Clinical Application of Radiofrequency Ablation for Malignant Liver Tumor during Interruption of Hepatic Blood Flow

Abstract

An experiment was conducted to investigate the changes in the thermocoagulation area induced by radiofrequency ablation (RFA) during interruption of the hepatic blood flow using the liver of a bovine. In a clinical case, the RFA was delivered percutaneously to hepatocellular carcinoma with a diameter of 25 mm during interruption of the hepatic blood flow. The RFA equipment used was 460-KHz Leveen needle electrode 26-207 (Boston Scientific, Tokyo, Japan). In the animal experiment, the radiofrequency electrode was introduced to a depth of 2 cm under the surface of the liver, and then eight umbrella-type needles were unfolded. Subsequently, RFA were of 40 W was delivered for 150 sec. The RFA delivery was carried out by the same procedure under the condition of hepatic blood flow interruption with a hemostatic tape. In the clinical application, a 6 F balloon catheter was inserted into the right hepatic vein, which was the dranage vein of the cancer-bearing area, and the artery was embolized with gel form the hepatic artery. Interruption of the portal blood flow in the cancer-bearing area was confirmed by CT scanning with portal venography. The animal experiment results showed that interruption of the hepatic arterial and portal blood flow provided more than twice the diameter of thermocoagulation by the non-interruption of the blood flow, and that the shape of the coagulation area was almost spherical. In conclusion, complete and spherical thermocoagulation was achieved by delivery of the RFA of 40 W, to hepatocellular carcinoma of 25 mm in diameter, for 4 minutes during interruption the hepatic blood flow.