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Safety and effectiveness of endobiliary radiofrequency ablation according to the different power and target temperature in a swine model
Author(s) -
Cho Jae Hee,
Lee Kwang Hyuck,
Kim Joon Mee,
Kim Yeon Suk,
Lee Don Haeng,
Jeong Seok
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13472
Subject(s) - medicine , radiofrequency ablation , ablation , perforation , bile duct , catheter , catheter ablation , nuclear medicine , ablation zone , surgery , radiology , materials science , punching , metallurgy
Background and Aim 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 mm 2 , 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.