Percutaneous transluminal radiofrequency closure of the coronary artery in animal studies

Zhang,Chenyun; Yi,Wei; Cai,Yunchang; Fang,Shounian; Jiang,Xinan; Wen,Anzhi; Wu,Qiang

doi:10.3892/etm.2013.1262

Percutaneous transluminal radiofrequency closure of the coronary artery in animal studies

Authors:
- Chenyun Zhang
- Wei Yi
- Yunchang Cai
- Shounian Fang
- Xinan Jiang
- Anzhi Wen
- Qiang Wu
View Affiliations

Affiliations: Guizhou Provincial Cardiovascular Institute and Cardiology Department of Guizhou Provincial Hospital, Guiyang, Guizhou 550002, P.R. China
Published online on: August 16, 2013 https://doi.org/10.3892/etm.2013.1262
Pages: 1044-1048

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of this study was to investigate the safety and effectiveness of a novel method for the selective transcoronary closure of small coronary arteries by the intraluminal application of radiofrequency (RF) energy. Twenty-six small (diameter of 1-2 mm) coronary artery branches were selected in 13 dogs. An RF electrode wire (CRW-Zcy) was placed into the target vessel and a coronary balloon was used to transiently block the blood flow and limit damage to the proximal vessel. A therapeutic dosage of 20-30 W of RT energy every 10-30 sec (selected according the diameter of the target artery) was discharged via the CRW-Zcy inside a microcatheter two or three times in order to achieve arterial closure. A high dosage of 60 W every 120 sec of RF energy was used to conduct the safety study. All 26 branches were successfully closed resulting in the complete blockage of the antegrade and retrograde flows. The area of injury was limited to the target artery and the supplied myocardium. High-dose RF did not cause injury to the adjacent vessels and myocardium. The animals tolerated the procedure well without any untoward systemic effects. A follow-up angiography at two weeks revealed no evidence of recanalization or retrograde filling of the target artery. Percutaneous transluminal radiofrequency closure is a safe and effective interventional approach for closing the small coronary arteries, and is potentially valuable for further investigation.

View Figures

View References

1.	Hsieh KS, Huang TC and Lee CL: Coronary artery fistulas in neonates, infants, and children: clinical findings and outcome. Pediatr Cardiol. 23:415–419. 2002. View Article : Google Scholar : PubMed/NCBI
2.	Qureshi SA and Tynan M: Catheter closure of coronary artery fistulas. J Interv Cardiol. 14:299–307. 2001. View Article : Google Scholar : PubMed/NCBI
3.	Armsby LR, Keane JF, Sherwood MC, Forbess JM, Perry SB and Lock JE: Management of coronary artery fistulae. Patient selection and results of transcatheter closure. J Am Coll Cardiol. 39:1026–1032. 2002. View Article : Google Scholar : PubMed/NCBI
4.	Okubo M, Nykanen D and Benson LN: Outcomes of transcatheter embolization in the treatment of coronary artery fistulas. Catheter Cardiovasc Interv. 52:510–517. 2001. View Article : Google Scholar : PubMed/NCBI
5.	National Research Council (US) Committee for the Update of the Guide for the Care and Use of Laboratory Animals: Guide for the Care and Use of Laboratory Animals. 8th edition. National Academies Press; Washington: 2011
6.	Rajs J, Brodin LA, Hertzfeld I and Larsen FF: Death related to coronary artery fistula after rupture of an aneurysm to the coronary sinus. Am J Forensic Med Pathol. 22:58–61. 2001. View Article : Google Scholar : PubMed/NCBI
7.	Cotton JL: Diagnosis of a left coronary artery to right ventricular fistula with progression to spontaneous closure. J Am Soc Echocardiogr. 13:225–228. 2000. View Article : Google Scholar : PubMed/NCBI
8.	Wong KT and Menahem S: Coronary arterial fistulas in childhood. Cardiol Young. 10:15–20. 2000.
9.	Hirose H, Amano A, Yoshida S, et al: Coronary artery aneurysm associated with fistula in adults: collective review and a case report. Ann Thorac Cardiovasc Surg. 5:258–264. 1999.PubMed/NCBI
10.	Dorros G, Thota V, Ramireddy K and Joseph G: Catheter-based techniques for closure of coronary fistulae. Catheter Cardiovasc Interv. 46:143–150. 1999. View Article : Google Scholar : PubMed/NCBI
11.	Wang S, Wu Q, Hu S, et al: Surgical treatment of 52 patients with congenital coronary artery fistulas. Chin Med J (Engl). 114:752–755. 2001.PubMed/NCBI
12.	Maeda M, Konagai N, Yano H, et al: Surgical treatment of coronary artery-pulmonary artery fistula with coronary aneurysm. Kyobu Geka. 54:1033–1037. 2001.(In Japanese).
13.	Seggewiss H, Gleichmann U, Faber L, Fassbender D, Schmidt HK and Strick S: Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: acute results and 3-month follow-up in 25 patients. J Am Coll Cardiol. 31:252–258. 1988. View Article : Google Scholar
14.	Kazmierczak J, Kornacewixz-Jach Z, Kisly M, Gil R and Wojtarowicz A: Electrocardiographic changes after alcohol septal ablation in hypertrophic obstructive cardiomyopathy. Heart. 80:257–262. 1998. View Article : Google Scholar : PubMed/NCBI
15.	Tsuchikane E, Nakamura T, Yamazaki K, et al: Transluminal percutaneous septal myocardial ablation in a patient with hypertrophic obstructive cardiomyopathy. Jpn Circ J. 63:537–540. 1998. View Article : Google Scholar : PubMed/NCBI
16.	Gspar J, Martínez-Ríos MA, Vonderwaide C, et al: Pericardium-covered stent for septal myocardial ablation in hypertrophic obstructive cardiomyopathy. Catheter Cardiovasc Intev. 47:73–79. 1999.PubMed/NCBI
17.	Sigwart U: Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet. 346:211–214. 1995. View Article : Google Scholar : PubMed/NCBI
18.	Faber L, Seggewiss H, Ziemssen P and Gleichmann U: Intraprocedural myocardial contrast echocardiography as a routine procedure in percutaneous transluminal septal myocardial ablation: detection of threatening myocardial necrosis distant from the septal target area. Catheter Cardiovasc Interv. 47:462–466. 1999. View Article : Google Scholar
19.	Faber L, Seggewiss H and Gleichmann U: Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: results with respect to intraprocedural myocardial contrast echocardiography. Circulation. 98:2415–2421. 1998. View Article : Google Scholar
20.	Seggewiss H, Faber L and Gleichmann U: Percutaneous transluminal septal ablation hypertrophic obstructive cardiomyopathy. Thorac Cardiovasc Surg. 47:94–100. 1999. View Article : Google Scholar
21.	Gietzen FH, Leuner CJ, Raute-Kreinsen U, et al: Acute and long-term results after transcoronary ablation of septal hypertrophy (TASH). Catheter interventional treatment for hypertrophic obstructive cardiomyopathy. Eur Heart J. 20:1342–1354. 1999. View Article : Google Scholar
22.	Kim JJ, Lee CW, Park SW, et al: Improvement in exercise capacity and exercise blood pressure response after transcoronary alcohol ablation of septal hypertrophy in hypertrophic cardiomyopathy. Am J Cardiol. 83:1220–1223. 1999. View Article : Google Scholar
23.	Kuhn H, Gietzen FH, Schäfers M, et al: Changes in the left ventricular outflow tract after transcoronary ablation of septal hypertrophy (TASH) for hypertrophic obstructive cardiomyopathy as assessed by transoesophageal echocardiography and by measuring myocardial glucose utilization and perfusion. Eur Heart J. 20:1808–1817. 1999.
24.	Stellbrink C, Diem B, Schauerte P, Ziegert K and Hanrath P: Transcoronary venous radiofrequency catheter ablation of ventricular tachycardia. J Cardiovasc Electrophysiol. 8:916–921. 1997. View Article : Google Scholar : PubMed/NCBI
25.	de Paola AA, Melo WD, Távora MZ and Martinez EE: Angiographic and electrophysiological substrstes for ventricular tachycardia mapping through the coronary veins. Heart. 79:59–63. 1998.PubMed/NCBI
26.	Dubuc M, Talajic M, Roy D, Thibault B, Leung TK and Friedman PL: Feasibility of cardiac cryoablation using a transvenous steerable electrode catheter. J Interv Card Electrophysiol. 2:285–292. 1998. View Article : Google Scholar : PubMed/NCBI