Su1612 Safety and Efficacy of a Novel Endobiliary Radiofrequency Ablation Catheter (Elra®) in a Swine Model

Cho, Jae Hee; Lee, Kwang Hyuck; Kim, Joon Mee; Kim, Yoon Jae; Lee, Don Haeng; Jeong, Seok

doi:10.1016/j.gie.2015.03.574

Cited by 5 publications

(5 citation statements)

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“…To circumvent some of these problems, a new electrode has been introduced. The unique feature of the ELRA probe is the temperature control feature, which results in safe ablation causing least damage to blood vessels and prevents tissue charring 10 .…”

Section: Discussionmentioning

confidence: 99%

“…The generator is set to 10 watts but the current flow is determined by the temperature measured at the tip of the probe. In animal studies this has been shown to limit the charring process, leading to longer-lasting current flow and more effective tissue ablation 10 . We describe the first UK experience with use of this endoluminal RFA probe in a series of patients for treatment of blocked metal biliary stents.…”

Section: Introductionmentioning

confidence: 99%

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Novel temperature-controlled RFA probe for treatment of blocked metal biliary stents in patients with pancreaticobiliary cancers: initial experience

et al. 2018

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Background and study aims Radiofrequency ablation (RFA) is used to treat blocked biliary stents in patients with pancreaticobiliary (PB) tumors with varying results. We report our experience with a novel temperature-controlled probe for treatment of blocked metal stents. Patients and methods Patients with histologically proven PB cancers and a blocked biliary stents were treated using ELRATM electrode (Taewoong Medical) under fluoroscopic guidance. Demographics, clinical outcome, stricture diameter improvements, complications and mortality at 30 days were prospectively recorded. Results Nine procedures were performed on seven patients (4 male, 3 female); mean age 65.33 (range 56 – 82 years). Mean stricture diameter prior to RFA was 1.13 mm (SD ± 0.54) and 4.42 mm (SD ± 1.54) following RFA ( P < 0.0001). Five of seven patients (71 %) required additional stents to ensure optimal drainage. There were no procedure-related complications. Mean follow-up was 193.55 days (range 31 – 540) and three of nine patients (33 %) died due to terminal cancer. Conclusion These are the first reported data on use of a temperature-controlled RFA catheter in humans to treat blocked metal biliary stents. The device is safe but further randomized trials are required to establish the efficacy and survival benefits of this probe.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Novel temperature-controlled RFA probe for treatment of blocked metal biliary stents in patients with pancreaticobiliary cancers: initial experience

et al. 2018

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“…The generator is VIVA (Taewoong Medical, South Korea) mostly set to two minutes interval, maximum temperature of 80°C and a power of 10 watts (Figure 2). In animal studies this represents the ideal setting to reduce the charring process, allowing more prolongated current stream and more effective tissue ablation[13,14].…”

Section: Technical Aspectsmentioning

confidence: 99%

Radiofrequency and malignant biliary strictures: An update

Auriemma

Luca

Bianchetti

et al. 2019

WJGE

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Malignant biliary strictures are usually linked to different types of tumors, mainly cholangiocarcinoma, pancreatic and hepatocellular carcinomas. Palliative measures are usually adopted in patients with nonresectable or borderline resectable biliary disease. Stent placement is a well-known and established treatment in patients with unresectable malignancy. Intraductal radiofrequency ablation (RFA) represents a procedure that involves the use of a biliary catheter device, via an endoscopic approach. Indications for biliary RFA described in literature are: Palliative treatment of malignant biliary strictures, avoiding stent occlusion, ablating ingrowth of blocked metal stents, prolonging stent patency, ablating residual adenomatous tissue after endoscopic ampullectomy. In this mini-review we addressed focus on technical success defined as deployment of the RF catheter, virtually succeeded in all patients included in the studies. About efficacy, three main outcome measures have been contemplated: Biliary decompression and stent patency, survival. Existing studies suggest a beneficial effect on survival and stent patency with RFA, but current impression is limited because most of studies have been performed using a retrospective design, on diminutive and dissimilar cohorts of patients.

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“…The RF probe used in all the reported cases was the Habib TM EndoHBP. The ELRA TM electrode has been launched to the market recently, and to date, only one experimental study on animals has been reported[ 65 ]. Power and time settings ranged from 5 to 10 W and from 60 to 180 s, respectively; nevertheless, most studies applied RF at 10 W over a period of 90 s. In most studies, patients underwent RFA only once.…”

Section: Endoscopic Biliopancreatic Rf In Clinical Practice: Review Omentioning

confidence: 99%

Review of endoscopic radiofrequency in biliopancreatic tumours with emphasis on clinical benefits, controversies and safety

Alvarez-Sánchez¹,

Napoléon²

2016

WJG

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Most pancreatic cancers and extrahepatic cholangiocarcinomas are unresectable at the time of diagnosis, and even in case of a resectable cancer, for elderly or patients with coexistent comorbidities, surgery is not an option. Current treatment alternatives in these scenarios are very limited. Biliary stenting with self-expanding metal stents (SEMS) is the mainstay palliative treatment of biliary obstruction due to unresectable pancreatic cancer or cholangiocarcinoma. Nevertheless, more than 50% of SEMS become occluded after 6 mo due to tumour over- and ingrowth, leading to hospital readmissions and reinterventions that significantly impair quality of life. Regimes of chemotherapy or chemoradiotherapy also provide minimal survival benefits. Therefore, novel therapies are eagerly awaited. Radiofrequency (RF) energy causes coagulative necrosis leading to local destruction of the accessed malignant tissue and has an established role in the treatment of malignancies in several solid organs, especially liver cancers. However, pancreatic and extrahepatic biliary cancers are not easily accessed by a percutaneous route, making the procedure dangerous. Over the past five years, the development of dedicated devices compatible with endoscopic instruments has offered a minimally invasive option for RF energy delivery in biliopancreatic cancers. Emerging experience with endoscopic RF ablation (RFA) in this setting has been reported in the literature, but little is known about its feasibility, efficacy and safety. A literature review makes it clear that RFA in biliopancreatic tumours is feasible with high rates of technical success and acceptable safety profile. Although available data suggest a benefit of survival with RFA, there is not enough evidence to draw a firm conclusion about its efficacy. For this reason, prospective randomized trials comparing RFA with standard palliative treatments with quality-of-life and survival endpoints are required. Anecdotal reports have also highlighted a potential curative role of RFA in small pancreatic tumours and benign conditions, such as ductal extension of ampullomas, intrahepatic adenomas or non-tumoural biliary strictures. These newest indications also deserve further examination in larger series of studies.

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Su1612 Safety and Efficacy of a Novel Endobiliary Radiofrequency Ablation Catheter (Elra®) in a Swine Model

Cited by 5 publications

References 0 publications

Novel temperature-controlled RFA probe for treatment of blocked metal biliary stents in patients with pancreaticobiliary cancers: initial experience

Novel temperature-controlled RFA probe for treatment of blocked metal biliary stents in patients with pancreaticobiliary cancers: initial experience

Radiofrequency and malignant biliary strictures: An update

Review of endoscopic radiofrequency in biliopancreatic tumours with emphasis on clinical benefits, controversies and safety

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