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Effects of Blood Flow and/or Ventilation Restriction on Radiofrequency Coagulation Size in the Lung: An Experimental Study in Swine

Journal Article · · Cardiovascular and Interventional Radiology
; ; ;  [1];  [2];  [1];  [3]; ;  [1]; ;  [4]; ;  [1]
  1. Oregon Health and Science University, Dotter Interventional Institute (United States)
  2. Veterans Administration Medical Center, Department of Radiology (United States)
  3. Oregon Health and Science University/Veterans Administration Medical Center, Department of Pathology (United States)
  4. Nara Medical University, Department of Radiology (Japan)

The purpose of this study was to investigate how the restriction of blood flow and/or ventilation affects the radiofrequency (RF) ablation coagulation size in lung parenchyma. Thirty-one RF ablations were done in 16 normal lungs of 8 living swine with 2-cm LeVeen needles. Eight RF ablations were performed as a control (group G1), eight with balloon occlusion of the ipsilateral mainstem bronchus (G2), eight with occlusion of the ipsilateral pulmonary artery (G3), and seven with occlusion of both the ipsilateral bronchus and pulmonary artery (G4). Coagulation diameters and volumes of each ablation zone were compared on computed tomography (CT) and gross specimen examinations. Twenty-six coagulation zones were suitable for evaluation: eight in G1, five in G2, seven in G3, and six in G4 groups. In G1, the mean coagulation diameter was 21.5 {+-} 3.5 mm on CT and 19.5 {+-} 1.78 mm on gross specimen examination. In G2, the mean diameters were 26.5 {+-} 5.1 mm and 23.0 {+-} 2.7 mm on CT and gross specimen examination, respectively. In G3, the mean diameters were 29.4 {+-} 2.2 mm and 27.4 {+-} 2.9 mm on CT and gross specimen examination, respectively, and in G4, they were 32.6 {+-} 3.33 mm and 28.8 {+-} 2.6 mm, respectively. The mean coagulation volumes were 3.39 {+-} l.52 cm{sup 3} on CT and 3.01 {+-} 0.94 cm{sup 3} on gross examinations in G1, 6.56 {+-} 2.47 cm{sup 3} and 5.22 {+-} 0.85 cm{sup 3} in G2, 10.93 {+-} 2.17 cm{sup 3} and 9.97 {+-} 2.91 cm{sup 3} in G3, and 13.81 {+-} 3.03 cm{sup 3} and 11.06 {+-} 3.27 cm{sup 3} in G4, respectively. The mean coagulation diameters on gross examination and mean coagulation volumes on CT and gross examination with G3 and G4 were significantly larger than those in G1 (p < 0.0001, p < 0.0001, p < 0.0001, respectively) or in G2 (p < 0.05, p < 0.005, p < 0.005, respectively). Pulmonary collapse occurred in one lung in G2 and pulmonary artery thrombus in two lungs of G3 and two lungs of G4. The coagulation size of RF ablation of the lung parenchyma is increased by ventilation and particularly by pulmonary artery blood flow restriction. The value of these restrictions for potential clinical use needs to be explored in experimentally induced lung tumors.

OSTI ID:
21091139
Journal Information:
Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 5 Vol. 29; ISSN 0174-1551; ISSN CAIRDG
Country of Publication:
United States
Language:
English

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