利用静脉系统的灵长类动物大脑皮层射频消融技术的进展：导管消融技术治疗癫痫的改进。
Advances in radiofrequency ablation of the cerebral cortex in primates using the venous system: Improvements for treating epilepsy with catheter ablation technology.
机构信息
Instituto Brasília de Arritmia, Brasília, Brazil.
Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States.
出版信息
Epilepsy Res. 2014 Aug;108(6):1026-31. doi: 10.1016/j.eplepsyres.2014.04.002. Epub 2014 Apr 27.
BACKGROUND
Pharmacology frequently fails for the treatment of epilepsy. Although surgical techniques are effective, these procedures are highly invasive. We describe feasibility and efficacy of minimally invasive mapping and ablation for the treatment of epilepsy.
METHODS
Mapping and radiofrequency ablations were performed via the venous system in eleven baboons and three dogs.
RESULTS
Mapping in deep cerebral areas was obtained in all animals. High-frequency pacing was able to induce seizure activity of local cerebral tissue in 72% of our attempts. Cerebral activity could be seen during mapping. Ablative lesions were deployed at deep brain sites without steam pops or sudden impedance rise. Histologic analysis showed necrosis at the sites of ablation in all primates.
CONCLUSION
Navigation through the cerebral venous system to map seizure activity is feasible. Radiofrequency energy can be delivered transvenously or transcortically to successfully ablate cortical tissue in this animal model using this innovative approach.
背景
药理学在治疗癫痫方面经常失败。尽管手术技术有效，但这些手术具有高度侵入性。我们描述了微创定位和消融术治疗癫痫的可行性和疗效。
方法
在 11 只狨猴和 3 只狗中通过静脉系统进行定位和射频消融。
结果
所有动物均获得了深部脑区的定位。高频起搏能够在 72%的尝试中诱发局部脑组织的癫痫活动。在定位过程中可以观察到脑活动。在没有蒸汽弹出或突然阻抗升高的情况下，在深部脑部位部署了消融性病变。组织学分析显示，所有灵长类动物的消融部位均有坏死。
结论
通过大脑静脉系统进行导航以定位癫痫活动是可行的。通过这种创新方法，射频能量可以通过静脉或皮质内传递，以成功消融该动物模型中的皮质组织。
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