APPLICABILITY AND EFFECTIVENESS OF ADVANCED ENDOSCOPIC BALLOON-TYPE IRREVERSIBLE ELECTROPORATION CATHETER ON THE ESOPHAGUS: PRECLINICAL ANIMAL PILOT STUDY

Aims The irreversible electroporation (IRE) is a new destructive technique that removes the undesirable tissue by applying an electric field. Thus, the aim of the present study is to demonstrate the feasibility and applicability of tissue destruction in the esophagus by applying a newly designed endoscopic balloon-type IRE catheter.

Methods The electrical field with temperature generated during ablation at 1500V and 2000V with 40 pulses in the esophagus were simulated using COMSOL Multiphysics​. A balloon catheter was manually manipulated into the esophagus along the 0.035-inch JagwireTM. The fluoroscopy with contrast medium was employed to establish deployment. Following ablation of the esophagus sequentially, Interruptions of ablations were recorded. Finally, the pigs were sacrificed 24 hours later and then histologic evaluation including H&E and TUNEL assay was performed.

Results As a result of COMSOL​ simulation, it is estimated that the heat, approximately 43℃ was observed at the edge of the electrodes, and the other areas of electrodes were normal during ablation at 1500V with 40 pulses. Fluoroscopy and endoscopy showed that the balloon catheter was not adjacent to the heart and blocked the lumen of the esophagus. Balloon-type endoscopic IRE catheter withstood muscle contractions during ablation and delivered all electrical energy. A total of 24 ablations were performed in 6 pigs, and the success rate of balloon catheter was 91.7% (11/12). TUNEL assay represented stained brown nuclei, which defer apoptosis.

Conclusions The IRE balloon-type catheter demonstrated applicability and effectiveness in the esophagus and showed successful ablation results.

Publication History

Article published online:
14 April 2022