title: Normal Porcine Ureter Retains Lumen Wall Integrity but Not Patency Following Catheter-Directed Irreversible Electroporation: Imaging and Histologic Assessment over 28 Days.
abstract: OBJECTIVE
  To evaluate the effect of catheter-directed irreversible electroporation (IRE) on the integrity, patency, and function of the normal porcine ureter.
  
  
  METHODS
  A catheter-mounted electrode was used to perform fluoroscopy-guided IRE in 8 healthy pigs. Two unilateral ablations (90 pulses at 2,000 V, 100 μs) were performed in each animal in the proximal and distal ureter. Serum creatinine measurements and contrast-enhanced computed tomography imaging were performed at 1, 7, 14, 21, and 28 days after IRE, and findings were compared with baseline values by Student t test. Two animals each were euthanized at 1, 7, 14, and 28 days after IRE for histologic assessment of treatment effects. Quantitative histologic analysis of regeneration and healing of the ureteral wall was graded on a five-point scale.
  
  
  RESULTS
  IRE was successfully performed in all animals. Preservation of ureteral wall integrity was confirmed by the leakage-free passage of contrast medium in the treated ureter of all animals through the observation period. Ureteral strictures and associated renal pelvicaliceal dilation were observed in all animals by study days 7 (P = .005) and 14 (P = .007) and did not resolve by day 28. Urothelial recovery was observed in tissue samples from day 7, with progressive replacement of the tunica muscularis with granulation tissue. Despite extensive scarring of the tunica muscularis, full recovery of the urothelium was observed by day 28.
  
  
  CONCLUSIONS
  The normal porcine ureter retains lumen wall integrity and function following catheter-directed IRE. Scarring of the tunica muscularis in the treated ureter results in stricture formation and reduction of lumen patency.
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York. Electronic address: srimaths@mskcc.org.
authors.forename: Govindarajan
authors.initials: G
authors.lastname: Srimathveeravalli
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York; Tenon Hospital, Assistance Publique-Hôpitaux de Paris Pierre & Marie Curie University, Paris, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Cornelis
authors.affiliation: Medical University of Graz, Graz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wimmer
authors.affiliation: Laboratory of Comparative Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; The Rockefeller University, Weill Cornell Medicine, New York, New York.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Monette
authors.affiliation: Department of Urology, Palo Alto Medical Foundation, Palo Alto, California.
authors.forename: Simon Y
authors.initials: SY
authors.lastname: Kimm
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Majid
authors.initials: M
authors.lastname: Maybody
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Solomon
authors.affiliation: Department of Surgery, Division of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Coleman
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Jeremy C
authors.initials: JC
authors.lastname: Durack
mesh_terms: D000818:Animals; D003287:Contrast Media; D003404:Creatinine / Q000097:blood; D018274:Electroporation / Q000379:methods*; D005471:Fluoroscopy; D023421:Models, Animal; D013552:Swine; D014057:Tomography, X-Ray Computed; D014513:Ureter / Q000473:pathology*
chemical_list: D003287:Contrast Media; D003404:Creatinine