Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig model.
The aim of this study was to assess the effect of vascular occlusion on radio-frequency (RF) lesion size and on potential associated biliary and portal lesions. Radio-frequency lesions using a 1-cm exposed-tip cooled electrode were created in pig liver. Liver perfusion was modified by arterial embolization (n=2), left portal clamping (n=2), and both (n=2). Two pigs were used as controls. Two weeks after, control portography was performed, animals were killed, and ex-vivo cholangiography was carried out. Pathological studies evaluated the lesion surface and associated portal and biliary damages. A mathematical regression model showed that portal occlusion increased by 43 mm2 (+40%) the surface of RF lesions, arterial occlusion by 135 mm2 (+126%), and associated occlusion by 466 mm2 (+435%). Biliary stenoses were found in 4 cases (two arterial occlusions, one portal occlusion, and one associated occlusion). One case of partial portal vein thrombosis was found in one case of portal occlusion and resolved at 2 weeks. Ischemic damages adjacent to RF lesions were found in cases of combined occlusions. The reduction of liver perfusion increases significantly the size of RF lesions but is associated with a risk of biliary, portal, or parenchymal complications.
Denys
A L
AL
Department of Interventional Radiology, Centre Hospitalo Universitaire Vaudois, 1011 Lausanne, Switzerland. Alban.Denys@chuv.hospvd.ch
De Baere
T
T
Mahe
C
C
Sabourin
J C
JC
Sa Cunha
A
A
Germain
S
S
Roche
A
A
D000818:Animals; D001157:Arterial Occlusive Diseases / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation; D002779:Cholestasis / Q000473:pathology* / Q000601:surgery*; D004195:Disease Models, Animal; D006499:Hepatic Artery / Q000473:pathology* / Q000601:surgery*; D008099:Liver / Q000601:surgery*; D008962:Models, Theoretical; D011169:Portal Vein / Q000473:pathology* / Q000601:surgery*; D013552:Swine