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10.1016/j.jacc.2014.07.937 http://scihub22266oqcxt.onion/10.1016/j.jacc.2014.07.937 C4377282!4377282!25212640     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       J+Am+Coll+Cardiol 2014 ; 64 (11): 1079-87 Nephropedia Template TP {{tp|p=25212640|t=2014. Innervation Patterns May Limit Response to Endovascular Renal Denervation |pdf=|usr=}}{{25212640}} gab.com Text Innervation Patterns May Limit Response to Endovascular Renal Denervation JO: J Am Coll Cardiol http://www.kidney.de/pget.php?&tw=1&pmid=25212640 #FOAvip BACKGROUND: Renal denervation is a new interventional approach to treat hypertension with variable results. OBJECTIVES: The purpose of this study was to correlate response to endovascular radiofrequency ablation of renal arteries with nerve and ganglia distributions. We examined how renal neural network anatomy affected treatment efficacy. METHODS: A multielectrode radiofrequency catheter (15 W/60 s) treated 8 renal arteries (group 1). Arteries and kidneys were harvested 7 days post-treatment. Renal norepinephrine (NEPI) levels were correlated with ablation zone geometries and neural injury. Nerve and ganglion distributions and sizes were quantified at discrete distances from the aorta and were compared with 16 control arteries (group 2). RESULTS: Nerve and ganglia distributions varied with distance from the aorta (p < 0.001). A total of ?75% of nerves fell within a circumferential area of 9.3, 6.3, and 3.4 mm of the lumen and 0.3, 3.0, and 6.0 mm from the aorta. Efficacy (NEPI 37 ng/g) was observed in only 1 of 8 treated arteries where ablation involved all 4 quadrants, reached a depth of 9.1 mm, and affected 50% of nerves. In 7 treated arteries, NEPI levels remained at baseline values (620 to 991 ng/g), ?20% of the nerves were affected, the ablation areas were smaller (16.2 ± 10.9 mm2) and present in only 1 to 2 quadrants at maximal depths of 3.8 ± 2.7 mm. CONCLUSIONS: Renal denervation procedures that do not account for asymmetries in renal periarterial nerve and ganglia distribution may miss targets and fall below the critical threshold for effect. This phenomenon is most acute in the ostium but holds throughout the renal artery, which requires further definition. Twit Text FOAVip Innervation Patterns May Limit Response to Endovascular Renal Denervation ????J Am Coll Cardiol http://www.kidney.de/pget.php?&tw=1&pmid=25212640 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=25212640 #FOAvip English Wikipedia <ref>{{Cite pmid|25212640}}</ref> Innervation Patterns May Limit Response to Endovascular Renal Denervation #MMPMID25212640 Tzafriri AR; Mahfoud F; Keating JH; Markham PM; Spognardi A; Wong G; Fuimaono K; Böhm M; Edelman ER J Am Coll Cardiol 2014[Sep]; 64 (11): 1079-87 PMID25212640show ga BACKGROUND: Renal denervation is a new interventional approach to treat hypertension with variable results. OBJECTIVES: The purpose of this study was to correlate response to endovascular radiofrequency ablation of renal arteries with nerve and ganglia distributions. We examined how renal neural network anatomy affected treatment efficacy. METHODS: A multielectrode radiofrequency catheter (15 W/60 s) treated 8 renal arteries (group 1). Arteries and kidneys were harvested 7 days post-treatment. Renal norepinephrine (NEPI) levels were correlated with ablation zone geometries and neural injury. Nerve and ganglion distributions and sizes were quantified at discrete distances from the aorta and were compared with 16 control arteries (group 2). RESULTS: Nerve and ganglia distributions varied with distance from the aorta (p < 0.001). A total of ?75% of nerves fell within a circumferential area of 9.3, 6.3, and 3.4 mm of the lumen and 0.3, 3.0, and 6.0 mm from the aorta. Efficacy (NEPI 37 ng/g) was observed in only 1 of 8 treated arteries where ablation involved all 4 quadrants, reached a depth of 9.1 mm, and affected 50% of nerves. In 7 treated arteries, NEPI levels remained at baseline values (620 to 991 ng/g), ?20% of the nerves were affected, the ablation areas were smaller (16.2 ± 10.9 mm2) and present in only 1 to 2 quadrants at maximal depths of 3.8 ± 2.7 mm. CONCLUSIONS: Renal denervation procedures that do not account for asymmetries in renal periarterial nerve and ganglia distribution may miss targets and fall below the critical threshold for effect. This phenomenon is most acute in the ostium but holds throughout the renal artery, which requires further definition. äInnervation Patterns May Limit Response to Endovascular Renal Denervat(epmc).pdf DeepDyve Pubget Overpricing