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Vol. 21, Art. 6 (pp. 55-74)    |    2020       

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Types of pulmonary artery injuries, nervous structures and environmental fat cell in the pig bifurction area in circular radio frequency ablation

Almazov National Medical Research Centre

Brief summary

Pulmonary arterial hypertension leads to right ventricular failure and premature death. Recently, a new method for treating the disease has been proposed - radiofrequency ablation, designed to destroy sympathetic nerve fibers and ganglia in adventitia and perivascular fatty tissue of the pulmonary artery. Purpose. To evaluate the various types and degree of damage to the wall of the pulmonary artery, nerve fibers and surrounding fatty tissue during radiofrequency ablation in a pig experiment. Materials and methods. In 17 Landrace pigs, radiofrequency ablation of the pulmonary artery was performed. In 9 cases, ablation was carried out with the aim of creating a mark on the intimate (group No. 1), in 8 cases, with the aim of creating transmural necrosis of the wall (group No. 2). A histological and immunohistochemical study was performed with antibodies to S100, tyrosine hydroxylase, muscarinic acetylcholine receptor M1, dopamine receptor D5. Results. A morphological study revealed the presence of dissections, hemorrhages in media and adventitia, coagulation of adventitia and adipose tissue in both groups, but the length of the latter was greater in group No. 2. Only in 2 cases was necrosis of a part of the nervous structures recorded (in group No. 1 and No. 2). There was no complete correspondence between macroscopic, histological and immunohistochemical changes. The latter were more pronounced. The largest area of expression loss was observed at the M1-muscarinic acetylcholinergic receptor. Conclusion. The most sensitive method for determining morphological damage during ablation of the pulmonary artery is immunohistochemical analysis, and the most sensitive marker is the M1 receptor. Insignificant damage to the nerve structures in our experiment may be due to the fact that the process of their fibrous replacement is stretched over time, which is caused not by direct, but by ischemic-mediated damage.


Key words

pulmonary hypertension; pulmonary artery denervation; radiofrequency ablation

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