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Optimizing Irreversible Electroporation Ablation with a Bipolar Electrode.

Ayelet Wandel1, Eliel Ben-David2, B Said Ulusoy2

  • 1Department of Diagnostic Imaging, Hadassah Hebrew University Medical Center, POB 12000, Ein Kerem, Jerusalem 9112001, Israel; Department of Diagnostic Imaging, Wolfson Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Holon, Israel.

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Summary
This summary is machine-generated.

Optimizing bipolar irreversible electroporation (IRE) involves increasing voltage and pulse width, alongside controlled hypotonic fluid instillation or electrode cooling. This enhances ablation zone size while preventing system failures during liver treatments.

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Area of Science:

  • Medical Devices
  • Electrophysiology
  • Surgical Technology

Background:

  • Irreversible electroporation (IRE) is an ablation technique using electrical pulses.
  • Optimizing IRE parameters is crucial for effective tissue ablation.
  • Bipolar IRE offers potential advantages in controlling ablation geometry.

Purpose of the Study:

  • To optimize single-insertion bipolar irreversible electroporation (IRE) parameters.
  • To characterize the effects of electrical parameters on IRE ablation in a porcine liver model.
  • To investigate methods for controlling tissue electrical properties to improve IRE outcomes.

Main Methods:

  • Single-insertion bipolar IRE was performed in 28 porcine livers.
  • Varied parameters included voltage, pulse number, cycles, and pulse width.
  • Tissue conductivity was modulated using hypertonic/hypotonic fluids, and thermal effects were assessed via electrode cooling.

Main Results:

  • Increased voltage, cycles, and pulse width enhanced ablation dimensions.
  • Pulse width increases to 100 µs at 6 cycles led to larger ablations but caused system crashes.
  • Controlled hypotonic fluid instillation and 37°C electrode perfusion minimized arcing and improved ablation size without crashes.

Conclusions:

  • Bipolar IRE ablation zones can be significantly increased.
  • Repetitive high voltage and wider pulse widths are key factors.
  • Judicious use of hypotonic fluids or internal electrode perfusion is essential to mitigate arcing and ensure treatment success.