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Microwave Ablation of the Lung in a Porcine Model: Vessel Diameter Predicts Pulmonary Artery Occlusion

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Abstract

Purpose

To determine the size of pulmonary artery (PA) at risk for occlusion during percutaneous microwave ablation and to assess the effect of vessel diameter, number, and patency, on ablation zone volume.

Materials and Methods

Computed tomography (CT) fluoroscopy-guided percutaneous microwave ablations were performed in 8 pigs under general anesthesia. All ablations were performed at 65 W for 5 min with a single 17-gauge antenna positioned in the central third of the lungs. A CT pulmonary angiogram was performed immediately after the ablations. The maximum diameter, number and patency of PA branches within each ablation zone were recorded. Ablation volumes were measured at gross dissection and with CT. Student’s t test was used to compare ablation zone volumes among groups.

Results

Twenty-one pulmonary ablations were performed. Six of the ablation zones (29%) contained at least 1 occluded PA branch. The mean diameter of the occluded PA branches in the ablation zones (2.4 mm; range, 2.0–2.8 mm) was significantly smaller than non-occluded PA branches (3.7 mm; range: 2.1–6.9 mm; p = 0.009). No PA branches ≥3 mm in size were occluded. There was no significant difference in volume of gross ablation zones that contained occluded versus non-occluded PAs (p = 0.42), one versus multiple PAs (p = 0.71), or PAs <3 mm versus ≥3 mm in diameter (p = 0.44).

Conclusions

PAs ≥3 mm in size have a low risk for iatrogenic occlusion during percutaneous microwave ablation. The presence of multiple adjacent PA branches, an occluded PA branch, and a vessel diameter ≥3 mm within the ablation zone had no observed effect on ablation zone volume.

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Acknowledgements

This study was funded in part by National Institutes of Health Grant R01 CA149379 and by the RSNA Research and Education Foundation, Fellow Research Grant. The authors wish to acknowledge veterinary technician Lisa Sampson, BS for her commitment to ensuring ethical care during the animal experiments.

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Authors and Affiliations

  1. Department of Radiology, University of Wisconsin–Madison, 600 Highland Ave., Madison, WI, 53792, USA

    George A. Carberry, Elisabetta Nocerino, Mircea M. Cristescu & Amanda R. Smolock

  2. Department of Radiology and Biomedical Engineering, University of Wisconsin–Madison, 600 Highland Ave., Madison, WI, 53792, USA

    Fred T. Lee Jr. & Christopher L. Brace

Authors
  1. George A. Carberry
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  2. Elisabetta Nocerino
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  3. Mircea M. Cristescu
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  4. Amanda R. Smolock
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  5. Fred T. Lee Jr.
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  6. Christopher L. Brace
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Correspondence to George A. Carberry.

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Conflict of interest

George A. Carberry, Elisabetta Nocerino, Mircea M. Cristescu and Amanda R. Smolock declare that they have no conflict of interests. Fred T. Lee Jr. and Christopher L. Brace are paid consultants for NeuWave Medical, Inc.

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Carberry, G.A., Nocerino, E., Cristescu, M.M. et al. Microwave Ablation of the Lung in a Porcine Model: Vessel Diameter Predicts Pulmonary Artery Occlusion. Cardiovasc Intervent Radiol 40, 1609–1616 (2017). https://doi.org/10.1007/s00270-017-1689-y

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  • DOI: https://doi.org/10.1007/s00270-017-1689-y

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