Eisuke Ueshima1, Mark Schattner2, Robin Mendelsohn2, Hans Gerdes2, Sebastien Monette3, Haruyuki Takaki4, Jeremy C Durack5, Stephen B Solomon5, Govindarajan Srimathveeravalli5. 1. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Radiology, Kobe University, Kobe, Japan. 2. Gasteroenterology and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA. 3. Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, The Rockefeller University, and Weill Cornell Medical College, New York, New York, USA. 4. Department of Radiology, Hyogo Medical College, Hyogo, Japan. 5. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Radiology, Weill Cornell Medical College, New York, New York, USA.
Abstract
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.
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.
Authors: Govindarajan Srimathveeravalli; Mikhail Silk; Thomas Wimmer; Sebastien Monette; Simon Kimm; Majid Maybody; Stephen B Solomon; Jonathan Coleman; Jeremy C Durack Journal: J Vasc Interv Radiol Date: 2015-03-11 Impact factor: 3.464
Authors: Jae Woong Choi; David S K Lu; Ferdnand Osuagwu; Steven Raman; Charles Lassman Journal: Cardiovasc Intervent Radiol Date: 2013-11-07 Impact factor: 2.740
Authors: Marco Dollinger; Florian Zeman; Christoph Niessen; Sven A Lang; Lukas P Beyer; Martina Müller; Christian Stroszczynski; Philipp Wiggermann Journal: J Vasc Interv Radiol Date: 2016-01 Impact factor: 3.464
Authors: Mikhail T Silk; Thomas Wimmer; Kyungmouk S Lee; Govindarajan Srimathveeravalli; Karren T Brown; Peter T Kingham; Yuman Fong; Jeremy C Durack; Constantinos T Sofocleous; Stephen B Solomon Journal: J Vasc Interv Radiol Date: 2013-11-18 Impact factor: 3.464
Authors: Daniel S Strand; Natalie D Cosgrove; James T Patrie; Dawn G Cox; Todd W Bauer; Reid B Adams; James A Mann; Bryan G Sauer; Vanessa M Shami; Andrew Y Wang Journal: Gastrointest Endosc Date: 2014-05-15 Impact factor: 9.427
Authors: Wolf Bäumler; Mareike Sebald; Ingo Einspieler; Andreas Schicho; Jan Schaible; Philipp Wiggermann; Marco Dollinger; Christian Stroszczynski; Lukas Philipp Beyer Journal: Cancer Manag Res Date: 2020-09-14 Impact factor: 3.989