Development of Radiofrequency Ablation Generator and Balloon-Based Catheter for Microendoluminal Thin-Layer Ablation Therapy Using the Rat Duodenum as a Model of Low-Impedance Tissue.

Jana Nociarova,Marek Novak,Jan Polak,Aleksandr N Grebenyuk,Jozef Rosina,Radek Sery,Robert Gurlich,Jan Hrudka,Jan Hajer,Michal Koc,Stefan Porubsky,Ayush Dogra

doi:10.1155/2021/9986874

Abstract

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.

Highlights

Radiofrequency ablation (RFA) is a well-established method for local tissue destruction
Custom Catheter and Generator Development. e construction of a custom catheter for radiofrequency ablation of duodenal mucosa in a rat model was successful with the subsequent verification. e generator is capable of generating RF pulses with varying voltage amplitude and length
The generator is optimized for low-impedance balloon catheters and high energy to surface area ratio ablation

Summary

Introduction

Radiofrequency ablation (RFA) is a well-established method for local tissue destruction It is a treatment modality broadly used for various medical conditions, predominantly as adjuvant therapy for malignancies of solid organs (liver and kidney) [1] and therapy of atrial fibrillation in cardiology [2]. The most common application of MR is the endoscopic treatment of Barrett’s esophagus, a precancerous condition, in which the normal squamous epithelium of the distal esophagus transforms to columnar-lined intestinal metaplasia In this case, destruction of the mucosa by MR is subsequently followed by restoration of the squamous epithelium [10]

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