Department of Internal Medicine, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague 100 34, Czech Republic.
Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University, Prague 100 00, Czech Republic.
J Healthc Eng. 2021 Sep 23;2021:9986874. doi: 10.1155/2021/9986874. eCollection 2021.
Radiofrequency ablation (RFA) is a routinely used, safe, and effective method for the tissue destruction. Often, in case of its application in malignant conditions, the extent of tissue destruction is insufficient due to the size of the target lesion, as well as due to the risk of heat-induced damage to the surrounding organs. Nevertheless, there are conditions requiring superficial precise-depth ablation with preservation of deeper layers. These are represented, for example, by mucosal resurfacing in case of Barrett's esophagus or treatment of recurrent mucosal bleeding in case of chronic radiation proctitis. Recently, new indications for intraluminal RFA use emerged, especially in the pancreatobiliary tract. In the case of intraductal use of RFA (e.g., biliary and pancreatic tract), there are currently available rigid and needle tip catheters. An expandable balloon-based RFA catheter suitable for use in such small-diameter tubular organs could be of benefit due to possible increase of contact between the probe and the target tissue; however, to prevent excessive tissue damage, a compatible generator suitable for low-impedance catheter/tissue is essential. This project aimed to develop a radiofrequency ablation generator and bipolar balloon-based catheter optimized for the application in the conditions of low-impedance tissue and (micro)endoluminal environment. Subsequent evaluation of biological effect in vivo was performed using duodenal mucosa in Wistar rat representing conditions of endoluminal radiofrequency ablation of low-impedance tissue. Experiments confirming the safety and feasibility of RFA with our prototype devices were conducted.
射频消融(RFA)是一种常规使用的、安全有效的组织破坏方法。通常,在恶性疾病应用的情况下,由于目标病变的大小以及热诱导对周围器官损伤的风险,组织破坏的程度不足。然而,存在需要浅层精确深度消融并保留深层组织的情况。例如,在巴雷特食管的情况下需要进行粘膜表面消融,或者在慢性放射性直肠炎的情况下需要治疗复发性粘膜出血。最近,腔内 RFA 使用的新适应症出现了,特别是在胰胆管系统中。在胆管和胰管等管腔内使用 RFA 时,目前有刚性和针尖导管可供选择。一种适用于此类小直径管状器官的可膨胀球囊式 RFA 导管可能会因其与目标组织之间的接触增加而受益;然而,为了防止过度的组织损伤,需要一种适合低阻抗导管/组织的兼容发生器。该项目旨在开发一种射频消融发生器和双极球囊式导管,优化用于低阻抗组织和(微)腔内环境的应用。随后使用代表低阻抗组织腔内射频消融条件的 Wistar 大鼠十二指肠粘膜进行体内生物学效应的评估。进行了证实我们的原型设备的 RFA 的安全性和可行性的实验。