To describe our experience in percutaneous treatment of intraabdominal tumor lesions with irreversible electroporation (IRE).
Minimally invasive percutaneous tumor ablation is an established treatment option for focal solid tumors in the liver,
bone and lung,
with ever-expanding indication for focal tumors in additional locations.
Irreversibe electroporation (IRE) is a non thermal technique of tissue ablation that allows the destruction of tumor cells using a series of short high-voltage electric pulses that induce cellular apoptosis through the formacion of nanopores in the cell membrane.
Efficacy of current thermal ablation techniques,
such as radiofrecuency and microwave,
decrease for large tumors (3-5cm)...
Findings and procedure details
A six channel IRE generator capable of delivering a maximmum of 3000V and 50A was used (NanoKnife,AngioDynamics).
The generator could use two to six 19-gauge electrodes with adjustable exposure of the length of active tip (5-40mm). Fig. 3
To prevent ventricular arhythmia,
energy was deposited within refractory stimulating myocrdial time (ST segment of electrocardiography) by using cardiac synchronization (Accusync; Accusync Medical Research Corp.,
IRE can be performed with CT or ultrasound guidance under general anesthesia.
To insert the electodes in the...
In a little over 7 years since IRE has been commercially available,
it has moved from being a novelty to a technology that has demonstrated the potential to be a valuable addition to the other ablation tools.
IRE offers a safe therapeutic oportunity to treat tumoral lesions near vascular critical structure when the other ablative techniques are contraindicated.
Large and comparative estudies with additional follow-up are required to confirm treatment efectiveness
Safety and Efficacy of Irreversible Electroporation for the Treatment of Hepatocellular Carcinoma Not Amenable to Thermal Ablation Techniques: A Retrospective Single-Center Case Series Olivier Sutter,
Irreversible Electroporation Ablation: Is All the Damage Nonthermal?