Irreversible Electroporation of the Liver and Liver Hilum in Swine

Department of Surgery, Rode Island Hospital and Warren Alpert School of Medicine at Brown University, Providence, RI, USA.
HPB (Impact Factor: 2.68). 03/2011; 13(3):168-73. DOI: 10.1111/j.1477-2574.2010.00261.x
Source: PubMed


Irreversible electroporation (IRE) is a novel, non-thermal form of ablation. We studied the safety and efficacy of IRE for the ablation of liver tissue around the liver hilum. We also studied the ability of triphenyltetrazolium chloride staining (TTC) to predict the zone of ablation after IRE.
Eight swine underwent 20 ablations of the liver and liver hilum. Two monopolar probes were positioned 2 cm apart. IRE was performed using 90 pulses of 2500-3000 V/cm. IRE treatments were performed from 15 min to 14 days (n= 4) before sacrifice.
All animals survived. No major complications were encountered. Ablation width ranged from 2.27 to 4.45 cm and ablation height ranged from 1.5 to 1.8 cm. TTC staining demonstrated the zone of ablation in all animals. Hepatocyte necrosis occurs immediately adjacent to large central veins without evidence of heat sink. Bile ducts, portal veins and hepatic arteries appear to be more resistant to the effects of IRE.
IRE appears to be safe and effective for liver tissue ablation in the liver hilum. The portal structures appear more resistant to the effects of IRE. TTC staining can predict the zone of IRE ablation as early as 15 min after treatment.

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    • "IRE, previously viewed as an undesireable upper limit of reversible electroporation because it rendered the cells permanently permeable and therefore nonviable, is now used clinically as a form of nonthermal ablation. While supported by animal models [39–41] and available commercially for use in patients, IRE has not been well studied in patients. It does have the theoretical advantages, however, of being very fast (micro- to milliseconds), preserving connective tissue architecture thereby allowing ablation close to vital structures in the liver hilum for example, and unlike thermal techniques it is not likely affected by blood flow [38]. "
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