Ablação da atividade simpática renal com cateter de ponta irrigada: uma opção atraente?

• Autor(a) principal: Staico, Rodolfo
• Data de Publicação: 2013
• Outros Autores: Armaganijan, Luciana, Dietrich, Cristiano de Oliveira [UNIFESP], Abizaid, Alexandre Antonio Cunha [UNIFESP], Moreira, Dalmo, Lopes, Renato Delascio [UNIFESP], Almeida, Joaquim [UNIFESP], Franco, Marcello Fabiano de [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S2179-83972013000100004; http://repositorio.unifesp.br/handle/11600/7674
• topic: Hypertension; Renal artery; Sympathectomy; Catheter ablation; Hipertensão; Artéria renal; Simpatectomia; Ablação por cateter

BACKGROUND: Catheter-based renal sympathetic denervation has emerged as an adjunct strategy to control refractory hypertension. No studies have yet compared the tissue effects of different catheters, powers and time periods of radiofrequency application, which was the objective of this study. METHODS: Six porcine renal arteries were sectioned in their longitudinal axis and placed in the flow chamber designed to simulate physiological renal flow conditions. The catheters were placed obliquely to the artery with constant contact pressure. Radiofrequency ablations were performed using three different catheters: 4 mm/5 F solid-tip electrode, 4 mm/7 F solid-tip electrode, and open irrigated-tip 4 mm/7 F electrode. Two different powers were used (8 W and 15 W) for 30, 60 and 120 seconds. RESULTS: A total of 18 ablations were performed. More significant nerve damage was observed with the 4 mm/5 F catheter and power of 8 W only when the application duration was extended to 120 seconds. On the other hand, significant nerve damage was observed with the 4 mm/7 F catheter with all power (8 W and 15 W) and duration (30, 60, and 120 seconds) options tested. Deeper lesions were observed with the use of the irrigated catheter, regardless of power and time periods of radiofrequency application. CONCLUSIONS: The irrigated-tip catheters produce deeper lesions than solid-tip catheters and their use might be more beneficial in treating patients with renal sympathetic denervation. The clinical applicability of these results, however, should be confirmed.