Superselective particle embolization enhances efficacy of radiofrequency ablation: effects of particle size and sequence of action.
OBJECTIVE
To evaluate the effects of particle size and course of action of superselective bland transcatheter arterial embolization (TAE) on the efficacy of radiofrequency ablation (RFA).


METHODS
Twenty pigs were divided into five groups: group 1a, 40-μm bland TAE before RFA; group 1b, 40-μm bland TAE after RFA; group 2a, 250-μm bland TAE before RFA; group 2b, 250-μm bland TAE after RFA and group 3, RFA alone. A total of 40 treatments were performed with a combined CT and angiography system. The sizes of the treated zones were measured from contrast-enhanced CTs on days 1 and 28. Animals were humanely killed, and the treated zones were examined pathologically.


RESULTS
There were no complications during procedures and follow-up. The short-axis diameter of the ablation zone in group 1a (mean ± standard deviation, 3.19 ± 0.39 cm) was significantly larger than in group 1b (2.44 ± 0.52 cm; P = 0.021), group 2a (2.51 ± 0.32 cm; P = 0.048), group 2b (2.19 ± 0.44 cm; P = 0.02), and group 3 (1.91 ± 0.55 cm; P < 0.001). The greatest volume of ablation was achieved by performing embolization with 40-μm particles before RFA (group 1a; 20.97 ± 9.65 cm(3)). At histology, 40-μm microspheres were observed to occlude smaller and more distal arteries than 250-μm microspheres.


CONCLUSIONS
Bland TAE is more effective before RFA than postablation embolization. The use of very small 40-μm microspheres enhances the efficacy of RFA more than the use of larger particles.
Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan. toshihir@bf6.so-net.ne.jp
Toshihiro
T
Tanaka
Peter
P
Isfort
Till
T
Braunschweig
Saskia
S
Westphal
Anna
A
Woitok
Tobias
T
Penzkofer
Philipp
P
Bruners
Kimihiko
K
Kichikawa
Thomas
T
Schmitz-Rode
Andreas H
AH
Mahnken
D015901:Angiography, Digital Subtraction; D000818:Animals; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives; D008099:Liver / Q000098:blood supply / Q000601:surgery*; D008863:Microspheres; D010316:Particle Size; D015641:Radiography, Interventional; D013552:Swine; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide