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CardioVascular and Interventional Radiology

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01-10-2014 | Laboratory Investigation

Chemical Renal Denervation by Vincristine: The Role of the Flow Rate of Delivery

Authors: Christodoulos Stefanadis, Andreas Synetos, Costas Tsioufis, Maria Drakopoulou, Eleftherios Tsiamis, Dimitris Tousoulis, George Agrogiannis, Efstratios Patsouris, Konstantinos Toutouzas

Published in: CardioVascular and Interventional Radiology | Issue 5/2014

Abstract

Purpose

Vincristine has been proven promising regarding its safety and efficacy for the renal artery denervation both in experimental models and in humans. The aim of the study was to compare in an experimental model the efficacy of constant versus random flow rate delivery of vincristine on renal sympathetic denervation.

Methods

We used 10 juvenile Landrace swine. After the introduction of a 7F sheath into the femoral artery, a guide wire was advanced into the distal part of the renal artery. Then the first delivery balloon catheter, which delivers vincristine in random flow rate, was advanced at the proximal part of the artery, and the balloon was inflated in order to locally deliver vincristine to the media of the renal artery. The process was repeated in the contralateral renal artery, with the use of the double balloon catheter that delivers vincristine with a constant flow rate. Euthanasia of the animals was performed at 28 days. All sections were processed for histological and immunohistochemical analysis.

Results

The delivery of vincristine with both catheters was successful and uncomplicated. Immunohistochemistry showed that the mean number of intact nerves in all sections was significantly lower in the group of vincristine delivered with constant flow catheter compared to the group that the delivery was performed in a random fashion. (1.48 ± 0.37 vs. 1.70 ± 0.41, p = 0.04).

Conclusion

Chemical renal denervation with vincristine by a constant flow rate catheter is more effective compared to the denervation performed by a catheter that delivers vincristine in a random fashion.

Kaltenbach B, Id D, Franke JC et al (2012) Renal artery stenosis after renal sympathetic denervation. J Am Coll Cardiol 60:2694–2695PubMedCrossRef

Gewirtz JR, Bisognano JD (2011) Catheter-based renal sympathetic denervation: a targeted approach to resistant hypertension. Cardiol J 18(1):97–102PubMed

Nomura G, Kurosaki M, Takabatake T et al (1972) Reinnervation and renin release after unilateral renal denervation in the dog. J Appl Physiol 33:649–655PubMed

Bhatt DL, Kandzari DE, O’Neill WW et al (2014) A controlled trial of renal denervation for resistant hypertension. N Engl J Med 370:1393–1401PubMedCrossRef

Esler MD, Krum H, Sobotka PA et al (2010) Renal sympathetic denervation in patients with treatment-resistant hypertension (the Symplicity HTN-2 trial): a randomised controlled trial. Lancet 376(9756):1903–1909PubMedCrossRef

Stefanadis C, Synetos A, Toutouzas K et al (2013) New double balloon delivery catheter for chemical denervation of the renal artery with vincristine. Int J Cardiol 168:4346–4348PubMedCrossRef

Stefanadis C, Toutouzas K, Vlachopoulos C et al (2013) Chemical denervation of the renal artery with vincristine for the treatment of resistant arterial hypertension: first-in-man application. Hellenic J Cardiol 54:318–321PubMed

Stefanadis C, Toutouzas K, Synetos A et al (2013) Chemical denervation of the renal artery by vincristine in swine. A new catheter based technique. Int J Cardiol 167:421–425PubMedCrossRef

Earl HM, Connolly S, Latoufis C et al (1998) Long-term neurotoxicity of chemotherapy in adolescents and young adults treated for bone and soft tissue sarcomas. Sarcoma 2(2):97–105PubMedCentralPubMedCrossRef

10.

Moore AS, Norris R, Price G et al (2011) Vincristine pharmacodynamics and pharmacogenetics in children with cancer: a limited-sampling, population modelling approach. J Paediatr Child Health 47:875–882PubMedCrossRef

11.

Hering D, Marusic P, Walton AS et al (2014) Sustained sympathetic and blood pressure reduction 1 year after renal denervation in patients with resistant hypertension. Hypertension 64(1):118–124PubMedCrossRef

12.

Consigny PM, Davalian D, Donn R et al (2014) Chemical renal denervation in the rat. Cardiovasc Intervent Radiol 37:218–223PubMedCrossRef

13.

Feng XL, Usui H, Fujita T et al (1998) Postnatal developmental changes in NSE and NNE mRNA expression in the rat pineal gland: in situ hybridization histochemistry. J Pineal Res 24:108–116PubMedCrossRef

14.

Jorgensen OS, Honegger P (1986) Development of neuronal markers in aggregating fetal rat telencephalon cells cultured in the presence of triiodothyronine. Int J Dev Neurosci 4:519–524PubMedCrossRef

15.

Nishimura M, Takashima S, Takeshita K, Tanaka J (1985) Developmental changes of neuron-specific enolase in human brain: an immunohistochemical study. Brain Dev 7:1–6PubMedCrossRef

16.

Ledig M, Tholey G, Mandel P (1982) Neuron-specific and non-neuronal enolase in developing chick brain and primary cultures of chick neurons. Brain Res 256:451–454PubMedCrossRef

17.

Kirino T, Brightman MW, Oertel WH et al (1983) Neuron-specific enolase as an index of neuronal regeneration and reinnervation. J Neurosci 3:915–923PubMed

18.

Mann R, Bhathal PS, Bell C (1991) Sympathetic innervation of the liver in man and dog: an immunohistochemical study. Clin Auton Res 1:141–145PubMedCrossRef

19.

Sheppard MN, Kurian SS, Henzen-Logmans SC et al (1983) Neurone-specific enolase and S-100: new markers for delineating the innervation of the respiratory tract in man and other mammals. Thorax 38:333–340PubMedCentralPubMedCrossRef

20.

Carai A, Diaz G, Santa Cruz R, Santa Cruz G (2002) Computerized quantitative color analysis for histological study of pulmonary fibrosis. Anticancer Res 22(6C):3889–3894PubMed

21.

Johansson AC, Visse E, Widegren B et al (2001) Computerized image analysis as a tool to quantify infiltrating leukocytes: a comparison between high- and low-magnification images. J Histochem Cytochem 49:1073–1079PubMedCrossRef

22.

Tallarida G, Baldoni F, Peruzzi G et al (1979) Cardiovascular and respiratory chemoreflexes from the hindlimb sensory receptors evoked by intra-arterial injection of bradykinin and other chemical agents in the rabbit. J Pharmacol Exp Ther 208:319–329PubMed

23.

Gewirtz JR, Bisognano JD (2011) Catheter-based renal sympathetic denervation: a targeted approach to resistant hypertension. Cardiol J 18:97–102PubMed

24.

Stefanadis C (2011) Renal denervation in resistant hypertension: radiofrequency ablation and chemical denervation. Hellenic J Cardiol 52:481–482PubMed

25.

Fischell TA, Vega F, Raju N et al (2013) Ethanol-mediated perivascular renal sympathetic denervation: preclinical validation of safety and efficacy in a porcine model. Eurointervention 9:140–147PubMedCrossRef

26.

Reddy S, Kumar P, Prasad K (2011) Histomorphometric and sympathetic innervation of the human renal artery: a cadaveric study. Urol Ann 3:141–146PubMedCentralPubMedCrossRef

27.

Benet L, Kroetz D, Sheiner L (1996) Pharmacokinetics: the dynamics of drug absorption, distribution, and elimination. In: Hardman JG, Limbird LE, Molinoff PB et al (eds) The pharmacological basis of therapeutics, 9th edn. McGraw-Hill, New York, pp 3–11

28.

Creel CJ, Lovich MA, Edelman ER (2000) Arterial paclitaxel distribution and deposition. Circ Res 86:879–884PubMedCrossRef

Title: Chemical Renal Denervation by Vincristine: The Role of the Flow Rate of Delivery
Authors: Christodoulos Stefanadis
Andreas Synetos
Costas Tsioufis
Maria Drakopoulou
Eleftherios Tsiamis
Dimitris Tousoulis
George Agrogiannis
Efstratios Patsouris
Konstantinos Toutouzas
Publication date: 01-10-2014
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 5/2014
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-014-0958-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Chemical Renal Denervation by Vincristine: The Role of the Flow Rate of Delivery

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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