High-Frequency Irreversible Electroporation: Safety and Efficacy of Next-Generation Irreversible Electroporation Adjacent to Critical Hepatic Structures. Siddiqui, I. A., Kirks, R. C., Latouche, E. L., DeWitt, M. R., Swet, J. H., Baker, E. H., Vrochides, D., Iannitti, D. A., Davalos, R. V., & McKillop, I. H. Surg Innov, 24(3):276-283, 2017. 1553-3514 Siddiqui, Imran A Kirks, Russell C Latouche, Eduardo L DeWitt, Matthew R Swet, Jacob H Baker, Erin H Vrochides, Dionisios Iannitti, David A Davalos, Rafael V McKillop, Iain H Journal Article United States 2017/05/12 Surg Innov. 2017 Jun;24(3):276-283. doi: 10.1177/1553350617692202. Epub 2017 Feb 1.doi abstract bibtex Irreversible electroporation (IRE) is a nonthermal ablation modality employed to induce in situ tissue-cell death. This study sought to evaluate the efficacy of a novel high-frequency IRE (H-FIRE) system to perform hepatic ablations across, or adjacent to, critical vascular and biliary structures. Using ultrasound guidance H-FIRE electrodes were placed across, or adjacent to, portal pedicels, hepatic veins, or the gall bladder in a porcine model. H-FIRE pulses were delivered (2250 V, 2-5-2 pulse configuration) in the absence of cardiac synchronization or intraoperative paralytics. Six hours after H-FIRE the liver was resected and analyzed. Nine ablations were performed in 3 separate experimental groups (major vessels straddled by electrodes, electrodes placed adjacent to major vessels, electrodes placed adjacent to gall bladder). Average ablation time was 290 ± 63 seconds. No electrocardiogram abnormalities or changes in vital signs were observed during H-FIRE. At necropsy, no vascular damage, coagulated-thermally desiccated blood vessels, or perforated biliary structures were noted. Histologically, H-FIRE demonstrated effective tissue ablation and uniform induction of apoptotic cell death in the parenchyma independent of vascular or biliary structure location. Detailed microscopic analysis revealed minor endothelial damage within areas subjected to H-FIRE, particularly in regions proximal to electrode insertion. These data indicate H-FIRE is a novel means to perform rapid, reproducible IRE in liver tissue while preserving gross vascular/biliary architecture. These characteristics raise the potential for long-term survival studies to test the viability of this technology toward clinical use to target tumors not amenable to thermal ablation or resection.
@article{RN168,
author = {Siddiqui, I. A. and Kirks, R. C. and Latouche, E. L. and DeWitt, M. R. and Swet, J. H. and Baker, E. H. and Vrochides, D. and Iannitti, D. A. and Davalos, R. V. and McKillop, I. H.},
title = {High-Frequency Irreversible Electroporation: Safety and Efficacy of Next-Generation Irreversible Electroporation Adjacent to Critical Hepatic Structures},
journal = {Surg Innov},
volume = {24},
number = {3},
pages = {276-283},
note = {1553-3514
Siddiqui, Imran A
Kirks, Russell C
Latouche, Eduardo L
DeWitt, Matthew R
Swet, Jacob H
Baker, Erin H
Vrochides, Dionisios
Iannitti, David A
Davalos, Rafael V
McKillop, Iain H
Journal Article
United States
2017/05/12
Surg Innov. 2017 Jun;24(3):276-283. doi: 10.1177/1553350617692202. Epub 2017 Feb 1.},
abstract = {Irreversible electroporation (IRE) is a nonthermal ablation modality employed to induce in situ tissue-cell death. This study sought to evaluate the efficacy of a novel high-frequency IRE (H-FIRE) system to perform hepatic ablations across, or adjacent to, critical vascular and biliary structures. Using ultrasound guidance H-FIRE electrodes were placed across, or adjacent to, portal pedicels, hepatic veins, or the gall bladder in a porcine model. H-FIRE pulses were delivered (2250 V, 2-5-2 pulse configuration) in the absence of cardiac synchronization or intraoperative paralytics. Six hours after H-FIRE the liver was resected and analyzed. Nine ablations were performed in 3 separate experimental groups (major vessels straddled by electrodes, electrodes placed adjacent to major vessels, electrodes placed adjacent to gall bladder). Average ablation time was 290 ± 63 seconds. No electrocardiogram abnormalities or changes in vital signs were observed during H-FIRE. At necropsy, no vascular damage, coagulated-thermally desiccated blood vessels, or perforated biliary structures were noted. Histologically, H-FIRE demonstrated effective tissue ablation and uniform induction of apoptotic cell death in the parenchyma independent of vascular or biliary structure location. Detailed microscopic analysis revealed minor endothelial damage within areas subjected to H-FIRE, particularly in regions proximal to electrode insertion. These data indicate H-FIRE is a novel means to perform rapid, reproducible IRE in liver tissue while preserving gross vascular/biliary architecture. These characteristics raise the potential for long-term survival studies to test the viability of this technology toward clinical use to target tumors not amenable to thermal ablation or resection.},
keywords = {Ablation Techniques/*methods
Animals
Apoptosis
Biomedical Engineering
Electroporation/*methods
Female
Histocytochemistry
Liver/cytology/diagnostic imaging/*surgery
Liver Neoplasms
Surgery, Computer-Assisted/methods
Swine
image-guided surgery
surgical oncology},
ISSN = {1553-3506},
DOI = {10.1177/1553350617692202},
year = {2017},
type = {Journal Article}
}
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Epub 2017 Feb 1.","abstract":"Irreversible electroporation (IRE) is a nonthermal ablation modality employed to induce in situ tissue-cell death. This study sought to evaluate the efficacy of a novel high-frequency IRE (H-FIRE) system to perform hepatic ablations across, or adjacent to, critical vascular and biliary structures. Using ultrasound guidance H-FIRE electrodes were placed across, or adjacent to, portal pedicels, hepatic veins, or the gall bladder in a porcine model. H-FIRE pulses were delivered (2250 V, 2-5-2 pulse configuration) in the absence of cardiac synchronization or intraoperative paralytics. Six hours after H-FIRE the liver was resected and analyzed. Nine ablations were performed in 3 separate experimental groups (major vessels straddled by electrodes, electrodes placed adjacent to major vessels, electrodes placed adjacent to gall bladder). Average ablation time was 290 ± 63 seconds. No electrocardiogram abnormalities or changes in vital signs were observed during H-FIRE. At necropsy, no vascular damage, coagulated-thermally desiccated blood vessels, or perforated biliary structures were noted. Histologically, H-FIRE demonstrated effective tissue ablation and uniform induction of apoptotic cell death in the parenchyma independent of vascular or biliary structure location. Detailed microscopic analysis revealed minor endothelial damage within areas subjected to H-FIRE, particularly in regions proximal to electrode insertion. These data indicate H-FIRE is a novel means to perform rapid, reproducible IRE in liver tissue while preserving gross vascular/biliary architecture. These characteristics raise the potential for long-term survival studies to test the viability of this technology toward clinical use to target tumors not amenable to thermal ablation or resection.","keywords":"Ablation Techniques/*methods Animals Apoptosis Biomedical Engineering Electroporation/*methods Female Histocytochemistry Liver/cytology/diagnostic imaging/*surgery Liver Neoplasms Surgery, Computer-Assisted/methods Swine image-guided surgery surgical oncology","issn":"1553-3506","doi":"10.1177/1553350617692202","year":"2017","bibtex":"@article{RN168,\n author = {Siddiqui, I. A. and Kirks, R. C. and Latouche, E. L. and DeWitt, M. R. and Swet, J. H. and Baker, E. H. and Vrochides, D. and Iannitti, D. A. and Davalos, R. V. and McKillop, I. H.},\n title = {High-Frequency Irreversible Electroporation: Safety and Efficacy of Next-Generation Irreversible Electroporation Adjacent to Critical Hepatic Structures},\n journal = {Surg Innov},\n volume = {24},\n number = {3},\n pages = {276-283},\n note = {1553-3514\nSiddiqui, Imran A\nKirks, Russell C\nLatouche, Eduardo L\nDeWitt, Matthew R\nSwet, Jacob H\nBaker, Erin H\nVrochides, Dionisios\nIannitti, David A\nDavalos, Rafael V\nMcKillop, Iain H\nJournal Article\nUnited States\n2017/05/12\nSurg Innov. 2017 Jun;24(3):276-283. doi: 10.1177/1553350617692202. Epub 2017 Feb 1.},\n abstract = {Irreversible electroporation (IRE) is a nonthermal ablation modality employed to induce in situ tissue-cell death. This study sought to evaluate the efficacy of a novel high-frequency IRE (H-FIRE) system to perform hepatic ablations across, or adjacent to, critical vascular and biliary structures. Using ultrasound guidance H-FIRE electrodes were placed across, or adjacent to, portal pedicels, hepatic veins, or the gall bladder in a porcine model. H-FIRE pulses were delivered (2250 V, 2-5-2 pulse configuration) in the absence of cardiac synchronization or intraoperative paralytics. Six hours after H-FIRE the liver was resected and analyzed. Nine ablations were performed in 3 separate experimental groups (major vessels straddled by electrodes, electrodes placed adjacent to major vessels, electrodes placed adjacent to gall bladder). Average ablation time was 290 ± 63 seconds. No electrocardiogram abnormalities or changes in vital signs were observed during H-FIRE. At necropsy, no vascular damage, coagulated-thermally desiccated blood vessels, or perforated biliary structures were noted. Histologically, H-FIRE demonstrated effective tissue ablation and uniform induction of apoptotic cell death in the parenchyma independent of vascular or biliary structure location. 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