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Irreversible electroporation for treatment of metal stent occlusion in biliary tract – ex vivo experimental model

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ANDRAŠINA Tomáš VÁLEK Vlastimil ROHAN Tomáš JŮZA Tomáš MATKULČÍK Peter POKORNÁ Jana VÁLEK Vlastimil

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Fakulta / Pracoviště MU

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Popis Purpose To prove the safety and feasibility of irreversible electroporation (IRE) using tubular catheters to treat biliary metal stent occlusions in an ex vivo experiment model. Material and methods IRE was performed using 3-electrode tubular IRE catheters placed in metal stents (EGIS biliary stent 10x80 mm) in ex vivo porcine liver models. The IRE catheter was connected to an IRE generator, with two electrodes set as active and one as indifferent. One-hundred 100 us pulses at voltages 300V, 650V, 1000V, and 1300V were used. Stent occlusion was simulated using porcine liver tissues of different thickness (2±1 mm and 5±1 mm). Five scenarios of geometry settings between stent, electrodes, and inner tissue were analysed. Values of electric current, impedance, and power output were measured. Potentially dangerous thermal effects were monitored thermographically and visually on the stent and surrounding parenchyma. Results The IRE procedure was feasible for all settings of the voltages of 300V and 650V. The maximum current limit of the generator was exceeded in case of low profile ingrowth tissue connected with one electrode and in all settings with use of 1300V. In these cases, thermal changes of the liver tissue were visualised. In contrast, heat changes in protocols using 300-650V were recorded only in range of 1,0-4,5°C. Significant difference of impedance between one-electrode and two-electrodes ranges of simulated stent occlusion was observed (p = 0,02, Mann-Whitney). Conclusion IRE using a 3-electrode tubular catheter shows feasibility for treatment of metal stent ingrowth in ex vivo experiments. We have established a safe and applicable IRE protocol for further in vivo experiments.
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