title: Effect of Peripheral Artery Sympathetic Denervation on Muscle Microperfusion and Macroperfusion in an Animal Peripheral Artery Disease Model Using Contrast-Enhanced Ultrasound and Doppler Flow Measurement.
abstract: OBJECTIVE
  To determine the effects of catheter-based peripheral sympathetic denervation (CPSD) on peripheral artery sympathetic tone and peripheral microperfusion (PMP).
  
  
  METHODS
  The effects of bilateral CPSD in common iliac arteries on PMP of the biceps femoris were determined in pigs using contrast-enhanced ultrasound, and mean transit time (mTT) and wash-in rate (WiR) were calculated during steady-state infusion of INN-sulfur-hexafluoride. Measurements were performed bilaterally at rest and during infusion of adenosine 70 μg/kg/min after unilateral moderate left external iliac artery stenosis.
  
  
  RESULTS
  Before CPSD, PMP decreased significantly (P < .05) under adenosine stress compared with resting conditions, with right mTT of 7.5 seconds ± 3.6 versus 16.9 seconds ± 11.9 and WiR of 63.1 arbitrary units (AU) ± 49.0 versus 25.0 AU ± 17.5 and left mTT of 29.2 seconds ± 18.0 versus 56.3 seconds ± 38.7 and WiR of 13.6 AU ± 8.4 versus 6.0 AU ± 4.1. After CPSD, PMP did not differ significantly (P > .05) between conditions of adenosine stress and rest, with right mTT of 19.9 seconds ± 24.7 versus 23.2 seconds ± 21.0 and WiR of 16.2 AU ± 25.0 versus 20.5 AU ± 19.7 and left mTT of 23.3 seconds ± 23.1 versus 25.8 seconds ± 21.7 and WiR of 12.5 AU ± 6.2 versus 20.0 AU ± 12.1.
  
  
  CONCLUSIONS
  CPSD reduced peripheral artery sympathetic tone and may be an alternative to surgical or computed tomography-guided sympathectomy for the treatment of end-stage peripheral artery disease and Raynaud phenomenon.
authors.affiliation: Departments of Anaesthesiology and Intensive Care Medicine, University of Bonn, Bonn, Germany.
authors.forename: Verena A
authors.initials: VA
authors.lastname: Steinberg
authors.affiliation: Department of Vascular and Endovascular Surgery, Marienhospital Aachen, Aachen, Germany.
authors.forename: Gottfried
authors.initials: G
authors.lastname: Mommertz
authors.affiliation: Institute of Pathology, University of Bonn, Bonn, Germany.
authors.forename: Thore
authors.initials: T
authors.lastname: Thiesler
authors.affiliation: Institute of Pathology, University of Bonn, Bonn, Germany.
authors.forename: Glen
authors.initials: G
authors.lastname: Kristiansen
authors.affiliation: Radiology, University of Bonn, Bonn, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Schild
authors.affiliation: Radiology, University of Bonn, Bonn, Germany. Electronic address: cp@naehle.net.
authors.forename: Claas P
authors.initials: CP
authors.lastname: Naehle
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D003287:Contrast Media; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D058729:Peripheral Arterial Disease / Q000503:physiopathology* / Q000601:surgery*; D013552:Swine; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
chemical_list: D003287:Contrast Media