title: Short-term safety and efficiency of cryoablation for renal sympathetic denervation in a swine model.
abstract: BACKGROUND
  Renal sympathetic nerves are involved in the reflective activation of the sympathetic nervous system in circulatory control. Catheter-based renal denervation (RDN) ameliorated treatment-resistant hypertension safely, but 10%-20% of treated patients are nonresponders to radiofrequency denervation. The purpose of this study was to investigate the safety and efficiency of cryoablation for sympathetic denervation in a swine model and to explore a new way of RDN.
  
  
  METHODS
  Seven swines randomly assigned to two groups: Renal cryoablation (CR) group and control group. The control group underwent renal angiogram only. The CR group underwent renal angiogram plus bilateral renal cryoablation. Renal angiograms via femoral were performed before denervation, after denervation and prior to the sacrifice to access the diameter of renal arterial and the pressure of aorta abdominalis. Euthanasia of the swine was performed on 28-day to access norepinephrine (NE) changes of the renal cortex and the changes of renal nerves.
  
  
  RESULTS
  Cryoablation did not induce severe complications at any time point. There was no significant change in diameter of renal artery. CR reduced systolic blood pressure (BP) from 145.50 ± 9.95 mmHg at baseline to 119.00 ± 14.09 mmHg. There was a slight but insignificant decrease in diastolic BP. The main nerve changes at 28-day consisted of necrosis with perineurial fibrosis at the site of CR exposure in conjunction with the nerve vacuolation. Compared with the control group, renal tissue NE of CR group decreased by 89.85%.
  
  
  CONCLUSIONS
  Percutaneous catheter-based cryoablation of the renal artery is safe. CR could effectively reduce NE storing in the renal cortex, and the efficiency could be maintained 28-day at least.
authors.forename: Meng
authors.initials: M
authors.lastname: Ji
authors.forename: Li
authors.initials: L
authors.lastname: Shen
authors.forename: Yi-Zhe
authors.initials: YZ
authors.lastname: Wu
authors.forename: Zhi-Feng
authors.initials: ZF
authors.lastname: Yao
authors.forename: Jia-Sheng
authors.initials: JS
authors.lastname: Yin
authors.forename: Jia-Hui
authors.initials: JH
authors.lastname: Chen
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Jia
authors.forename: Ling-Juan
authors.initials: LJ
authors.lastname: Qiao
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Jun-Bo
authors.initials: JB
authors.lastname: Ge
mesh_terms: D000818:Animals; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D007668:Kidney / Q000294:innervation*; D008297:Male; D013552:Swine; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome