Document Detail

Radiofrequency endothelial ablation prevents recanalization after endovascular coil occlusion: in vitro and in vivo assessment.
MedLine Citation:
PMID:  19944624     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Coil embolization of intracranial aneurysms may be followed by recurrences. Radiofrequency (RF) ablation of the endothelium may prevent recanalization after coil embolization. MATERIALS AND METHODS: The authors performed in vitro experiments in chicken meat and egg white models to investigate the thermal distribution and geometry of lesions created with RF applied through standard coils alone or by using a prototype RF electrode inserted in a coil or a mass of coils. A mathematic model was designed to predict perianeurysmal isotherm lesions by using the bio-heat equation. In an in vivo coil arterial occlusion model (six dogs), the authors compared angiographic and pathologic results of coil embolization (n = 8) with those of coil embolization preceded by RF ablation (n = 7) by using a cardiac electrode at 1 month. RESULTS: Current coils offer high impedance (400 Omega) at high current frequencies and are damaged by RF transmission. A dedicated electrode generated reproducible lesions, but contact with coils interferes with lesion reproducibility. When the coil mass was used, a uniform RF lesion that conformed to the coil mass shape was produced. The mathematic model predicted a uniform heat distribution within 1 mm from the coil mass periphery. Arterial coil embolization led to occlusion followed by recanalization (n = 8), whereas RF ablation (20-30 W for 60 seconds) prevented recanalization in all coil-occluded arteries (P < .001, chi(2) test). Pathologic findings helped confirm complete arterial occlusion with RF ablation. One animal developed brachial plexus injury with excessive levels of RF ablation. CONCLUSIONS: RF ablation can prevent recanalization after coil occlusion-at least in the arterial model. Modifications of coils, dedicated neurovascular electrodes, and technique optimization remain necessary before considering a clinical application.
Jean Raymond; Pierre Savard; Igor Salazkin; Fatiha Bouzeghrane
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-27
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  21     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-04-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  101-7     Citation Subset:  IM    
Interventional Neuroradiology Research Laboratory, Research Center, Centre Hospitalier de l'Universit? de Montr?al, Notre-Dame Hospital, 1560 Sherbrooke East Pavillon Simard, Ste Z12909, Montreal, Quebec, Canada. <>
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MeSH Terms
Catheter Ablation / methods*
Combined Modality Therapy
Computer Simulation
Embolization, Therapeutic / instrumentation,  methods*
Intracranial Aneurysm / radiography,  therapy*
Models, Cardiovascular*
Models, Neurological
Treatment Failure
Treatment Outcome
Grant Support
MOP-44062//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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