Key result
Fiberoptic pulmonary artery laser denervation in an ovine model produced effective lesions reaching the adventitia in 40% of cases, with 20 W ablation energy being safer than 30 W.
Why the study?
Pulmonary artery denervation can reduce pulmonary artery pressure, but comparison of pulmonary artery nerve distribution across specimens and the feasibility of an ovine model for laser denervation required evaluation.
Is an ovine model feasible for percutaneous pulmonary artery laser denervation, and what are the acute lesion characteristics?
Is an ovine model feasible for percutaneous pulmonary artery laser denervation, and what are the acute lesion characteristics?
An ovine model is feasible for studying pulmonary artery laser denervation, demonstrating that 20 W energy provides effective and safe adventitial lesions, despite anatomical differences in nerve distribution compared to humans.
Establishes ovine PADN model feasibility; leaves open human translation and efficacy trials.
BACKGROUND: Pulmonary artery denervation (PADN) is an evolving interventional procedure capable to reduce pulmonary artery (PA) pressure. We aimed to compare PA nerve distribution in different specimens and assess the feasibility of an ovine model for a denervation procedure and evaluate the acute changes induced by laser energy. METHODS: The experiment was divided into two phases: (1) the analysis of PA nerve distribution in sheep, pigs, and humans using histological and immunochemical methods; (2) fiberoptic PADN in sheep and postmortem laser lesion characteristics. RESULTS: PA nerve density and distribution in sheep differ from humans, although pigs and sheep share similar characteristics, nerve fibers are observed in the media layer, adventitia, and perivascular tissue in sheep. Necrosis of the intima and focal hemorrhages within the media, adventitia, and perivascular adipose tissue were evidenced post laser PADN. Among the identified lesions, 40% reached adventitia and could be classified as effective for PADN. The use of 20 W ablation energy was safer and 30 W-ablation led to collateral organ damage. CONCLUSIONS: An ovine model is suitable for PADN procedures; however, nerve distribution in the PA bifurcation and main branches differ from human PA innervation. Laser ablation can be safely used for PADN procedures.
No takes yet. Share an insight, caveat, or question.
Leandro et al. (2021) studied Pulmonary artery denervation model. Fiberoptic pulmonary artery laser denervation was evaluated on Postmortem laser lesion characteristics reaching adventitia. Fiberoptic pulmonary artery laser denervation in an ovine model produced effective lesions reaching the adventitia in 40% of cases, with 20 W ablation energy being safer than 30 W.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: