Background and Aims
The aim of this study was to evaluate the feasibility and early safety of catheter-directed
irreversible electroporation (IRE) of the normal common bile duct (CBD) in swine.
Methods
IRE (2000 V, 90 pulses, 100 μs pulse) was performed in the CBD of 6 Yorkshire pigs
using a catheter electrode under endoscopic guidance. Ductal patency was assessed
with immediate retrograde cholangiography and contrast-enhanced CT imaging at 1 or
7 days after treatment. Animals were killed at either 1 day (n = 4, 2 ablations/animal)
or 7 days (n = 2, 1 ablation/animal) after treatment. The biliary tract was extracted
en bloc and the length of the ablation along the CBD mucosa was measured. The depth
of ablation was quantified using cross-sections of the treated CBD wall stained with
hematoxylin and eosin. Single-sample hypothesis testing was performed to verify whether
the depth of ablation in the CBD was a representative outcome of IRE treatment.
Results
IRE of the CBD did not result in perforation or obstruction of the organ at 1 or 7
days after treatment. The length of ablation along the CBD mucosa was 17.27 ± 5.55 mm
on day 1 samples, and transmural ablation of the CBD wall was a representative outcome
of the treatment (7/8 samples, P < .05). Day 1 samples demonstrated loss of epithelium, transmural necrosis, with
preservation of lumen integrity. Day 7 samples demonstrated re-epithelialization,
with diffuse transmural fibrosis of the CBD wall. These findings were absent from
sham tissue samples.
Conclusions
Intraluminal catheter-directed IRE is feasible and safe for full-thickness ablation
of the normal porcine CBD without affecting lumen patency up to 1 week after treatment.
Abbreviations:
CBD (common bile duct), IRE (irreversible electroporation), RFA (radiofrequency ablation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 10, 2017
Accepted:
May 1,
2017
Received:
February 21,
2017
Footnotes
DISCLOSURE: Mark Schattner has served as a consultant for Boston Scientific. Stephen B. Solomon has served as a consultant for Medtronics and is a shareholder of Aspire Bariatrics. All other authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr Srimathveeravalli at [email protected]
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© 2018 by the American Society for Gastrointestinal Endoscopy
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Access this article on ScienceDirectLinked Article
- Aspiring to inspIRE: catheter-directed electrical therapy and biliary metal stent patencyGastrointestinal EndoscopyVol. 88Issue 2
- PreviewIn the January issue of Gastrointestinal Endoscopy, Ueshima et al1 describe the feasibility and safety of catheter-directed irreversible electroporation (IRE) of a normal common bile duct (CBD) in an animal model. The authors report the results of their initial experience with a novel catheter (20 mm long, 7F) using a modified 240-cm balloon dilation catheter, which serves as a monopolar device to perform direct IRE at 2000 V, 90 pulses, and 100-μs pulse. On the basis of these preliminary results.
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