Mo1587 Gastric Ablation As a Novel Therapeutic Technique for Modulating Gastric Slow Wave Activity

Angeli, Timothy R.; Quesada, Maria Jose Herrera; Du, Peng; Paskaranandavadivel, Niranchan; Amirapu, Satya; Beyder, Arthur; Asirvatham, Samuel J.; Farrugia, Gianrico; Cheng, Leo K.; O’Grady, Gregory

doi:10.1016/s0016-5085(16)32458-1

Cited by 2 publications

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“…This requires ablation of muscle tissue while maintaining the inner mucosal lining of the stomach wall. While the feasibility of using gastric ablation to modulate electrophysiologic activity of the stomach has been demonstrated using radio frequency ablation (RFA) [6], the depth and pattern of ablation for optimally resolving gastric dysrhythmias is currently unknown. A limitation of RFA is that the tissue must be directly contacted by the electrode.…”

Section: Introductionmentioning

confidence: 99%

Microwave Ablation: A Potential Minimally Invasive Solution for Gastric Motility Disorders

Hardenburger

Prakash

Angeli

et al. 2019

2019 Design of Medical Devices Conference

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Many gastric motility disorders, including gastroparesis, are caused by dysrhythmias occurring in the stomach musculature. Microwave ablation (MWA) offers potential as a minimally invasive endoscopic approach for targeted thermal destruction of the gastric musculature to disrupt irregular electrical rhythm within the stomach wall. An experimental study was conducted in a gel phantom to analyze the transient heating profile of a water-cooled 2.45 GHz MWA antenna enclosed within a PET balloon. Fiber-optic temperature sensors were used to collect temperature data at distances 1.5–7.5 mm from the balloon surface. Ablation profiles were also characterized in ex vivo porcine skeletal muscle. With 20 W applied power and cooling water temperature of 5 °C, temperature measured at 3.5 mm from the balloon surface exceeded the temperature at 1.5 mm from the balloon surface by 3 °C. In ex vivo tissue, for 40 W applied power, tissue within 2 mm of the balloon surface remained unablated. With adequate cooling and power, it may be feasible to thermally spare tissue within 2 mm of the MWA balloon applicator.

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Section: Introductionmentioning

confidence: 99%

Microwave Ablation: A Potential Minimally Invasive Solution for Gastric Motility Disorders

Hardenburger

Prakash

Angeli

et al. 2019

2019 Design of Medical Devices Conference

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Bayesian inverse methods for spatiotemporal characterization of gastric electrical activity from cutaneous multi-electrode recordings

et al. 2019

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Gastrointestinal (GI) problems give rise to 10 percent of initial patient visits to their physician. Although blockages and infections are easy to diagnose, more than half of GI disorders involve abnormal functioning of the GI tract, where diagnosis entails subjective symptom-based questionnaires or objective but invasive, intermittent procedures in specialized centers. Although common procedures capture motor aspects of gastric function, which do not correlate with symptoms or treatment response, recent findings with invasive electrical recordings show that spatiotemporal patterns of the gastric slow wave are associated with diagnosis, symptoms, and treatment response. We here consider developing non-invasive approaches to extract this information. Using CT scans from human subjects, we simulate normative and disordered gastric surface electrical activity along with associated abdominal activity. We employ Bayesian inference to solve the ill-posed inverse problem of estimating gastric surface activity from cutaneous recordings. We utilize a prior distribution on the spatiotemporal activity pertaining to sparsity in the number of wavefronts on the stomach surface, and smooth evolution of these wavefronts across time. We implement an efficient procedure to construct the Bayes optimal estimate and demonstrate its superiority compared to other commonly used inverse methods, for both normal and disordered gastric activity. Region-specific wave direction information is calculated and consistent with the simulated normative and disordered cases. We apply these methods to cutaneous multi-electrode recordings of two human subjects with the same clinical description of motor function, but different diagnosis of underlying cause. Our method finds statistically significant wave propagation in all stomach regions for both subjects, anterograde activity throughout for the subject with diabetic gastroparesis, and retrograde activity in some regions for the subject with idiopathic gastroparesis. These findings provide a further step towards towards non-invasive phenotyping of gastric function and indicate the long-term potential for enabling population health opportunities with objective GI assessment.

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Mo1587 Gastric Ablation As a Novel Therapeutic Technique for Modulating Gastric Slow Wave Activity

Cited by 2 publications

References 0 publications

Microwave Ablation: A Potential Minimally Invasive Solution for Gastric Motility Disorders

Microwave Ablation: A Potential Minimally Invasive Solution for Gastric Motility Disorders

Bayesian inverse methods for spatiotemporal characterization of gastric electrical activity from cutaneous multi-electrode recordings

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