Exploratory Study of the Effects of Irreversible Electroporation on Atherosclerotic Plaque in a Rabbit Model

This study evaluated the effects of irreversible electroporation (IRE), a non-thermal ablation method, on carotid atherosclerotic plaques induced by high-fat feeding combined with balloon dilation in 30 rabbits. Carotid plaques were subjected to IRE ablation (1000 V/cm alone, 2000 V/cm alone, or 1000 V/cm with rapamycin). There were no acute vascular changes post-ablation; however, IRE induced apoptosis and polarity of cells. At 7-30 days post-ablation, there was a significant decrease in lipid density within the plaque, with replacement by multilayered anterograde smooth muscle cells. Remodeling led to residual plaque becoming sandwiched between the new and original smooth muscle layers and to vessel wall thickening but with improved elasticity. Addition of rapamycin delayed remodeling. IRE reduced lipid deposition, triggered structural vascular reorganization, and improved elasticity, suggesting a potential therapeutic role in atherosclerosis. The tissue selectivity of this technique and non-thermal mechanism may offer advantages over conventional treatments.