Purpose
Percutaneous radiofrequency ablation (RFA) of liver tumors has been extensively described and is considered safe and effective. It continues to be a promising technique in prolonging survival by achieving local control while preserving local liver parenchyma. The location of these tumors, however, has its own unique challenges. Lesions must be carefully selected as unintended thermal injury to nearby structures can occur and has been reported in percutaneous, laparoscopic and open procedures (Siperstein et al, 2000; Pearson et al, 1999). Since the liver is closely opposed...
Methods and Materials
All experimental procedures were performed in accordance with the National Institutes of Health guidelines for humane handling of animals, and was approved by the Animal Institutional Review Board at our institution. Yorkshire-mix pigs weighing an average of 120 lb were used, and all procedures were performed with animals under general anesthesia. All vital signs including heart rate, respiratory rate, body temp, sp O2 and Co2 were continuously monitored by a certified vet technologist. The pigs were placed in the supine position after adequate anesthesia was...
Results
All 32 lesions created had visible extension to the hepatic surface. All 7 control lesions produced transdiaphragmatic injury (grade 3), including one of which injured the nearby lung parenchyma. Of the 25 balloon protected lesions, 21 lesions (84%) had no associated diaphragmatic injury (grade 0), two lesions (8%) had minimal diaphragmatic injury. Two of these lesions had associated moderate diaphragmatic injury (8%). These two lesions, however, had the complication of protective balloon device rupture during the ablation procedure. Therefore, the balloon had not been completely...
Conclusions
Injury to the diaphragm is a possible drawback when percutaneous radiofrequency ablation is performed near the hepatic dome. We offer a new technique in using a balloon angioplasty catheter as a means to protect the diaphragm during these RF procedures and offer future hope in extending RF treatment to those patients with lesions in these critical areas. In our preliminary study, we show the feasibility of using this balloon catheter as a way to isolate hepatic dome from the adjacent diaphragm. Our model of using...