Publication details

Irreversible electroporation for treatment of biliary metal stent occlusion – experimental model



Year of publication 2020
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Description Purpose: To prove the safety and feasibility of irreversible electroporation (IRE) using tubular catheter to treat biliary metal stent occlusions in an experiment liver model. Material and methods: IRE was performed using 3-electrode tubular IRE catheter placed in metal stents (EGIS biliary stent 10x80 mm) in porcine liver models. The IRE catheter was connected to an IRE generator, with two electrodes set as active and one as indifferent. Ninety 100 us pulses at voltages 300V, 650V, 1000V, and 1300V were used. In the ex vivo part, stent occlusion was simulated by inserting pig liver tissue between the stent and the IRE catheter. In vivo (3 pigs in general anaesthesia) was used incised lower edge of the liver inserted into the stent. Three scenarios of geometry settings between stent, electrodes and inserted tissue were analysed. Values of electric current, impedance, and power output were measured. Pigs were sacrificed 72 hours after the procedure and harvested samples (14 in experimental group, 13 controls) underwent histopathological analysis. Results: The IRE procedure was feasible for all settings of the voltages of 300V and 650V, short circuit immediately occurred at 1300 V and when both active IRE electrodes were in contact with the stent. No complications during and after the procedure were observed. Significant difference of impedance between one-electrode and two-electrodes ranges of simulated stent occlusion was observed (ex vivo p 0,0001, in vivo p=0,02 Mann-Whitney). The extent of necrotic changes in experimental samples in vivo corelated with value of measured electric current, no necrotic changes in control samples were present Conclusion: IRE using a 3-electrode tubular catheter shows feasibility for treatment of metal stent ingrowth. The stent and IRE-electrode relationship can be estimated based on impedance values.
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