Predictors of thrombosis in hepatic vasculature during microwave tumor ablation of an in vivo porcine model.
Predictors of thrombosis in hepatic vasculature during microwave tumor ablation of an in vivo porcine model.
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DOI：
10.1016/j.jvir.2014.07.022
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发表时间：
2014-12
期刊：
影响因子：
--
通讯作者：
Brace CL
中科院分区：
文献类型：
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作者：
Chiang J;Willey BJ;Del Rio AM;Hinshaw JL;Lee FT;Brace CL
这项研究的目的是评估和模拟微波消融过程中每种肝脏血管类型体内血栓形成的风险，作为血管直径、速度和血管-天线间距的函数。将单个微波消融天线插入邻近肝动脉、肝静脉或门静脉分支的单个猪叶(共15个)。常规超声和多普勒超声测量血管直径、血流速度和血管-天线间距。然后在100W下创建微波消融区，持续5min。术后即刻行超声成像评估血栓形成情况。采用Logistic回归分析评价血管直径、血流速度和血管天线间距对血管血栓形成的预测价值。门静脉血栓发生率为53%，肝静脉血栓发生率为13%，肝动脉血栓发生率为0。肝动脉的平均峰值血流速度明显大于肝静脉和门静脉。峰值血流速度<12.45 cm/s、血管内径<5.10 mm、血管天线间距<3.75 mm是肝静脉血栓形成的重要预测指标。然而，这些个体因素并不能预测更常见的门静脉血栓形成。在微波消融术中，肝动脉似乎不存在血栓形成的风险。在微波消融治疗中，门静脉血栓形成比肝静脉血栓形成更常见，但仅根据血管直径、血流速度或血管-天线间距无法预测。
The goal of this study was to evaluate and model the risk of in-vivo thrombosis in each hepatic vessel type during hepatic microwave ablation as a function of vessel diameter, velocity and vessel-antenna spacing. A single microwave ablation antenna was inserted into a single porcine lobe (n=15 total) adjacent to a hepatic artery, hepatic vein, or portal vein branch. Conventional and Doppler ultrasound were used to measure the vessel diameter, blood flow velocity, and vessel-antenna spacing. A microwave ablation zone was then created at 100 W for 5 minutes. Thrombus formation was evaluated on immediate post-procedure ultrasound imaging. Logistic regression was used to evaluate the predictive value of vessel diameter, blood flow velocity and vessel-antenna spacing on vascular thrombosis. Thrombosis was identified in 53% of portal veins, 13% of hepatic veins and 0% of the hepatic arteries. The average peak blood flow rate of the hepatic artery was significantly greater than that of the hepatic vein and portal vein. Peak blood flow velocities less than 12.45 cm/sec, vessel diameters less than 5.10 mm and vessel-antenna spacings less than 3.75 mm were strong predictors of hepatic vein thrombosis. However, these individual factors were not predictive of the more common portal vein thrombosis. Hepatic arteries do not appear to be at risk for thrombosis during microwave ablation procedures. Portal vein thrombosis was more common than hepatic vein thrombosis during microwave ablation treatments, but was not as predictable based upon vessel diameter, flow velocities, or vessel-antenna spacing alone.