title: Renal Sympathetic Denervation by CT-scan-Guided Periarterial Ethanol Injection in Sheep.
abstract: BACKGROUND
  Renal nerves are a recent target in the treatment of hypertension. Renal sympathetic denervation (RSD) is currently performed using catheter-based radiofrequency ablation (RFA) and because this method has limitations, percutaneous magnetic resonance (MR)-guided periarterial ethanol injection is a suggested alternative. However, few studies have been conducted on the effectiveness of percutaneous ethanol injection for RSD.
  
  
  OBJECTIVE
  To evaluate the feasibility, efficacy, and complications of computed tomography (CT)-guided periarterial ethanol injection.
  
  
  METHODS
  Ethanol (10 ml, 99.6%) was injected around the right renal artery in six sheep under CT guidance with the left kidney serving as a control. Before and after the intervention, the sheep underwent MR imaging studies and the serum creatinine level was measured. One month after the intervention, the sheep were euthanized and norepinephrine (NE) concentration in the renal parenchyma was measured to evaluate the efficacy of the procedure. The treated tissues were also examined histopathologically to evaluate vascular, parenchymal, and neural injury.
  
  
  RESULTS
  The right kidney parenchymal NE concentration decreased significantly compared with the left kidney after intervention (average reduction: 40%, P = 0.0016). Histologic examination revealed apparent denervation with no other vascular or parenchymal injuries observed in the histological and imaging studies.
  
  
  CONCLUSIONS
  Effective and feasible RSD was achieved using CT-guided periarterial ethanol injection. This technique may be a potential alternative to catheter-based RFA in the treatment of hypertension.
authors.affiliation: Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TMUS), Tehran, 1419733141, Iran, k_firouznia@yahoo.com.
authors.forename: Kavous
authors.initials: K
authors.lastname: Firouznia
authors.forename: Sayed Jaber
authors.initials: SJ
authors.lastname: Hosseininasab
authors.forename: Saeid
authors.initials: S
authors.lastname: Amanpour
authors.forename: Arya
authors.initials: A
authors.lastname: Haj-Mirzaian
authors.forename: Roza
authors.initials: R
authors.lastname: Miri
authors.forename: Ahad
authors.initials: A
authors.lastname: Muhammadnejad
authors.forename: Samad
authors.initials: S
authors.lastname: Muhammadnejad
authors.forename: Amir H
authors.initials: AH
authors.lastname: Jalali
authors.forename: Farrokhlagha
authors.initials: F
authors.lastname: Ahmadi
authors.forename: Hadi
authors.initials: H
authors.lastname: Rokni-Yazdi
mesh_terms: D000818:Animals; D000431:Ethanol / Q000008:administration & dosage*; D005240:Feasibility Studies; D007668:Kidney / Q000294:innervation*; D023421:Models, Animal; D015641:Radiography, Interventional; D012077:Renal Artery / Q000000981:diagnostic imaging*; D012756:Sheep; D013562:Sympathectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D000431:Ethanol