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Parameters associated with acute morphometric lesion dimensions created by cryocatheters.

Shinsuke Miyazaki1, Heather O'Connell2, Baerbel Maus3

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Summary

Cryoablation lesion size is significantly influenced by catheter type and tip orientation. Maintaining tissue contact before freezing is crucial for effective cryoenergy delivery and optimal lesion dimensions.

Keywords:
Catheter ablationCryoablationCryoenergyCryothermal energy

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Area of Science:

  • Medical Devices
  • Surgical Technology
  • Cryoablation

Background:

  • Cryoenergy is widely used in medical procedures.
  • Data on specific ablation parameters influencing lesion size is limited.

Purpose of the Study:

  • To evaluate the impact of catheter type, ablation time, heat load, and tip orientation on lesion dimensions.
  • Utilized a porcine thigh model for focal cryoablation.

Main Methods:

  • Created 251 lesions in 6 pigs, varying catheter types (4, 6, 8 mm tips), ablation times, heat loads (1-2 L/min), and tip orientations (perpendicular/parallel).
  • Assessed lesion dimensions (length, depth, cross-sectional area) immediately post-ablation.
  • Included a sub-study on tissue contact importance.

Main Results:

  • Catheter type and the interaction of orientation/type significantly affected lesion cross-sectional area.
  • Lesion length and depth were significantly impacted by catheter type and orientation.
  • Perpendicular orientation created deeper lesions compared to parallel placement for 6-mm and 8-mm tips.
  • Ablation time and heat load did not significantly impact lesion size.
  • Lesion creation with an ice ball reduced lesion depth.

Conclusions:

  • Catheter type and tip orientation are key determinants of cryoablation lesion size.
  • Ensuring tissue contact before applying cryoenergy is essential for effective lesion formation.