Percutaneous Approach to Irreversible Electroporation of the Pancreas: Miami Protocol

Percutaneous irreversible electroporation with systemic treatment for locally advanced pancreatic adenocarcinoma

“…The results confirm the safety of IRE-ablation in previously studies (12,(15)(16)(17)(18)(19). To date there has been no mortality directly attributed to the procedure using the percutaneous approach.…”

“…To date there has been no mortality directly attributed to the procedure using the percutaneous approach. Of the 43 patients undergoing 50 sessions of IRE ablation of the pancreatic carcinoma, Venkat and colleagues reported the complications of abdominal pain (23%), pancreatitis (14%), haematoma (16%), 1 case each (2%) of spontaneous pneumothorax, duodenal stenosis, portal vein thrombosis and sepsis (18). In the PANFIRE study of 25 LAPC cases, 11 patients developed gastrointestinal grade-I/II adverse events, 9 developed grade-III complications (2 pancreatitis, 3 biliary obstruction requiring stenting, 1 cholangitis requiring percutaneous drainage, 1 high grade SMA stenosis) and 2 grade-IV adverse events (1 pancreatitis and 1 bleeding from duodenal ulcer) (19).…”

“…Intriguingly, 4 IRE-treated LAPC patients were downstaged to resectability, when this had not been achieved prior to IRE with any prior treatment strategy. Similarly, 2 of 30 LAPC patients from the Miami study went on to have surgery after IRE ablation with R0 resection (18).…”

Irreversible Electroporation: Expanding the Armamentarium against Pancreatic Cancer

“…Further reading is available regarding technical details of the ablation procedure. 30,31 Irreversible Electroporation-Future Directions Irreversible electroporation is a promising addition to the armamentarium against pancreatic cancer, and further research is needed to define the clinical utility of the disease. As previously discussed, the PANFIRE study 29 is a first attempt to establish prospective data on safety in irreversible electroporation, and the larger CROSSFIRE trial is ongoing.…”

Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation): A Review

“…Indications are as follows. Almost all the applications of IRE on PDAC are on stage-III LAPC [ 23 , 24 , 27 , 47 , 65 – 71 ]. Narayanan et al reported three cases of application of IRE on stage-IV patients with centimetric liver metastases from PDAC and two cases of application of IRE as a “bridge” therapy in LAPC before submitting the patients successfully to a radical surgical resection [ 72 ].…”