Chemical renal denervation by vincristine: the role of the flow rate of delivery

Cardiovasc Intervent Radiol. 2014 Oct;37(5):1336-42. doi: 10.1007/s00270-014-0958-2. Epub 2014 Aug 12.

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.

MeSH terms

  • Animals
  • Catheter Ablation / methods*
  • Renal Artery / drug effects
  • Renal Artery / innervation*
  • Swine
  • Sympathectomy, Chemical / methods*
  • Vincristine / administration & dosage*

Substances

  • Vincristine