Irreversible Electroporation

Ball, Christine; Thomson, Kenneth R.; Kavnoudias, Helen

doi:10.1213/ane.0b013e3181d27b30

Cited by 182 publications

(57 citation statements)

References 10 publications

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“…[52] In addition, IRE can cause unintended injury to other structures when electrodes are placed. Ball et al [43] reported 3 instances of pneumothorax during their study. One of these cases occurred after transabdominal placement of electrodes in the liver.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac arrhythmia is also a notable serious complication from IRE due to the presence of high current close to the heart. Ventricular bigeminy, ventricular tachycardia, and atrial fibrillation were reported by Ball et al and Thomson et al [43,44] According to the study, the most serious cardiac rhythm disturbance occurred during the ablation of a very large hepatic tumor which was directly beneath the diaphragm and close to the inferior cardiac border. [43] …”

Section: Discussionmentioning

confidence: 99%

“…In 2010, Ball et al [43] published a clinical trial report of IRE on evaluating the complications associated with IRE procedure which is the first report of IRE intervention in human subjects. They found IRE to be an encouraging new technique and most importantly, it spared adjacent tissues with no vascular damage.…”

Section: Ire Of Hepatic Tumors In Clinical Settingsmentioning

confidence: 99%

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Irreversible electroporation in primary and metastatic hepatic malignancies

Lyu

Wang

et al. 2017

Medicine

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Background:Liver cancer makes up a huge percentage of cancer mortality worldwide. Irreversible electroporation (IRE) is a relatively new minimally invasive nonthermal ablation technique for tumors that applies short pulses of high frequency electrical energy to irreversibly destabilize cell membrane to induce tumor cell apoptosis.Methods:This review aims to investigate the studies regarding the use of IRE treatment in liver tumors and metastases to liver. We searched PubMed for all of IRE relevant English language articles published up to September 2016. They included clinical trials, experimental studies, observational studies, and reviews. This review manuscript is nothing with ethics issues and ethical approval is not provided.Results:In recent years, increasingly more studies in both preclinical and clinical settings have been conducted to examine the safety and efficacy of this new technique, shedding light on the crucial advantages and disadvantages that IRE possesses. Unlike the current leading thermal ablation techniques, such as radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation, IRE requires shorter ablation time without damaging adjacent important vital structures.Conclusion:Although IRE has successfully claimed its valuable status in the field of hepatic cancer treatment both preclinical and clinical settings. In order to systemically test and establish its safety and efficacy for clinical applications, more studies still need to be conducted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Ire Of Hepatic Tumors In Clinical Settingsmentioning

confidence: 99%

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Irreversible electroporation in primary and metastatic hepatic malignancies

Lyu

Wang

et al. 2017

Medicine

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“…Because cells survive these high subzero freezing temperatures, cryosurgery/PEF would retain PEFs' ability to selectively ablate only cellular membranes without affecting the extracellular matrix, when cryosurgery/PEF is used at high subzero temperatures. Another advantage of this combination may be related to elimination of certain side effects and limitations of PEF [41], [42]. The most severe side effects are arrhythmias and involuntary muscle contractions [41], [42] caused by low strength electric fields that expand beyond the PEF treatment zone.…”

Section: Resultsmentioning

confidence: 99%

“…Another advantage of this combination may be related to elimination of certain side effects and limitations of PEF [41], [42]. The most severe side effects are arrhythmias and involuntary muscle contractions [41], [42] caused by low strength electric fields that expand beyond the PEF treatment zone. The solution to arrhythmias through a synchronizer device is described in [42].…”

Section: Resultsmentioning

confidence: 99%

Cryosurgery with Pulsed Electric Fields

Daniels

Rubinsky

2011

PLoS ONE

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This study explores the hypothesis that combining the minimally invasive surgical techniques of cryosurgery and pulsed electric fields will eliminate some of the major disadvantages of these techniques while retaining their advantages. Cryosurgery, tissue ablation by freezing, is a well-established minimally invasive surgical technique. One disadvantage of cryosurgery concerns the mechanism of cell death; cells at high subzero temperature on the outer rim of the frozen lesion can survive. Pulsed electric fields (PEF) are another minimally invasive surgical technique in which high strength and very rapid electric pulses are delivered across cells to permeabilize the cell membrane for applications such as gene delivery, electrochemotherapy and irreversible electroporation. The very short time scale of the electric pulses is disadvantageous because it does not facilitate real time control over the procedure. We hypothesize that applying the electric pulses during the cryosurgical procedure in such a way that the electric field vector is parallel to the heat flux vector will have the effect of confining the electric fields to the frozen/cold region of tissue, thereby ablating the cells that survive freezing while facilitating controlled use of the PEF in the cold confined region. A finite element analysis of the electric field and heat conduction equations during simultaneous tissue treatment with cryosurgery and PEF (cryosurgery/PEF) was used to study the effect of tissue freezing on electric fields. The study yielded motivating results. Because of decreased electrical conductivity in the frozen/cooled tissue, it experienced temperature induced magnified electric fields in comparison to PEF delivered to the unfrozen tissue control. This suggests that freezing/cooling confines and magnifies the electric fields to those regions; a targeting capability unattainable in traditional PEF. This analysis shows how temperature induced magnified and focused PEFs could be used to ablate cells in the high subzero freezing region of a cryosurgical lesion.

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Irreversible Electroporation for the Ablation of Liver Tumors

Charpentier¹

2012

Arch Surg

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Irreversible Electroporation

Cited by 182 publications

References 10 publications

Irreversible electroporation in primary and metastatic hepatic malignancies

Irreversible electroporation in primary and metastatic hepatic malignancies

Cryosurgery with Pulsed Electric Fields

Irreversible Electroporation for the Ablation of Liver Tumors

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