Vessel Occlusion with Transcatheter Electrocoagulation

  • William M. Thompson
  • Irwin S. Johnsrude
  • Kurt Amplatz
  • William M. Thompson
  • Irwin S. Johnsrude
Conference paper


Transcatheter intravascular electrocoagulation for therapeutic occlusion of vessels has been experimentally developed and successfully used clinically as an alternative to, and in conjunction with, more routine methods of vessel occlusion. A constant current power source and a steelguide wire anode are used for the occlusion. The subject is grounded with a standard bovie plate insulated from the skin by a highly lubricated sponge. Permanent occlusion of strategic vessels at accurately controlled sites has been achieved with little risk of embolization of non-target areas. There has been minimal damage to vessel walls, and complete occlusion has been possible despite heparinization and/or thrombocytopenia. One limitation is the inconstant ability to position the anode precisely at the desired site of occlusion. Also, a long time may be required (up to one hour) to occlude larger vessels with presently available anodes. Wider use must await refinements in development of the anode material and in its delivery system.

Key words

Arteries, therapeutic blockade Catheters and catheterization Electrocoagulation Interventional radiology 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Araki, C, Handa, H., Yoshida, K.: Electrically induced thrombosis for the treatment of intracranial aneurysms and angiomas. Excerpta Medica International Congress Series 110: 651–654, 1965Google Scholar
  2. 2.
    Athanasoulis, C.A., Baum, S., Waltman, A.A., Ring, E.J., Im-bembo, A., Vander Salm, T.J.: Control of acute gastric mucosal hemorrhage. N. Engl. J. Med. 290: 597–603, 1974PubMedCrossRefGoogle Scholar
  3. 3.
    Baker, R., Hirschfeld, B., Pizzo, S., Thompson, W.M.: The effect of increasing current for transcatheter electrocoagulation (TCEC). Invest. Radiol, (in press)Google Scholar
  4. 4.
    Bookstein, J.J., Chlosta, E.M., Foley, D., Walter, J.F.: Trans-catheter hemostasis of gastrointestinal bleeding using modified autogenous clot. Radiology 113: 277–285, 1974PubMedGoogle Scholar
  5. 5.
    Bookstein, J.J., Goldstein, H.M.: Successful management of postbiopsy arteriovenous fistula with selective arterial embolization. Radiology 109: 535–536, 1973PubMedGoogle Scholar
  6. 6.
    Carey, L.S., Grace, D.M.: The brisk bleed: Control by arterial catheterization and Gelfoam plug. J. Can. Assoc. Radiol. 25: 113–115, 1974PubMedGoogle Scholar
  7. 7.
    Diulzio, V., Curri, G., Capestro, F., Boccanelli, A., Renzi, R.: Electrolytic phenomena and massive gas generation around pacemaker electrodes. Eur. J. Cardiol. 3: 297, 1975Google Scholar
  8. 8.
    Dymond, A.M.: Characteristics of the metal tissue interfaced of stimulation electrodes. IEEE Trans. Biomed. Eng. 23: 274–280, 1976PubMedCrossRefGoogle Scholar
  9. 9.
    Eisenberg, H., Steer, J.L.: The nonoperative treatment of massive pyloroduodenal hemorrhage by retracted autologous clot embolization. Surgery 79: 414–421, 1976PubMedGoogle Scholar
  10. 10.
    Gold, R.E., Blair, D.C., Finlay, J.D., Johnston, D.W.B.: Transarterial electrocoagulation therapy of a pseudoaneurysm in the head of the pancreas. Am. J. Roentgenol. 125: 422–426, 1975Google Scholar
  11. 11.
    Goldman, M.L., Freeny, P.C., Tallman, J.M., Galambos, J.T., Bradley, E.L., Salom, A., Oen, K.-T., Gordon, I.J., Menne-meyer, R.: Transcatheter vascular occlusion therapy with isobu-tyl 2-cyanoacrylate (Bucrylate) for control of massive upper gastrointestinal bleeding. Radiology 129: 41–49, 1978PubMedGoogle Scholar
  12. 12.
    Goldstein, H.M., Wallace, S., Anderson, J.H., Bree, R.L., Gianturco, C.: Transcatheter occlusion of abdominal tumors. Radiology 120: 539–545, 1976PubMedGoogle Scholar
  13. 13.
    Gomes, A.S., Rysauy, J.A., Spadaccini, C.A., Probst, P., D’Souza, V., Amplatz, K.: The use of the bristle brush for transcatheter embolization. Radiology 129: 345–350, 1978PubMedGoogle Scholar
  14. 14.
    Greatbatch, W., Piersma, B., Shannon, F.D., Calhoon, S.W.: Polarization phenomena relating to physiological electrodes. Advances in cardiac pacemakers. Ann. N.Y. Acad. Sci. 167: 722–744, 1969CrossRefGoogle Scholar
  15. 15.
    Hirschfeld, B.J., Clark, H.C., Thompson, W.M.: The effect of temperature and pH in transcatheter electrocoagulation (TCEC). Invest. Radiol. (in press)Google Scholar
  16. 16.
    Hirschfeld, B., McAlister, D.S., Lowther, D., Jackson, D.C., Pizzo, S., Thompson, W.M.: An evaluation of size and position of the anode and cathode during transcatheter electrocoagulation (TCEC). Invest. Radiol. 14: 387, 1979Google Scholar
  17. 17.
    Hosobuchi, Y.: Electrothrombosis of carotid-cavernous fistula. J. Neurosurg. 42: 76–85, 1975PubMedCrossRefGoogle Scholar
  18. 18.
    Leeming, M.N., Ray, C, Jr., Howland, W.S.: Low voltage, direct current burns, JAMA 214: 1681–1684, 1970PubMedCrossRefGoogle Scholar
  19. 19.
    Loucks, R.B., Weinberg, H., Smith, M.: The erosion of electrodes by small currents. Electroencephalogr. Clin. Neurophy-siol. 11: 823, 1959CrossRefGoogle Scholar
  20. 20.
    McAlister, D.S., Johnsrude, I.S., Miller, M.D., Clapp, J., Thompson, W.M.: Occlusion of an acquired renal arteriovenous fistula with transcatheter electrocoagulation: A case report. Am. J. Roentgenol. 132: 998–1000, 1979Google Scholar
  21. 21.
    Miller, F.J., Rankin, R.S., Gliedman, J.B.: Experimental internal iliac artery embolization: Evaluation of low viscosity silicone rubber isobutyl 2-cyanoacrylate, and carbon microspheres. Radiology 129: 51–58, 1978PubMedGoogle Scholar
  22. 22.
    Miller, M.D., Johnsrude, I.S., Limberakis, A.J., Jackson, B.C., Pizzo, S., Thompson, W.M.: Clinical use of transcatheter electrocoagulation. Radiology 129: 211–214, 1978PubMedGoogle Scholar
  23. 23.
    Mullan, S.: Experiences with surgical thrombosis of intracranial berry aneurysms and carotid cavernous fistulas. J. Neurosurg. 41: 657–670, 1974PubMedCrossRefGoogle Scholar
  24. 24.
    Phillips, J.F.: Transcatheter electrocoagulation of blood vessels. Invest. Radiol. 8: 295–304, 1973PubMedCrossRefGoogle Scholar
  25. 25.
    Phillips, J.F., Robinson, A.E., Johnsrude, I.S., Jackson, D.C.: Experimental closure of arteriovenous fistulae by transcatheter electrocoagulation. Radiology 115: 319–321, 1975PubMedGoogle Scholar
  26. 26.
    Rösch, J., Dotter, C.T., Brown, M.J.: Selective arterial embolization. A new method for control of acute gastrointestinal bleeding. Radiology 102: 202–206, 1972Google Scholar
  27. 27.
    Rowley, B.A.: Electrolysis — a factor in cardiac pacemaker electrode failure. IEEE Trans. Biomed Electr. 10: 176, 1963Google Scholar
  28. 28.
    Sawyer, P.N., Pate, J.W.: Bio-electrical phenomena as an etio-logic factor in intravascular thrombosis. Am. J. Physiol. 175: 103–107, 1973Google Scholar
  29. 29.
    Serbienko, F.A.: Balloon catheterization and occlusion of major cerebral vessels. J. Neurosurg 41: 125–145, 1974CrossRefGoogle Scholar
  30. 30.
    Tadavarthy, S.M., Moller, J.H., Amplatz, K.: Polyvinyl alcohol (Ivalon): A new embolic material. Am. J. Roentgenol. 125: 609–616, 1975Google Scholar
  31. 31.
    Thompson, W.M., Pizzo, S.V., Jackson, D.C., Johnsrude, I.S.: Transcatheter electrocoagulation: A therapeutic angiographic technique for vessel occlusion. Invest. Radiol. 12: 146–153, 1977PubMedCrossRefGoogle Scholar
  32. 32.
    Thompson, W.M., Pizzo, S., Jackson, D.C., Johnsrude, I.S.: The effect of drug induced thrombocytopenia on direct current transcatheter electrocoagulation. Radiology 124: 831–833, 1977PubMedGoogle Scholar
  33. 33.
    Thompson, W.M., McAlister, S., Miller, M., Pizzo, S.V., Jackson, D.C, Johnsrude, I.S.: Transcatheter electrocoagulation: An experimental evaluation of the anode. Invest Radiol. 14: 41–47, 1979PubMedCrossRefGoogle Scholar
  34. 34.
    Thompson, W.M., Johnsrude, I.S., Jackson, D.C, McAlister, S., Miller, M.D., Pizzo, S.V.: Vessel occlusion with transcatheter electroagulation: An initial clinical experience. Radiology 133: 335–340, 1979PubMedGoogle Scholar
  35. 35.
    Wallace, S., Gianturco, C., Anderson, J.H., Goldstein, H.M., Davis, L.J., Bree, R.L.: Therapeutic vascular occlusion utilizing steel coil technique: Clinical applications. Am. J. Roentgenol. 127: 381–387, 1976Google Scholar
  36. 36.
    White, R.L, Kaufmann, S.L., Barth, K.H., DeCaprio, V., Strandberg, J.D.: Embolotherapy with detachable silicone balloons: Technique and clinical results. Radiology 131: 619–627, 1979PubMedGoogle Scholar
  37. 37.
    Yoneda, S., Matsuda, M., Shimizu, Y., Goto, H., Handa, H., Ogawa, Y.: Electrothrombosis of arteriovenous malformation. Neurol. Med. Chir. 17: 19–28, 1977CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1981

Authors and Affiliations

  • William M. Thompson
    • 1
  • Irwin S. Johnsrude
    • 2
  • Kurt Amplatz
    • 3
  • William M. Thompson
  • Irwin S. Johnsrude
  1. 1.Departments of RadiologyDuke University Medical CenterDurhamUSA
  2. 2.Pitt County Memorial HospitalGreenvilleUSA
  3. 3.Department of RadiologyUniversity Hospitals, University of MinnesotaMinneapolisUSA

Personalised recommendations