys; 3 (3/14 (21%)) right kidneys showed hydronephrosis; (2) There was a significant decrease in creatinine (p=0.02) between preoperatively and 1 month postoperatively. There was no evidence of renal infarction during the course of the procedure. Angiography at the final 3 months showed no evidence of stenosis in any of the 14 arteries. The serum noradrenaline was significantly lower at 3 months compared to the preoperaton (p=0.03). Blood pressure showed a significant decrease at 1 and 3 months (p<0.03, respectively).
The results only suggest the efficacy and safety of renal sympathectomy with RFA.

Free Research Field

放射線医学

Academic Significance and Societal Importance of the Research Achievements

カテーテルによる腎交感神経除神経術の代わりにラジオ波焼灼術(RFA)による徐神経術を行った。14個の腎のうち、1個の焼灼後に出血が認められた。3個の右腎には術後水腎症が認められた。3か月後の腎機能は有意に低下していた。腎梗塞や3か月後に血管の狭小化は認めなかった。ノルアドレナリンは術後3か月で有意な低下を認めた。血圧は、1か月、3か月と低下を認めた。これらの結果からは、RFAによる腎交感神経除神経術は高血圧の新たな治療として安全で有効であることが示唆されたが、さらなる検討が必要と考えられた。