Advertisement
New methods Experimental endoscopy| Volume 87, ISSUE 1, P300.e1-300.e6, January 2018

Download started.

Ok

Transmural ablation of the normal porcine common bile duct with catheter-directed irreversible electroporation is feasible and does not affect duct patency

      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

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Gastrointestinal Endoscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Steel A.W.
        • Postgate A.J.
        • Khorsandi S.
        • et al.
        Endoscopically applied radiofrequency ablation appears to be safe in the treatment of malignant biliary obstruction.
        Gastrointest Endosc. 2011; 73: 149-153
        • Strand D.S.
        • Cosgrove N.D.
        • Patrie J.T.
        • et al.
        ERCP-directed radiofrequency ablation and photodynamic therapy are associated with comparable survival in the treatment of unresectable cholangiocarcinoma.
        Gastrointest Endosc. 2014; 80: 794-804
        • Zhou C.
        • Wei B.
        • Gao K.
        • et al.
        Biliary tract perforation following percutaneous endobiliary radiofrequency ablation: a report of two cases.
        Oncol Lett. 2016; 11: 3813-3816
        • Shin J.U.
        • Lee K.H.
        • Kim S.A.
        • et al.
        Intraductal thermal injury using a heat probe and radiofrequency ablation electrode in a swine model of biliary stenosis.
        Clin Res Hepatol Gastroenterol. 2013; 37: 159-165
        • Park J.S.
        • Jeong S.
        • Kim J.M.
        • et al.
        Development of a swine benign biliary stricture model using endoscopic biliary radiofrequency ablation.
        J Korean Med Sci. 2016; 31: 1438-1444
        • Dollinger M.
        • Zeman F.
        • Niessen C.
        • et al.
        Bile duct injury after irreversible electroporation of hepatic malignancies: evaluation of MR imaging findings and laboratory values.
        J Vasc Interv Radiol. 2016; 27: 96-103
        • Silk M.T.
        • Wimmer T.
        • Lee K.S.
        • et al.
        Percutaneous ablation of peribiliary tumors with irreversible electroporation.
        J Vasc Interv Radiol. 2014; 25: 112-118
        • DeOliveira M.L.
        • Glenck M.
        • Castrezana L.
        • et al.
        Irreversible electroporation in HPB cancer treatment - a new ablation modality.
        HPB. 2016; 18: e745
        • Choi J.W.
        • Lu D.S.
        • Osuagwu F.
        • et al.
        Assessment of chronological effects of irreversible electroporation on hilar bile ducts in a porcine model.
        Cardiovasc Intervent Radiol. 2014; 37: 224-230
        • Srimathveeravalli G.
        • Silk M.
        • Wimmer T.
        • et al.
        Feasibility of catheter-directed intraluminal irreversible electroporation of porcine ureter and acute outcomes in response to increasing energy delivery.
        J Vasc Interv Radiol. 2015; 26: 1059-1066

      Linked Article

      • Aspiring to inspIRE: catheter-directed electrical therapy and biliary metal stent patency
        Gastrointestinal EndoscopyVol. 88Issue 2
        • Preview
          In 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.
        • Full-Text
        • PDF