Endoluminal IRE for recanalisation of an occluded metal stent - mathematical model

MATKULČÍK, Peter, Martin HEMZAL, Dalibor ČERVINKA, Veronika NOVOTNÁ, Tomáš ROHAN and Tomáš ANDRAŠINA. Endoluminal IRE for recanalisation of an occluded metal stent - mathematical model. In CIRSE 2022. 2022. Available from: https://dx.doi.org/10.1007/s00270-022-03246-4.

Basic information

• Original name: Endoluminal IRE for recanalisation of an occluded metal stent - mathematical model
• Authors: MATKULČÍK, Peter (703 Slovakia, guarantor, belonging to the institution), Martin HEMZAL (203 Czech Republic), Dalibor ČERVINKA (203 Czech Republic), Veronika NOVOTNÁ (203 Czech Republic), Tomáš ROHAN (203 Czech Republic, belonging to the institution) and Tomáš ANDRAŠINA (703 Slovakia, belonging to the institution).
• Edition: CIRSE 2022, 2022.

Other information

• Original language: English
• Type of outcome: Conference abstract
• Field of Study: 30224 Radiology, nuclear medicine and medical imaging
• Country of publisher: Spain
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• RIV identification code: RIV/00216224:14110/22:00129689
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1007/s00270-022-03246-4
• Keywords in English: irreversible electroporation; metal stent; recanalisation; stent occlusion; mathematical model
• Tags: International impact

Abstract

Purpose: To analyze heat distribution and ablation zones formed by endoluminal irreversible electroporation inside an occluded metallic stent based on 3D mathematical tissue model simulations. Materials and methods: The software utilizing finite element method (COMSOL Multiphysics) for 3D simulations, 2D and 3D calculations were used to define the extent of irreversible electroporation and thermal ablation zones in different IRE protocols (100 100µs pulses, 1Hz, 300V,650V,1000V,1300V). Endoluminal IRE procedure for recanalization of metal stent using the 3-electrode IRE catheter was simulated in mathematical model of perfused liver tissue. Multiple stents with specific mesh design by different manufactures (uncovered stents, Boston Scientific, Ella-CS, Micro-Tech medical, S&G Biotech) were analyzed. The obstruction of metal stent was simulated by 1,5mm layer of interposed tissue. Results were visualized as the color-coded distribution of electrical potential, electric field intensity and thermal stress in the tissue model. Results: There was no statistically significant difference between various stent mesh designs regarding electric current in interposed tissue and increase of temperature in the tissue surrounding the stent (p>0.6; Mann-Whitney test). Mean volume of IRE zone using 1300V protocol was 10.9-11.7% larger (184-189 vs 166-169mm^3) and the maximal temperature increase was 67.7-68.8% higher (15.2-15.6 vs 9.0-9.3°C) compared to IRE using 1000V. Conclusion: The different mesh design of biliary metal stent did not lead to significant difference of electric current and temperature increase, so the model seems to be universally usable across all analyzed uncovered metal stents.

Links

• MUNI/A/1388/2021, interní kód MU: Name: Význam radiologických intervencí a pokročilých zobrazovacích metod v diagnostice a léčbě pacientů s maligním onemocněním

Investor: Masaryk University

• NU21-08-00561, research and development project: Name: Využití ireverzibilní elektroporace a vysokofrekvenční ireverzibilní elektroporace k léčbě okluzí metalických stentů

Investor: Ministry of Health of the CR, Subprogram 1 - standard