Computational Modeling of Catheter-based Radiofrequency Renal Denervation with Patient-specific Model.

Abstract

Renal sympathetic denervation (RDN) is an effective approach for uncontrolled hypertension. Although several studies have compared the ablation characteristics at various locations, there is no direct comparative study on the effect of ablation in main and branch renal artery (RAs) and different electrode materials. The study aims to investigate the effect of different electrode materials (copper, gold, and platinum) and positions (proximal, middle, or distal site) on ablation. A 3D patient-specific renal artery model and a unipolar model (470 kHz) were constructed to mimic RDN. Two therapeutic strategies, including main (site 1 and 2) and branch (site 3) ablations were simulated with three electrode materials. The finite element method was used to calculate the coupled electric-thermal-flow field. Maximum lesion depth, width, area, and lesion angle were analyzed. The results showed that the difference in lesion width and depth was no mere than 0.5 mm, and the maximum difference value in lesion area is 0.683 mm2 among three electrode materials. The lesion angle of proximal site 1 versus middle site 2 was 58.39 ° and 52.23 °, but the difference between distal site 3 and site 1, or site 2 was 29.19 ° and 35.35 ° respectively. There is no significant difference in the use of the three electrode materials, and ablation at the distal site of the artery is more effective.Clinical Relevance-This provides a reference for the selection of RF electrode materials and ablation locations.