Cooling Effects Occur in Hepatic Microwave Ablation At Low Vascular Flow Rates and in Close Proximity to Liver Vessels – Ex Vivo

Autor: Franz G. M. Poch, Katharina J. Eminger, Christina A. Neizert, Beatrice Geyer, Christian Rieder, Hanne Ballhausen, Stefan M. Niehues, Janis L. Vahldiek, Kai S. Lehmann
Rok vydání: 2022
Předmět:
Zdroj: Surgical Innovation. 29:705-715
ISSN: 1553-3514
1553-3506
DOI: 10.1177/15533506221074619
Popis: Background. The impact of vascular cooling effects in hepatic microwave ablation (MWA) is controversially discussed. The objective of this study was a systematic assessment of vascular cooling effects in hepatic MWA ex vivo. Methods. Microwave ablations were performed in fresh porcine liver ex vivo with a temperature-controlled MWA generator (902-928 MHz) and a non-cooled 14-G-antenna. Energy input was set to 9.0 kJ. Hepatic vessels were simulated by glass tubes. Three different vessel diameters (3.0, 5.0, 8.0 mm) and vessel to antenna distances (5, 10, 20 mm) were examined. Vessels were perfused with saline solution at nine different flow rates (0-500 mL/min). Vascular cooling effects were assessed at the largest cross-sectional ablation area. A quantitative and semi-quantitative/morphologic analysis was carried out. Results. 228 ablations were performed. Vascular cooling effects were observed at close (5 mm) and medium (10 mm) antenna to vessel distances ( P < .05). Vascular cooling effects occurred around vessels with flow rates ≥1.0 mL/min ( P < .05) and a vessel diameter ≥3 mm ( P < .05). Higher flow rates did not result in more distinct cooling effects ( P > .05). No cooling effects were measured at large (20 mm) antenna to vessel distances ( P > .05). Conclusion. Vascular cooling effects occur in hepatic MWA and should be considered in treatment planning. The vascular cooling effect was mainly affected by antenna to vessel distance. Vessel diameter and vascular flow rate played a minor role in vascular cooling effects.
Databáze: OpenAIRE
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