Alcohol-mediated renal sympathetic neurolysis for the treatment of hypertension: The Peregrine™ infusion catheter

Bertog S, Sharma A, Mahfoud F, Pathak A, Schmieder R, Sievert K, Papademetriou V, Weber MA, Haratani N, Lobo MD, Saxena M, Kandzari DE, Fischell TA, Sievert H (2020)

Publication Type: Journal article, Review article

Publication year: 2020

Journal

Cardiovascular Revascularization Medicine Elsevier

DOI: 10.1016/j.carrev.2020.09.003

Abstract

Renal sympathetic denervation using conventional non-irrigated radiofrequency catheters has potential technical shortcomings, including limited penetration depth and incomplete circumferential nerve damage, potentially impacting therapeutic efficacy. Against this background, second generation multi-electrode, radiofrequency and ultrasound renal denervation systems have been developed to provide more consistent circumferential nerve ablation. Irrigated catheters may allow deeper penetration while minimizing arterial injury. In this context, catheter-based chemical denervation, with selective infusion of alcohol, a potent neurolytic agent, into the perivascular space, may minimize endothelial, intimal and medial injury while providing circumferential neurolysis. Animal studies demonstrate pronounced renal norepinephrine level reductions and consistent renal nerve injury after perivascular alcohol infusion using the Peregrine Catheter. Early clinical studies demonstrated significant blood pressure reductions and a reasonable safety profile. Randomized sham-controlled trials (NCT03503773, NCT02910414) are underway to examine whether the aforementioned theoretical advantages of alcohol-medicated denervation with the Peregrine System™ Kit translate into clinical benefits.

Authors with CRIS profile

Roland Schmieder Professur für Innere Medizin (Nephrologie)

Involved external institutions

CardioVasculäres Centrum Frankfurt DE Germany (DE) Queen Mary, University of London GB United Kingdom (GB) Ablative Solutions US United States (USA) (US) Piedmont Healthcare US United States (USA) (US) Washington DC VA Medical Center US United States (USA) (US) Va Midwest Health Care Network US United States (USA) (US) Universitätsklinikum des Saarlandes (UKS) DE Germany (DE) Centre Hospitalier Princesse Grace MC Monaco (MC) SUNY Downstate Medical Center US United States (USA) (US)

How to cite

APA:

Bertog, S., Sharma, A., Mahfoud, F., Pathak, A., Schmieder, R., Sievert, K.,... Sievert, H. (2020). Alcohol-mediated renal sympathetic neurolysis for the treatment of hypertension: The Peregrine™ infusion catheter. Cardiovascular Revascularization Medicine. https://doi.org/10.1016/j.carrev.2020.09.003

MLA:

Bertog, Stefan, et al. "Alcohol-mediated renal sympathetic neurolysis for the treatment of hypertension: The Peregrine™ infusion catheter." Cardiovascular Revascularization Medicine (2020).

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