Jae Hee Cho1, Kwang Hyuck Lee2, Joon Mee Kim3, Yeon Suk Kim1, Don Haeng Lee4, Seok Jeong4. 1. Department of Internal Medicine, Gil Medical Center, Gachon University, Incheon, Korea. 2. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 3. Department of Pathology, Inha University School of Medicine, Incheon, Korea. 4. Department of Gastroenterology and Hepatology, and the National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University School of Medicine, Incheon, Korea.
Abstract
BACKGROUND AND AIM: Endobiliary radiofrequency ablation (EB-RFA) is a new endoscopic palliation and adjunctive tool. Although EB-RFA is performed worldwide, a possibility of iatrogenic thermal injury leading to perforation or bleeding still remains. Therefore, we aimed to assess the effects of thermal and coagulation injury after in vivo EB-RFA using a new catheter with a temperature sensor in a swine model. METHODS: Twelve mini pigs were divided into four groups according to power (33 mm 10 W electrode vs. 18 mm 7 W electrode) and RFA target temperature (75°C vs. 80°C). All mini pigs underwent endoscopic retrograde cholangiography and target temperature controlled EB-RFA for 120 s. Additional cholangiogram was taken immediately after RFA, and all pigs were sacrificed after 24 h to assess the macroscopic/microscopic RFA injury. RESULTS: Microscopic maximal injury depth and ablation area of EB-RFA using a 33-mm 10 W RFA electrode were significantly deeper and larger than those of EB-RFA using an 18-mm 7 W electrode (median; 2.7 vs. 2.1 mm, P = 0.004, 48.9 vs. 36.2 mm2 , P = 0.016). However, there were no significant differences in microscopic ablation parameters between two different RFA target temperatures (75°C vs. 80°C). In addition, a post-RFA cholangiogram and assessment of the resected specimen at 24 h after the RFA showed no adverse events such as perforation or bleeding. CONCLUSIONS: EB-RFA using a temperature controlled RFA catheter successfully ablates the bile duct wall without adverse events in a swine model.
BACKGROUND AND AIM: Endobiliary radiofrequency ablation (EB-RFA) is a new endoscopic palliation and adjunctive tool. Although EB-RFA is performed worldwide, a possibility of iatrogenic thermal injury leading to perforation or bleeding still remains. Therefore, we aimed to assess the effects of thermal and coagulation injury after in vivo EB-RFA using a new catheter with a temperature sensor in a swine model. METHODS: Twelve mini pigs were divided into four groups according to power (33 mm 10 W electrode vs. 18 mm 7 W electrode) and RFA target temperature (75°C vs. 80°C). All mini pigs underwent endoscopic retrograde cholangiography and target temperature controlled EB-RFA for 120 s. Additional cholangiogram was taken immediately after RFA, and all pigs were sacrificed after 24 h to assess the macroscopic/microscopic RFA injury. RESULTS: Microscopic maximal injury depth and ablation area of EB-RFA using a 33-mm 10 W RFA electrode were significantly deeper and larger than those of EB-RFA using an 18-mm 7 W electrode (median; 2.7 vs. 2.1 mm, P = 0.004, 48.9 vs. 36.2 mm2 , P = 0.016). However, there were no significant differences in microscopic ablation parameters between two different RFA target temperatures (75°C vs. 80°C). In addition, a post-RFA cholangiogram and assessment of the resected specimen at 24 h after the RFA showed no adverse events such as perforation or bleeding. CONCLUSIONS: EB-RFA using a temperature controlled RFA catheter successfully ablates the bile duct wall without adverse events in a swine model.
Authors: Sung Ill Jang; Sungsoon Fang; Ji Hae Nahm; Jae Hee Cho; Min Young Do; Su Yeon Lee; Seok Jeong; Don Haeng Lee; Dong Ki Lee Journal: Sci Rep Date: 2022-05-25 Impact factor: 4.996