Publication details

Irreversible electroporation with endoluminal balloon catheterin perihilar region: preliminary results



Year of publication 2016
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Description 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.
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