Abstract
Objective To compare the effects of renal denervation (RDN) from intima and adventitia for hypension. Methods Twenty-five neurogenic hypertensive beagles were randomly divided into intimal group (n=10) gvien percutaneous RDN from the inside of renal artery, and adventitial group (n=10) given RDN from the outside of renal artery. The sham-operated group was set up (n=5). Arterial pressure, renin activity (PRA) and angiotensin Ⅱ (Ang Ⅱ) were detected before and 2, 4, 8 weeks after operation. Results (1) At 8th week after the hypertension model was established, the arterial pressure increased from (107.56±4.37) mmHg (1 mmHg=0.133 kPa) to (125.16±7.86) mmHg (P=0.003) in the intimal group, and from (105.66±5.43) mmHg to (124.08±8.98) mmHg in the adventitial group (P=0.012). In the control group the arterial pressure increased from (106.34±6.45) mmHg to (125.89±9.54) mmHg (P=0.007). PRA and AngII increased simultaneously (P=0.005); (2) At 2nd, 4th, and 8th week after operation, the arterial pressure decreased from (125.16±7.86) mmHg to (117.45±7.98) mmHg (P=0.001), (114.35±7.89) mmHg (P=0.008), (110.32±7.54) mmHg (P=0.003), and from (124.08±8.98) mmHg to (111.23±8.34) mmHg (P=0.004), (108.34±8.65) mmHg (P=0.002), (103.06±8.56) mmHg (P=0.001) in the adventitial group. The arterial pressure decreased more significantly in the adventitial group [(103.06±8.56) mmHg] than that in the intimal group [(110.32±7.54) mmHg] (P=0.013). PRA and AngII decreased simultaneously (P=0.015). The blood pressure had no significant change in the control group; (3) The renoarteriography showed on obvious abnormalities, but the pathological examination showed that a nerve fascicle from all denervation vessels with marked densification of collagen fibers in the surrounding connective tissue and a perineurium thickened, and the perineurium was thicker in the arteries. Conclusion RDN from both intima and adventitia is safe and results in reduction of substantial and sustained blood pressure and renal sympathetic active substances in beagle dog model, and it was better from the adventitia. Key words: Renal denervation; Hypertension; Sympathetic nerve
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