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Hepatic Multiprobe Radiofrequency Ablation in the Porcine Model

David A Iannitti, Sr., Jason McKee, Carolyn Simon, Damian Dupuy
Brown Medical School, Providence, RI

Objective:
Evaluate a multiprobe radiofrequency ablation (RF) device in an in-vivo liver model.
Design:
Nonrandomized trial.
Setting:
Tertiary care hospital animal facility.
Participants:
Eight pigs
Intervention:
Two monopolar 3.0 cm LeVeen radiofrequency probes spaced at 3.5 cm. were deployed into the liver. Ablation performed with a 200 watt RF generator according to impedance based algorithms, half with Pringle maneuver. Liver removed for gross and histological assessment.
Main Outcome Measurements:
Ablation dimensions, time, and histology.
Results:
Twelve ablations were performed resulting in a mean length of 7.0 cm and width of 2.9 cm (95% CI, 6.9 to 7.1; 1.8 to 4.0) in an average time of 596 sec. Pringle vs. No Pringle resulted in ablation times of 359 vs. 834 sec (P<0.05); ablation length 6.9 vs. 7.0 cm.; ablation widthlat 3.4 vs. 2.9 cm.; and ablation widthcentral 3.1 vs. 2.1 cm. Ablation volumes for the Pringle vs. No Pringle groups were 54.0 +/- 11.7 cm3 vs. 34.9 +/- 4.8 cm3 (P<0.05).
Conclusions:
Multiprobe RFA is a developing technology that has not yet been tested in perfused liver. The two probes have a synergistic effect which creates a larger area of ablation than two individual burns. The volume of thermocoagulation was significantly larger and the central area of ablation was more consistent in the Pringle group with a significantly shorter ablation time. This technology is promising but will need more evaluation to determine its clinical utility.

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