Evaluation of liver parenchymal pressure and portal endothelium damage during radio frequency ablation in an in vivo porcine model
Evaluation of liver parenchymal pressure and portal endothelium damage during radio frequency ablation in an in vivo porcine model
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DOI：
10.1111/j.1478-3231.2005.01167.x
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发表时间：
2005-12-01
影响因子：
6.7
通讯作者：
Nakamuta, M
中科院分区：
文献类型：
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作者：
Kotoh, K;Morizono, S;Nakamuta, M
背景/目标：我们之前开发了一种用于体外射频消融（RFA）的多步增量扩张方法（多步法），与其他方法相比，该方法可防止压力增加并缩短消融时间。在这项研究中，我们在体内猪模型中评估了使用不同器械和方案进行RFA期间的肝实质压力和门静脉内皮损伤。方法：健康雌性猪9只，麻醉后处死。使用两种不同的器械和方案进行RFA;一种涉及使用LeVeen针和单步完全扩张方法或多步法，另一种使用40或60 W功率的冷尖针。我们在RFA期间测量了肝实质和胆囊中的压力。我们还评估门静脉内皮细胞损伤的NADH染色。结果如下：使用LeVeen电极的多步法导致最低的实质和胆囊内压力（多步法<单步法< cool-tip 40 W < cool-tip 60 W）。相比之下，使用60 W的冷尖针的消融时间最短（冷尖60 W <冷尖40 W=多步法<单步法）。NADH染色显示冷尖针消融后内皮严重损伤，而LeVeen针仅轻微损伤。结论：使用LeVeen针消融，尤其是与多步骤方案一起使用时，与冷头电极相比，肝实质和胆囊内压力增加较少，对门静脉内皮细胞的损伤较少。
Background/Aims: We previously developed a multi-step, incremental expansion method (multi-step method) for radio frequency ablation (RFA) in vitro, which prevented increases in pressure and reduced the ablation time as compared with other methods. In this study, we evaluated liver parenchymal pressure and portal endothelium damage during RFA with different devices and protocols in an in vivo porcine model. Method: Nine healthy female pigs were anaesthetized. RFA was performed with two different devices and protocols; one involved the use of a LeVeen needle with a single-step full expansion method or a multi-step method, and the other used a cool-tip needle with 40 or 60 W power. We measured the pressure in the liver parenchyma and the gallbladder during RFA. We also evaluated portal endothelium damage by NADH staining. Results: The multi-step method with the LeVeen electrode resulted in the lowest parenchymal and intra-gallbladder pressures (multi-step method < single-step method < cool-tip 40 W < cool-tip 60 W). In contrast, the ablation time was shortest with the cool-tip needle at 60 W (cool-tip 60 W < cool-tip 40 W=multi-step method < single-step method). NADH staining revealed severe endothelium damage after ablation with the cool-tip needle, but only slight damage with the LeVeen needle. Conclusion: Ablation with the LeVeen needle, especially when used with a multi-step protocol, produced less of an increase in liver parenchymal and intra-gallbladder pressures and less damage to portal endothelial cells than did the cool-tip electrode.