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Effects of internal electrode cooling on irreversible electroporation using a perfused organ model

Timothy J. O'Brien, Mohammad Bonakdar, Suyashree Bhonsle, Robert E. Neal, Charles H. Aardema, John L. Robertson, S. Nahum Goldberg, Rafael V. Davalos
2018 International Journal of Hyperthermia  
Purpose: This study evaluates the effects of active electrode cooling, via internal fluid circulation, on the irreversible electroporation (IRE) lesion, deployed electric current and temperature changes using a perfused porcine liver model. Materials and methods: A bipolar electrode delivered IRE electric pulses with or without activation of internal cooling to nine porcine mechanically perfused livers. Pulse schemes included a constant voltage, and a preconditioned delivery combined with an
more » ... combined with an arc-mitigation algorithm. After treatment, organs were dissected, and treatment zones were stained using triphenyl-tetrazolium chloride (TTC) to demonstrate viability. Results: Thirty-nine treatments were performed with an internally cooled applicator and 21 with a non-cooled applicator. For the constant voltage scenario, the average final electrical current measured was 26.37 and 29.20 A for the cooled and uncooled electrodes respectively (p :001). The average final temperature measured was 33.01 and 42.43 C for the cooled and uncooled electrodes respectively (p :0001). The average measured ablations (fixed lesion) were 3.88-by-2.08 cm and 3.86-by-2.12 cm for the cooled and uncooled electrode respectively (p :2495, p :7507). Similarly, the preconditioned/arc-mitigation scenario yielded an average final electrical current measurement of a 41.07 and 47.20 A for the cooled and uncooled electrodes respectively (p :001). The average final temperature measured was 34.93 and 44.90 C for the cooled and uncooled electrodes respectively (p :005). The average measured ablations (fixed lesion) were 3.67-by-2.27 cm and 3.58-by-2.09 cm for the cooled and uncooled applicators (p :7906; p :5595). Conclusions: The internally-cooled bipolar applicator offers advantages that could improve clinical outcomes. Thermally mitigating internal perfusion technology reduced tissue temperatures and electric current while maintaining similar lesion sizes. ARTICLE HISTORY
doi:10.1080/02656736.2018.1473893 pmid:29806513 fatcat:b2lma4mrcjdfdlp5g5cum23kd4