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Percutaneous Irreversible Electroporation Lung Ablation: Preliminary Results in a Porcine Model

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Abstract

Objective

Irreversible electroporation (IRE) uses direct electrical pulses to create permanent “pores” in cell membranes to cause cell death. In contrast to conventional modalities, IRE has a nonthermal mechanism of action. Our objective was to study the histopathological and imaging features of IRE in normal swine lung.

Materials and Methods

Eleven female swine were studied for hyperacute (8 h), acute (24 h), subacute (96 h), and chronic (3 week) effects of IRE ablation in lung. Paired unipolar IRE applicators were placed under computed tomography (CT) guidance. Some applicators were deliberately positioned near bronchovascular structures. IRE pulse delivery was synchronized with the cardiac rhythm only when ablation was performed within 2 cm of the heart. Contrast-enhanced CT scan was performed immediately before and after IRE and at 1 and 3 weeks after IRE ablation. Representative tissue was stained with hematoxylin and eosin for histopathology.

Results

Twenty-five ablations were created: ten hyperacute, four acute, and three subacute ablations showed alveolar edema and necrosis with necrosis of bronchial, bronchiolar, and vascular epithelium. Bronchovascular architecture was maintained. Chronic ablations showed bronchiolitis obliterans and alveolar interstitial fibrosis. Immediate post-procedure CT images showed linear or patchy density along the applicator tract. At 1 week, there was consolidation that resolved partially or completely by 3 weeks. Pneumothorax requiring chest tube developed in two animals; no significant cardiac arrhythmias were noted.

Conclusion

Our preliminary porcine study demonstrates the nonthermal and extracellular matrix sparing mechanism of action of IRE. IRE is a potential alternative to thermal ablative modalities.

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Acknowledgments

This porcine study was supported by a research fund from Angiodynamics Inc, NY.

Conflict of interest

Research funds were provided by Angiodynamics, Inc. Queensbury, NY; S. S. is a scientific advisor to Angiodynamics Inc.; and G. S and W. H. are employees of Angiodynamics, Inc.

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Authors and Affiliations

  1. Interventional Radiology and Image-Guided Therapies, Memorial Sloan Kettering Cancer Center, New York, NY, 10021, USA

    Ajita Deodhar, Raymond H. Thornton, Constantinos T. Sofocleous, Majid Maybody & Stephen B. Solomon

  2. Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10021, USA

    Sébastien Monette

  3. Angiodynamics, Inc, Queensbury, NY, 12804, USA

    Gordon W. Single Jr & William C. Hamilton Jr

Authors
  1. Ajita Deodhar
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  2. Sébastien Monette
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  3. Gordon W. Single Jr
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  4. William C. Hamilton Jr
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  6. Constantinos T. Sofocleous
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  7. Majid Maybody
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  8. Stephen B. Solomon
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Correspondence to Stephen B. Solomon.

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Deodhar, A., Monette, S., Single, G.W. et al. Percutaneous Irreversible Electroporation Lung Ablation: Preliminary Results in a Porcine Model. Cardiovasc Intervent Radiol 34, 1278–1287 (2011). https://doi.org/10.1007/s00270-011-0143-9

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  • DOI: https://doi.org/10.1007/s00270-011-0143-9

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