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Simulation of the biliary metal stent recanalisation using endoluminal irreversible electroporation on porcine liver - in vivo experiment

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ROHAN Tomáš ANDRAŠINA Tomáš MATKULČÍK Peter JŮZA Tomáš ZAVADIL Jan SVOBODOVÁ Iva ČERVINKA Dalibor VÁLEK Vlastimil

Druh Konferenční abstrakty
Fakulta / Pracoviště MU

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Citace
Popis Purpose: To demonstrate feasibility of endoluminal irreversible electroporation using tubular catheter in biliary metal stent for recanalisation. Material and methods: 25 simulations of metal stent obstruction on porcine liver in vivo were performed by liver lower edge incision and its insertion in the biliary metal stent. In 14 cases endoluminal irreversible electroporation with tubular catheter prototype were performed, others were set as controls. Three diferent scenarios of IRE were simulated (one, two or zero electrodes in contact with metal stent). Ninety 100 us pulses with 300,650,1000 and 1300 Volts were used in each scenario. Electrical parameters, macroscopical changes, side efects were monitored during the procedure. Early complications were evaluated by CT immediately and 72 hours after the procedure, followed by samples harvesting. Results: There were no complications detected during the procedure and on following CTs, enduluminal IRE was succesful in all cases. Signifcant diference in impedance was observed between all scenario settings (p=0,02, Mann-Whitey). Short circuit occured immediately in 1300 V in all scenarios, in both cases of 1000 V with one electrode in contact with stent and in case where both electrodes were in contact with stent. The highest observed safe voltage for IRE in metal stent was 850 V/cm. Histopathological analysis showed signs of tissue necrosis which were not present in control samples. Conclusion: Endoluminal irreversible electroporation using tubular catheter seems safe and feasible method and has potential for non-thermal metal stent ingrowth treatment.
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