This study sought to evaluate perisplenic artery nerve distribution and the feasibility
of splenic artery denervation (SDN). The NEXION radiofrequency catheter was used to
perform SDN in healthy and inflammatory arthritis pigs. Splenic artery anatomy, nerve
distribution, and splenic norepinephrine (NEPI) levels were evaluated before and after
SDN. Perisplenic artery nerves were primarily distributed within 2.5 mm of the arterial
lumen and were largely sympathetic on the basis of tyrosine hydroxylase expression.
The pancreas, tended to be circumferentially positioned around the proximal splenic
artery, typically >2.5 mm from the lumen, ensuring that most of the nerves could be
targeted without affecting this sensitive organ. The mid segment of the splenic artery
was relatively free of contact with the adjacent pancreas. Splenic NEPI levels and
nerve abundance followed a decreasing gradient from the proximal to distal splenic
artery. SDN resulted in significant reductions in splenic NEPI levels at day 14 (60.7%,
P = 0.024) in naïve pigs and day 45 (100%, P = 0.001) in inflammatory arthritis pigs. There was no significant effect of SDN on
joint soft tissue injury or circulating inflammatory markers in the inflammatory arthritis
model. The majority of perisplenic arterial nerves are within close proximity of the
lumen and are primarily sympathetic efferent fibers. Nerves in the mid-segment may
be the preferred SDN target given their proximity to the artery and paucity of periarterial
off-target organs. SDN appears safe and effective at reducing splenic NEPI levels.
Abbreviations:
SDN (splenic artery denervation), NEPI (norepinephrine), SNS (sympathetic nervous system)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 30, 2019
Accepted:
July 22,
2019
Received in revised form:
July 9,
2019
Received:
February 5,
2019
Footnotes
Mazen Albaghdadi, MD is an Instructor in the Department of Medicine in the Division of Cardiology at Massachusetts General Hospital, Harvard Medical School. Dr. Albaghdadi is interventional cardiologist and physician-scientist with a research interest in translating novel diagnostic and therapeutic medical devices to improve patient care.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
