Effect of Variation of Portal Venous Blood Flow on Radiofrequency and Microwave Ablations in a Blood-perfused Bovine Liver Model

Dodd, Gerald D.; Dodd, Nicholas; Lanctot, Anthony C.; Glueck, Deborah A.

doi:10.1148/radiol.12120486

Cited by 101 publications

(76 citation statements)

References 49 publications

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“…The microwave near field, a circumferential energy field created around the active tip of the antenna, can be monitored in real-time ultrasound throughout the ablation and has been shown to correlate with the final thermocoagulation zone [17,18] ( fig. 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…Multiple placements may be necessary to achieve full coagulation. Studies in perfused bovine liver models revealed an inverse relationship between vessel flow and effective tissue ablation with radiofrequency ablation [17] . In contrast, when using microwave ablation, a predictable microwave near field is created through nonionizing radiation.…”

Section: Introductionmentioning

confidence: 99%

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Microwave Ablation for Twin-Reversed Arterial Perfusion Sequence: A Novel Application of Technology

Stephenson¹,

Temming

Pollack³

et al. 2015

Fetal Diagn Ther

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Introduction: Twin-reversed arterial perfusion sequence is a rare complication of monochorionic pregnancies that is characterized by the presence of an acardiac mass perfused by an apparently normal pump twin. The risk of death to the pump twin has led to a range of therapeutic interventions aimed at separating their vascular connection. We report a novel application of microwave ablation for vessel coagulation in the treatment of twin-reversed arterial perfusion sequence. Material and Methods: Microwave ablation has been adopted by surgical subspecialties as a superior energy source for vessel and tissue ablation as it creates heat without a circuit and has less thermal spread. We describe the use of a 2.45-GHz microwave system using a 1.8-mm antenna to coagulate the intra-abdominal portion of umbilical vessels of the acardiac mass. Results: We report 6 cases of twin-reversed arterial perfusion sequence treated by microwave ablation. All patients were treated with microwave ablation with successful coagulation of intra-abdominal umbilical cord vessels of the acardiac mass with cessation of flow. Discussion: Microwave ablation is an excellent energy source for vessel coagulation due to its thermal properties and can be used effectively in the treatment of twin-reversed arterial perfusion sequence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Microwave Ablation for Twin-Reversed Arterial Perfusion Sequence: A Novel Application of Technology

Stephenson¹,

Temming

Pollack³

et al. 2015

Fetal Diagn Ther

View full text Add to dashboard Cite

show abstract

“…Modern high-powered microwave ablation systems more effectively overcome this heat-sink effect by rapidly generating higher temperatures at greater depths compared with RF ablation (7). Microwave systems use this intrinsic heating advantage to create larger ablation zones and margins in the presence of nearby vasculature (7)(8)(9).…”

Section: Implications For Patient Carementioning

confidence: 99%

Effects of Microwave Ablation on Arterial and Venous Vasculature after Treatment of Hepatocellular Carcinoma

Chiang¹,

Cristescu²,

Lee³

et al. 2016

Radiology

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Purpose:To characterize vessel occlusion rates and their role in local tumor progression in patients with hepatocellular carcinoma (HCC) who underwent microwave tumor ablation. Materials and Methods:This Results:Occlusion was identified in 39.7% of portal veins (29 of 73), 15.0% of hepatic veins (six of 40), and 14.2% of hepatic arteries (10 of 70) encompassed within the ablation zone. Hepatic vein occlusion was significantly correlated with a smaller vessel size (P = .036) and vessel-antenna spacing (P = .006). Portal vein occlusion was only significantly correlated with a smaller vessel size (P = .001), particularly in vessels that were less than 3 mm in diameter. Local tumor progression rates were significantly correlated with patent hepatic arteries within the ablation zone (P = .02) but not with patent hepatic (P = .57) or portal (P = .14) veins. Conclusion:During microwave ablation of HCC, hepatic veins and arteries were resistant to vessel occlusion compared with portal veins, and only arterial patency within an ablation zone was related to local tumor progression.q RSNA, 2016

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“…Second, both human and swine hearts have variable levels of epicardial fat that acts as a thermal insulator. Combined with the degree of cardiac motion and wall thickness that differs with the chamber of the heart adjacent to the pulmonary ablation, a given antenna-heart distance may be a radiofrequency energy, is not limited by the electrical conductivity of the lung and is less affected by vascular heat sink (17,18). The difference in susceptibility to thermal injury of the intervening lung and cardiac tissue also may be related to the fixed position of the lung as opposed to the dynamic position of the moving heart relative to the microwave field.…”

Section: Vascular and Interventional Radiology: Pulmonary Microwave Amentioning

confidence: 99%

Pulmonary Microwave Ablation Near the Heart: Antenna Positioning Can Mitigate Cardiac Complications in a Porcine Model

et al. 2017

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Purpose:To determine how close to the heart pulmonary microwave ablation can be performed without causing cardiac tissue injury or significant arrhythmia. Materials and Methods:The study was performed with approval from the institutional animal care and use committee. Computed tomographic fluoroscopically guided microwave ablation of the lung was performed in 12 swine. Antennas were randomized to either parallel (180° 6 20°) or perpendicular (90° 6 20°) orientation relative to the heart surface and to distances of 0-10 mm from the heart. Ablations were performed at 65 W for 5 minutes or until a significant arrhythmia (asystole, heart block, bradycardia, supraventricular or ventricular tachycardia) developed. Heart tissue was evaluated with vital staining and histologic examination. Data were analyzed with mixed effects logistic regression, receiver operating characteristic curves, and the Fisher exact test. Results:Thirty-four pulmonary microwave ablations were performed with the antenna a median distance of 4 mm from the heart in both perpendicular (n = 17) and parallel (n = 17) orientation. Significant arrhythmias developed during six (18%) ablations. Cardiac tissue injury occurred with 17 ablations (50%). Risk of arrhythmia and tissue injury decreased with increasing antenna distance from the heart with both antenna orientations. No cardiac complication occurred with a distance of greater than or equal to 4.4 mm from the heart. The ablation zone extended to the pleural surface adjacent to the heart in 71% of parallel and 17% of perpendicular ablations performed 5-10 mm from the heart. Conclusion:Microwave lung ablations performed more than or equal to 5 mm from the heart were associated with a low risk of cardiac complications.

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Effect of Variation of Portal Venous Blood Flow on Radiofrequency and Microwave Ablations in a Blood-perfused Bovine Liver Model

Cited by 101 publications

References 49 publications

Microwave Ablation for Twin-Reversed Arterial Perfusion Sequence: A Novel Application of Technology

Microwave Ablation for Twin-Reversed Arterial Perfusion Sequence: A Novel Application of Technology

Effects of Microwave Ablation on Arterial and Venous Vasculature after Treatment of Hepatocellular Carcinoma

Pulmonary Microwave Ablation Near the Heart: Antenna Positioning Can Mitigate Cardiac Complications in a Porcine Model

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