Safety and effectiveness of endobiliary radiofrequency ablation according to the different power and target temperature in a swine model.
OBJECTIVE
Endobiliary radiofrequency ablation (EB-RFA) is a new endoscopic palliation and adjunctive tool. Although EB-RFA is performed worldwide, a possibility of iatrogenic thermal injury leading to perforation or bleeding still remains. Therefore, we aimed to assess the effects of thermal and coagulation injury after in vivo EB-RFA using a new catheter with a temperature sensor in a swine model.


METHODS
Twelve mini pigs were divided into four groups according to power (33 mm 10 W electrode vs. 18 mm 7 W electrode) and RFA target temperature (75°C vs. 80°C). All mini pigs underwent endoscopic retrograde cholangiography and target temperature controlled EB-RFA for 120 s. Additional cholangiogram was taken immediately after RFA, and all pigs were sacrificed after 24 h to assess the macroscopic/microscopic RFA injury.


RESULTS
Microscopic maximal injury depth and ablation area of EB-RFA using a 33-mm 10 W RFA electrode were significantly deeper and larger than those of EB-RFA using an 18-mm 7 W electrode (median; 2.7 vs. 2.1 mm, P = 0.004, 48.9 vs. 36.2 mm2, P = 0.016). However, there were no significant differences in microscopic ablation parameters between two different RFA target temperatures (75°C vs. 80°C). In addition, a post-RFA cholangiogram and assessment of the resected specimen at 24 h after the RFA showed no adverse events such as perforation or bleeding.


CONCLUSIONS
EB-RFA using a temperature controlled RFA catheter successfully ablates the bile duct wall without adverse events in a swine model.
Department of Internal Medicine, Gil Medical Center, Gachon University, Incheon, Korea.
Jae Hee
JH
Cho
Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kwang Hyuck
KH
Lee
Department of Pathology, Inha University School of Medicine, Incheon, Korea.
Joon Mee
JM
Kim
Department of Internal Medicine, Gil Medical Center, Gachon University, Incheon, Korea.
Yeon Suk
YS
Kim
Department of Gastroenterology and Hepatology, and the National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University School of Medicine, Incheon, Korea.
Don Haeng
DH
Lee
Department of Gastroenterology and Hepatology, and the National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University School of Medicine, Incheon, Korea.
Seok
S
Jeong
D000818:Animals; D001652:Bile Ducts / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D002058:Burns, Electric / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D017115:Catheter Ablation / Q000009:adverse effects* / Q000295:instrumentation*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004566:Electrodes; D005260:Female; D023421:Models, Animal; D034421:Sus scrofa; D013552:Swine; D013556:Swine, Miniature; D013696:Temperature
animal experiments; biliary neoplasms; endoscopic retrograde cholangiography; radiofrequency catheter ablation