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Comprehensive Assessment of Human Accessory Renal Artery Periarterial Renal Sympathetic Nerve Distribution
- Source :
- JACC. Cardiovascular interventions. 14(3)
- Publication Year :
- 2020
-
Abstract
- The aim of this study was to understand the anatomy of periarterial nerve distribution in human accessory renal arteries (ARAs).Renal denervation is a promising technique for blood pressure control. Despite the high prevalence of ARAs, the anatomic distribution of periarterial nerves around ARAs remains unknown.Kidneys with surrounding tissues were collected from human autopsy subjects, and histological evaluation was performed using morphometric software. An ARA was defined as an artery arising from the aorta above or below the dominant renal artery (DRA) or an artery that bifurcated within 20 mm of the takeoff of the DRA from the aorta. The DRA was defined as an artery that perfused50% of the kidney.A total of 7,287 nerves from 14 ARAs and 9 DRAs were evaluated. The number of nerves was smaller in the ARA than DRA (median: 30 [interquartile range: 17.5 to 48.5] vs. 49 [interquartile range: 36 to 76]; p 0.0001). In both ARAs and DRAs, the distance from the arterial lumen to nerve was shortest in the distal, followed by the middle and proximal segments. On the basis of the post-mortem angiography, ARAs were divided into large (≥3 mm diameter) and small (3 mm) groups. The number of nerves was greatest in the DRA, followed by the large and small ARA groups (53 [41 to 97], 38 [25 to 53], and 24.5 [10.5 to 36.3], respectively; p = 0.001).ARAs showed a smaller number of nerves than DRAs, but these results were dependent on the size of the ARA. Ablation, especially in large ARAs, may allow more complete denervation with the potential to further reduce blood pressure.
- Subjects :
- medicine.medical_specialty
Sympathetic Nervous System
Autopsy
030204 cardiovascular system & hematology
Kidney
Renal Artery Obstruction
03 medical and health sciences
0302 clinical medicine
Renal Artery
Interquartile range
Internal medicine
medicine.artery
medicine
Humans
heterocyclic compounds
030212 general & internal medicine
Renal artery
Sympathectomy
Denervation
Aorta
business.industry
food and beverages
biochemical phenomena, metabolism, and nutrition
carbohydrates (lipids)
medicine.anatomical_structure
Blood pressure
Treatment Outcome
Cardiology
lipids (amino acids, peptides, and proteins)
Cardiology and Cardiovascular Medicine
business
Artery
Subjects
Details
- ISSN :
- 18767605
- Volume :
- 14
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- JACC. Cardiovascular interventions
- Accession number :
- edsair.doi.dedup.....e47fcc4b4d1e50080159c6a64f1883c2