Pulmonary artery denervation in patients with pulmonary hypertension: present state and clinical experience

D A Feshchenko,F B Shukurov,N E Gavrilova,B A Rudenko,O M Drapkina,A V Kontsevaya,D K Vasiliev,A S Shanoyan

doi:10.15829/1560-4071-2019-12-162-168

Abstract

Despite treatment advances, the prognosis of patients with both primary and secondary pulmonary hypertension (PH) remains unfavorable. The increased activity of the sympathetic nervous system is one of the universal mechanisms involved in the PH pathogenesis. Pulmonary artery denervation is a novel minimally invasive pathogenetic method of PH treatment. The denervation procedure is mainly implemented by using radiofrequency ablation of the pulmonary trunk, where most sympathetic nerve fibers are located. In this article we present an overview and analysis of the present state, results of various experimental and clinical studies, as well as clinical experience. The results of studies demonstrated the safety of endovascular surgery and its beneficial effect on both hemodynamic and clinical parameters.

Highlights

The increased activity of the sympathetic nervous system is one of the universal mechanisms involved in the pulmonary hypertension (PH) pathogenesis
The denervation procedure is mainly implemented by using radiofrequency ablation of the pulmonary trunk, where most sympathetic nerve fibers are located
In this article we present an overview and analysis of the present state, results of various experimental and clinical studies, as well as clinical experience

Summary

Introduction

А. — д.м.н., врач рентгенэндоваскулярных методов диагностики и лечения, руководитель отдела инновационных методов профилактики, диагностики и лечения сердечно-сосудистых и других хронических неинфекционных заболеваний, ORCID: 0000-0003-0346-9069, Шаноян А. Б. — врач рентгенэндоваскулярных методов диагностики и лечения, ORCID: 0000-0001-7307-1502, Васильев Д. К. — лаборант-исследователь отдела инновационных методов профилактики, диагностики и лечения сердечно-сосудистых и других хронических неинфекционных заболеваний, врач рентгенэндоваскулярных методов диагностики и лечения, ORCID: 0000-0003-2602-5006.

Results

Conclusion