Irreversible electroporation with endoluminal ballooncatheterin perihilar region: preliminary results
2016
Purpose: To evaluate the safety and efficacy of endoluminal
irreversible electroporation (IRE) in biliary tract performed
with a balloon catheter in the perihilar region. Material and
methods: Endoluminal IRE of the common bile duct was performed
in 5 domestic swine using a balloon catheter inserted during
laparotomy. IRE catheter consists of 3 electrodes with the
length of 1 cm, attached around an inflatable balloon at 120
degrees. IRE was performed with parameters of 50-90 pulses of
1500-2000V delivered between each couple of electrodes. All
swine models were slaughtered 3 days after the procedure.
Imaging study using MRI and histopathologic follow-up was
performed. Results: The balloon insertion and IRE procedure was
successful in all porcine models. All animals survived for the
designated period of 3 days. Periablation edema in
hepatoduodenal ligament and adjacent liver tissue measured on
postprocedural MRI ranged from 13 to 40 mm in maximum diameter,
2, 5-18, 7 ml in volumetric assessment. No thrombosis of the
portal vein was detected on MRI on days 0 and 3. The elastic
membranes of the portal vein were preserved, while endothelial
cells were destroyed on histopathologic evaluation. The volume
of measured edema increased with energy delivered, in settings
with 90 pulses and 2000 V (approx. 2560 V/cm), perforation of
common bile duct and hematoma of hepatoduodenal ligament
developed in two animals with the highest energy setting (2000
V, 90 pulses). Conclusion: This preliminary study of
endoluminal IRE on porcine models demonstrates the feasibility
of non-thermal ablation in the perihilar region with a balloon
catheter. Higher energy delivered is associated with larger
ablation zones but also with higher risk of postprocedural
complications.
Keywords:
- Correction
- Source
- Cite
- Save
- Machine Reading By IdeaReader
0
References
0
Citations
NaN
KQI