title: Renal artery nerve distribution and density in the porcine model: biologic implications for the development of radiofrequency ablation therapies.
abstract: Catheter-based renal artery denervation has demonstrated to be effective in decreasing blood pressure among patients with refractory hypertension. The anatomic distribution of renal artery nerves may influence the safety and efficacy profile of this procedure. We aimed to describe the anatomic distribution and density of periarterial renal nerves in the porcine model. Thirty arterial renal sections were included in the analysis by harvesting a tissue block containing the renal arteries and perirenal tissue from each animal. Each artery was divided into 3 segments (proximal, mid, and distal) and assessed for total number, size, and depth of the nerves according to the location. Nerve counts were greatest proximally (45.62% of the total nerves) and decreased gradually distally (mid, 24.58%; distal, 29.79%). The distribution in nerve size was similar across all 3 sections (∼40% of the nerves, 50-100 μm; ∼30%, 0-50 μm; ∼20%, 100-200 μm; and ∼10%, 200-500 μm). In the arterial segments ∼45% of the nerves were located within 2 mm from the arterial wall whereas ∼52% of all nerves were located within 2.5 mm from the arterial wall. Sympathetic efferent fibers outnumbered sensory afferent fibers overwhelmingly, intermixed within the nerve bundle. In the porcine model, renal artery nerves are seen more frequently in the proximal segment of the artery. Nerve size distribution appears to be homogeneous throughout the artery length. Nerve bundles progress closer to the arterial wall in the distal segments of the artery. This anatomic distribution may have implications for the future development of renal denervation therapies.
authors.affiliation: Skirball Center for Cardiovascular Research, Cardiovascular Research Foundation, New York, NY.
authors.forename: Armando
authors.initials: A
authors.lastname: Tellez
authors.forename: Serge
authors.initials: S
authors.lastname: Rousselle
authors.forename: Taylor
authors.initials: T
authors.lastname: Palmieri
authors.forename: William R
authors.initials: WR
authors.lastname: Rate
authors.forename: Joan
authors.initials: J
authors.lastname: Wicks
authors.forename: Ashley
authors.initials: A
authors.lastname: Degrange
authors.forename: Chelsea M
authors.initials: CM
authors.lastname: Hyon
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Gongora
authors.forename: Randy
authors.initials: R
authors.lastname: Hart
authors.forename: Will
authors.initials: W
authors.lastname: Grundy
authors.forename: Greg L
authors.initials: GL
authors.lastname: Kaluza
authors.forename: Juan F
authors.initials: JF
authors.lastname: Granada
mesh_terms: D000818:Animals; D017115:Catheter Ablation / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000628:therapy; D007668:Kidney / Q000294:innervation; D008953:Models, Anatomic; D023421:Models, Animal; D008959:Models, Neurological; D012077:Renal Artery / Q000294:innervation*; D034421:Sus scrofa / Q000033:anatomy & histology*; D013562:Sympathectomy / Q000379:methods*; D013564:Sympathetic Nervous System / Q000033:anatomy & histology; D057170:Translational Research, Biomedical
keywords: BP; CGRP; NBF; SNS; TH; Tyrosine hydroxylase; blood pressure; calcitonin gene-related peptide; neutral buffered formalin; sympathetic nervous system