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

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Authors

MATKULČÍK Peter HEMZAL Martin ČERVINKA Dalibor NOVOTNÁ Veronika ROHAN Tomáš ANDRAŠINA Tomáš

Year of publication 2022
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Citation
Description 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.
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