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Minimal vascular flows cause strong heat sink effects in hepatic radiofrequency ablation ex vivo
Ist Teil von
Journal of hepato-biliary-pancreatic sciences, 2016-08, Vol.23 (8), p.508-516
Ort / Verlag
Japan: Blackwell Publishing Ltd
Erscheinungsjahr
2016
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Background
The present paper aims to assess the lower threshold of vascular flow rate on the heat sink effect in bipolar radiofrequency ablation (RFA) ex vivo.
Methods
Glass tubes (vessels) of 3.4 mm inner diameter were introduced in parallel to bipolar RFA applicators into porcine liver ex vivo. Vessels were perfused with flow rates of 0 to 1,500 ml/min. RFA (30 W power, 15 kJ energy input) was carried out at room temperature and 37°C. Heat sink effects were assessed in RFA cross sections by the decrease in ablation radius, area and by a high‐resolution sector planimetry.
Results
Flow rates of 1 ml/min already caused a significant cooling effect (P ≤ 0.001). The heat sink effect reached a maximum at 10 ml/min (18.4 mm/s) and remained stable for flow rates up to 1,500 ml/min.
Conclusions
Minimal vascular flows of ≥1 ml/min cause a significant heat sink effect in hepatic RFA ex vivo. A lower limit for volumetric flow rate was not found. The maximum of the heat sink effect was reached at a flow rate of 10 ml/min and remained stable for flow rates up to 1,500 ml/min. Hepatic inflow occlusion should be considered in RFA close to hepatic vessels.
Highlight
Lehmann and colleagues set out to determine the cooling effect of liver perfusion during radiofrequency ablation, which can lead to tumor recurrence. Surprisingly, even minimal flows of 1 ml/min caused a significant cooling effect ex vivo. They conclude that inflow occlusion should be considered in radiofrequency ablation close to hepatic vessels.