Ex vivo human bile duct radiofrequency ablation with a bipolar catheter

Atar, Mustafa; Kadayıfçı, Abdurrahman; Daglilar, Ebubekir; Hagen, Catherine; Castillo, Carlos Fernández‐del; Brugge, William R.

doi:10.1007/s00464-017-5984-0

Cited by 14 publications

(16 citation statements)

References 15 publications

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“…In endobiliary RFA, controlling the depth of ablation is the most important aspect for both efficacy and safety. 10,11 It is necessary to consistently achieve the target ablation depth. Our balloon-based RFA obtained a well-featured necrotic area proportional to the output power around the balloon.…”

Section: Discussionmentioning

confidence: 99%

Novel balloon catheter‐based endobiliary radiofrequency ablation system: Ex‐vivo experimental study

Inoue

Ito

Yoneda

2020

Digestive Endoscopy

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Background Endobiliary radiofrequency ablation (RFA) is a promising treatment option for malignant biliary obstruction, but conventional catheter RFA (Conventional‐RFA) has several limitations. We examined the feasibility of a novel approach to balloon‐based RFA (Balloon‐RFA) with an automatic temperature control system in freshly resected pig livers. Methods Balloon‐RFA application was performed in a step‐by‐step manner at target temperatures of 50°C, 60°C, and 70°C. The temperatures were maintained for 60 s. As a control, Conventional‐RFA was performed at 7 W of power for 90 s, 7 W 120 s, 10 W 90 s, and 10 W 120 s. The ablation areas were measured and compared between Balloon‐RFA and Conventional‐RFA. Results The maximum ablation depths in Balloon‐RFA were 1.86 ± 0.53, 2.29 ± 0.31, and 3.19 ± 0.47 mm at target temperatures of 50, 60, and 70°C, respectively. The maximum ablation depths in Conventional‐RFA were 2.81 ± 0.46, 4.09 ± 0.45, 3.41 ± 0.58, and 4.27 ± 0.29 mm at 7 W 90 s, 7 W 120 s, 10 W 90 s, and 10 W 120 s, respectively. Differences between the minimum and maximum depths were significantly smaller in Balloon‐RFA (0.73 ± 0.31 mm) than in Conventional‐RFA (2.00 ± 0.62 mm; P < 0.001). Excessive ablation occurred only in Conventional‐RFA (0% vs. 67%; P = 0.005). Conclusions The novel balloon‐based RFA system allows ablation to be finely tuned in order to successfully obtain consistent ablation depths and avoid excessive ablation.

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Section: Discussionmentioning

confidence: 99%

Novel balloon catheter‐based endobiliary radiofrequency ablation system: Ex‐vivo experimental study

Inoue

Ito

Yoneda

2020

Digestive Endoscopy

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“…The concept of endoluminal thermal ablation is not really new since it has already been used in clinical applications for vascular occlusion such as e.g. hepatic tumor arteries, varicose veins [8,9] and biliary tumors [10]. However, to our knowledge, there is no evidence that this technique has been previously employed for pancreatic remnant sealing, as proposed here.…”

Section: Introductionmentioning

confidence: 94%

Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct

Ewertowska

Andaluz

Moll

et al. 2019

International Journal of Hyperthermia

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Introduction: Endoluminal sealing of the pancreatic duct by glue or sutures facilitates the management of the pancreatic stump. Our objective was to develop a catheter-based alternative for endoluminal radiofrequency (RF) sealing of the pancreatic duct. Materials and methods: We devised a novel RF ablation technique based on impedance-guided catheter pullback. First, bench tests were performed on ex vivo models to tune up the technique before the in vivo study, after which endoluminal RF sealing of a $10 cm non-transected pancreatic duct was conducted on porcine models using a 3 Fr catheter. After 30 days, sealing effectiveness was assessed by a permeability test and a histological analysis. Results: The RF technique was feasible in all cases and delivered $5 W of power on an initial impedance of 308 ± 60 X. Electrical impedance evolution was similar in all cases and provided guidance for modulating the pullback speed to avoid tissue sticking and achieve a continuous lesion. During the follow-up the animals rate of weight gain was significantly reduced (p < 0.05). Apart from signs of exocrine atrophy, no other postoperative complications were found. At necropsy, the permeability test failed and the catheter could not be reintroduced endoluminally, confirming that sealing had been successful. The histological analysis revealed a homogeneous exocrine atrophy along the ablated segment in all the animals. Conclusions: Catheter-based RF ablation could be used effectively and safely for endoluminal sealing of the pancreatic duct. The findings suggest that a fully continuous lesion may not be required to obtain complete exocrine atrophy.

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“…30–40% of patients with pancreatic cancer are not eligible for radical resection [4], while radiofrequency ablation (RFA) is a treatment means that can be applied to advanced unresectable pancreatic cancer [31]. RFA causes protein denaturation and coagulative necrosis by heating, and blocks the blood supply to the tumor, further causing tumor cell ischemia and delaying tumor growth [32,33]. At the same time, RFA can also enhance the immunity of patients by promoting the immune function of T cells, natural killer cells and macrophages, thereby limiting tumor cell proliferation [34].…”

Section: Discussionmentioning

confidence: 99%

Possible involvement of HSP70 in pancreatic cancer cell proliferation after heat exposure and impact on RFA postoperative patient prognosis

Song

2019

Biochemistry and Biophysics Reports

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PurposeAs an alleviative treatment measured in patients with unresectable advanced pancreatic cancer, radiofrequency ablation (RFA) needed more clinical data to prove its advantages and to explore limitations in its utilization. This study was determined to observe the efficacy of RFA, and to explore its impact on perioperative periphery carcinoma as well as the normal pancreatic tissues.MethodsClinical data of 32 patients with pancreatic cancer accepted RFA surgery were collected. Followed up patients’ pain degree and the changes in serum tumor markers CA19-9 and CA 242 before and after surgery. Ex vivo, gave human pancreatic cancer cell line PANC-1 heat treatment to simulate the heat exposure condition periphery carcinoma was experienced during RFA surgery, and to observe the proliferation rate and HSP70 expression change compared with control group.ResultsOf the 32 patients, 1 died of upper gastrointestinal hemorrhage, and 29 survived for more than 5 months, 2 of which for more than 16 months. The average CA19-9 and CA 242 levels of the patients were significantly decreased in 3 months after surgery (t = 9.873, 5.978, P < 0.001). During in vitro experiments, the proliferation rate of PANC-1 cells after heating was significantly increased, accompanied with the increased HSP70 expression. The addition of HSP70 inhibitor can inhibit the rise of proliferation after heat therapy.ConclusionUtilizing RFA treat patients with unresectable advanced pancreatic cancer, could effectively relieve the pain, decline jaundice, and deduce tumor marker levels significantly. However, it failed to extend the long-term survival rate of the patients significantly. This study found that a higher proliferative rate accompanied with a higher HSP70 expression level were observed on in vitro cultured pancreatic carcinoma cells after heat treatment, which could be altered by HSP70 inhibitor. And these findings indicated that the heat exposure might impact periphery carcinoma during RFA surgery and HSP70 might play an important role in patients’ prognosis.

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Ex vivo human bile duct radiofrequency ablation with a bipolar catheter

Cited by 14 publications

References 15 publications

Novel balloon catheter‐based endobiliary radiofrequency ablation system: Ex‐vivo experimental study

Novel balloon catheter‐based endobiliary radiofrequency ablation system: Ex‐vivo experimental study

Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct

Possible involvement of HSP70 in pancreatic cancer cell proliferation after heat exposure and impact on RFA postoperative patient prognosis

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