Ablation System Research Articles

Trans-femoral transcatheter intramyocardial septal radiofrequency ablation: a novel therapeutic approach for obstructive hypertrophic cardiomyopathy

Abstract Background Septal reduction techniques play a pivotal role in mitigating morbidity and mortality among patients with obstructive hypertrophic cardiomyopathy (oHCM). While trans-apical intramyocardial septal radiofrequency ablation (PIMSRA or LIWEN procedure) has shown promise in reducing left ventricular outflow tract (LVOT) gradients and improving symptoms in oHCM patients, it is associated with complications such as cardiac tamponade and atrioventricular block. Objective This study introduces a novel approach for transcatheter radiofrequency ablation of hypertrophic septum via femoral access, utilizing the DragonFire Transcatheter Myocardial Puncture and Radiofrequency Ablation System. We aim to evaluate its safety and medium-term outcomes in patients with oHCM. Methods A prospective, single-center, single-arm study of tf-PIMSRA was conducted in patients with drug-refractory oHCM. Ten patients were enrolled and underwent the procedure under the guidance of transesophageal echocardiography. The primary outcome was 30-day major adverse clinical events, with secondary outcomes including 90-day improvements in outflow obstruction and quality of life. Results All patients, with an average age of 57±10 years, including 4 males, underwent the procedure successfully without any complications, including major adverse clinical events or conduction abnormalities. The average duration of the procedure was 125.2±34.6 minutes, with an average ablation time of 38.69±18.29 minutes and ablation energy of 3.60±1.49KJ. At 90-day follow-up, significant reductions were observed in peak LVOT gradients (resting gradient: from 82.00 [56.00] mmHg to 14.00 [6.25] mmHg; p < 0.001; provoked gradient: from 102.00 [76.25] mmHg to 33.00 [16.50] mmHg; p = 0.002), and interventricular septum thickness (from 22.00 [19.00] mm to 17.00 [15.00] mm; p = 0.002). These improvements were associated with enhancements in NYHA functional classification (from 3.00 [2.75] to 1.00 [1.00]; p < 0.0001), Kansas City Cardiomyopathy Questionnaire scores (from 59.00 [44.50] to 80.00 [77.25]; p < 0.02), 6-minute walk distance (from 441 [400] m to 480 [465] m; p < 0.01), and pro B-type natriuretic peptide levels (from 1738.00 [1113.25] pg/ml to 252.00 [200.00] pg/ml; p = 0.002). All patients achieved New York Heart Association functional class I or II at follow-up. Conclusions Transfemoral PIMSRA appears to be a safe and effective procedure for relieving LVOT obstruction and symptoms in patients with drug-refractory oHCM. These findings support further investigation through randomized clinical trials comparing it with established septal reduction therapies.Patient-Level Outcomes for the trans-fem

Role of 3D-electro-anatomical mapping on procedural characteristics and outcomes in pulsed-field ablation for atrial fibrillation

Abstract Introduction While the utilization of dedicated 3D-electro-anatomical mapping (EAM) systems for catheter ablation of atrial fibrillation (AF) is crucial using radiofrequency, its potential benefits in pulsed-field ablation (PFA) remain uncertain. This is of particular interest, since some PFA ablation systems will soon be available with integrated 3D-EAM capabilities. Objectives To compare the procedural characteristics and outcomes of patients undergoing PFA for pulmonary vein isolation (PVI) with mapping and with no mapping. Methods We prospectively enrolled patients undergoing their first PVI at a tertary referral center. In patients undergoing PVI with mapping, a multipolar mapping catheter was used to create voltage maps during sinus rhythm pre- and post-ablation. In the non-mapping group PVI was confirmed by assessing entrance block via the PFA catheter. The first 30 cases with mapping were excluded to account for a potential learning curve. Results A total of 197 consecutive patients were included (age 65 [interquartile range (IQR) 58 – 72] years; indexed left atrial volume 40 [IQR 35 – 44] mL/m2). Among these, 127 patients (64%) underwent PVI with mapping and 70 patients (36%) with no mapping. The median procedure duration, left atrial dwell time and the fluoroscopic time for the mapping vs the non-mapping group were 55 [IQR 45 – 67] min vs. 28 [IQR 23 – 35] min (p < 0.001), 38 [IQR 30 – 49] min vs. 15 [IQR 11 – 21] min (p < 0.001), 11 [IQR 9 – 14] min vs. 8 [IQR 7 – 11] min (p < 0.001), respectively. In the mapping group in 9% (11/127 patients) at least 1 PV was incompletely isolated and required additional applications. Acute PVI success was 100%. There were two complications in the mapping group (one stroke, one coronary artery air embolism) and none were observed in the non-mapping group. The recurrence rate of atrial arrythmias during a median follow-up of 267 [IQR 164 – 419] days was 14% in the mapping group and 17% in the non-mapping group, p = 0.728. Conclusion In conclusion, the use of PFA with no mapping was associated with a significant decrease in procedural characteristics, while AF-recurrence was not significantly different. The routine use of mapping for PFA-PVI may not be needed.Figure 1

Left atrial substrate modification for persistent atrial fibrillation and left atrial macro or microreentrant tachycardia using a single-shot pulsed field ablation system - a single centre case series

Abstract Background Pulsed field ablation (PFA) is a novel ablation technique for pulmonary vein isolation (PVI) in patients with paroxysmal and persistent atrial fibrillation. However, data for efficacy and safety of PFA for left atrial substrate modification in patients with long-standing persistent atrial fibrillation (AF) and macro- as well as microreentrant atrial tachycardia (AT) is scarce. Aim Here we provide a retrospective, single-centre case series regarding efficacy and safety of left atrial substrate modification, using a single-shot PFA system. Methods and Results Over a period of 6 months, 8 patients with long-standing persistent AF and AT underwent Re-PVI with left atrial substrate modification using a single-shot PFA system. Median age was 63 years (IQR 58 - 75), and 4/8 of patients were female. Time from first diagnosis of AF was 7 years (IQR 4 –10). All but 1 patient underwent previous PVI (IQR 1-3) with (5/7) or without (2/7) prior substrate modification using radiofrequency ablation. On transthoracic echocardiography, all patients showed severe left- and right-atrial enlargement, with LA volume of 58 ml/m2 (IQR 49.7–72) and RA diameter of 62 mm (IQR 55-75). In 8 patients, 9 ATs and 2 typical flutters were treated with PFA. Following PVI, additional posterior wall isolation was performed in 6/8 patients, roof in 6/8, and anterior wall (between superior mitral anulus and RSPV) in 4/8 patients. In addition, 2/8 patients had cavotricuspid isthmus ablation for typical atrial flutter. All patients received atropine prior to PVI, as well as bolus of nitro-glycerine prior to PFA of anterior wall and/or cavotricuspid isthmus. Acute success rate was 100% and all ATs as well as typical flutter terminated with PFA. After median follow-up time of 88 days (IQR 61-112), 3 patients had a documented recurrence of AF/AT, in 2 of which electrical cardioversion was necessary. We observed no acute and/or chronic complications following PFA, i.e. no pericardial effusion/tamponade, TIA/stroke, myocardial infarction, coronary artery spasm, AV-block, bleeding, or atrioesophageal fistula. Conclusion In this small, single-centre case series, left atrial substrate modification for long-standing persistent AF and AT using a single-shot PFA system was safe and showed an excellent acute success rate.

Thermal stability and anti-ablation performance of plasma spray coated-YSZ on Al2TiO5 modified novel ablative carbon-phenolic composites

Abstract Despite ongoing challenges, ablative thermal protection systems are among the most promising methods for safeguarding spacecraft during re-entry thermal protection systems (TPS). A novel aluminium titanate (Al2TiO5/AT) and a highly efficient thermal barrier of coating (TB/TBCs) made from yttria-stabilized zirconia (YSZ), powder, but deposited using the plasma spray technique on polyacrylonitrile (PAN)-based carbon fiber fabric(C)-reinforced with resorcinol phenol formaldehyde resin (RF) composites (C-RF)) would be a potential candidate for TPS applications. This study investigates the composites with varying wt.% of AT that were developed, namely 0 wt.% (YSZ-C-RF), 1 wt.%, 3 wt.%, and 5 wt.% (YSZ-AT-C-RF) by utilizing a hot press moulding machine. Thermal stability and ablation performance of unmodified C-RF with modified YSZ-C-RF and YSZ-AT-C-RF composites are examined through thermogravimetric analysis (TGA) and oxyacetylene torch test/OAT (4.0 MW/m2 for 60 sec). Also, the phase composition and microstructure of the ablated surface are determined by X-ray diffraction (XRD) and scanning electron microscopy (SEM) techniques. The TBC of YSZ has an obvious influence on the residual weight ratios at high temperatures in C-RF and also plays a positive role in increasing thermal stability under nitrogen atmosphere for enhancing ablation resistance concerning YSZ-C-RF. The mass and linear ablation rates (MAR and LAR) of the composites after modifying the surface by YSZ-coated particles are reduced by 82.98% and 15.65%, respectively. Similarly, the introduction of AT particles and TBC of YSZ results in evidence of improving the thermal stability and the ablation resistance in varying wt.% of YSZ-AT-C-RF composites. The primary optimum AT weight loading for enhancing ablation resistance in YSZ-C-RF composites is 1wt.%. The modification of 1wt.% AT particles and YSZ-Coated particles reduce MAR and LAR by 54.79% and 61.94%, respectively. This work offers a meaningful method to remarkably enhance the ablation performance of the modified C-RF and YSZ-AT-C-RF composites.

Methods and Techniques to Optimize Energy Delivery Using the Circular Array Pulsed Field Ablation Catheter

Pulsed field ablation (PFA) is a novel method of cardiac ablation in which electrical fields are used to create microscopic pores in the cardiomyocyte cell membrane resulting in cell death. Unlike traditional thermal radiofrequency and cryoablation technologies, PFA is cardiomyocyte preferential, reducing the risk of collateral damage to the esophagus and phrenic nerve. However, achieving durable lesions with PFA is dependent on the proximity to the tissue and presently approved systems do not provide contact force sensing. The PulseSelect pulsed field ablation system is the first FDA approved/ CE marked/PMDA approved system for pulsed field ablation of atrial fibrillation, however there is no consensus on workflow and best practices. We present here real-world experience from our centers in the United States, Europe and Japan, and propose techniques and methods for incorporating fluoroscopy, electro-anatomical mapping, and intracardiac echocardiography to assure optimal lesion delivery and predictability.

Constitutive modeling of thermo-chemical decomposition and thermo-mechanical deformation, coupled with transient heat conduction, in ablative matrix composite

Several thermal protection systems employ sacrificial composite layer that undergoes thermo-chemical decomposition in high-temperature environment. This results in the pyrolysis gas formation (endothermic reaction) that gets trapped inside the voids generated in the ablative matrix phase. These trapped gases apply pore pressure on the structure, along with the mechanical loading, thus significantly influencing the structure failure. A novel thermo-chemical (TC) decomposition and thermo-mechanical (TM) deformation-based coupled multi-physics formulation, applicable to ablative composite systems, is thus presented. A novel shrinkage expression, due to ablative matrix decomposition, is derived. The TC + TM coupled formulation is converted to stress update process, and its results are validated against the available experimental data. The proposed formulation is also converted to boundary value problem employing non-linear finite element framework (NL-FEM). The Jacobian matrices, for one- and two-dimensional cases, are systematically derived, and the proposed NL-FEM formulation is successfully verified against several benchmark problems.The transient heat conduction equation is finally coupled with the proposed TC + TM formulation (one-way coupling) thus enabling the analysis of more realistic situations where the constant heating rate assumption is not valid. The coupled formulation is finally implemented for several test cases and it is demonstrated that, it has a significant influence on pore pressure and porosity evolution (through pore volumetric strain) within the ablative matrix phase.

Pulsed Field Ablation to Treat Paroxysmal Atrial Fibrillation: Safety and Effectiveness in the AdmIRE Pivotal Trial.

Evidence from clinical trials of early pulsed field ablation (PFA) systems in treating atrial fibrillation has demonstrated their promising potential to reduce complications associated with conventional thermal modalities while maintaining efficacy. However, the lack of a fully integrated mapping system, a staple technology of most modern electrophysiology procedures, poses limitations in lesion creation and workflow options. A novel variable-loop PFA catheter integrated with an electroanatomic mapping system has been developed that allows for real-time nonfluoroscopic procedural guidance and lesion indexing as well as feedback of tissue-to-catheter proximity. AdmIRE (Assessment of Safety and Effectiveness in Treatment Management of Atrial Fibrillation With the Bosense-Webster Irreversible Electroporation Ablation System), a multicenter, single-arm, Food and Drug Administration investigational device exemption study, evaluated the long-term safety and effectiveness of this integrated PFA system in a large United States-based drug-refractory symptomatic paroxysmal atrial fibrillation patient population. Using the PFA catheter with a compatible electroanatomic mapping system, patients with drug-refractory symptomatic paroxysmal atrial fibrillation underwent pulmonary vein isolation. The primary safety end point was primary adverse event within 7 days of ablation. The primary effectiveness end point was a composite end point that included 12-month freedom from documented atrial tachyarrhythmia (ie, atrial fibrillation, atrial tachycardia, atrial flutter) episodes, failure to achieve pulmonary vein isolation, use of a nonstudy catheter for pulmonary vein isolation, repeat procedure (except for one redo during blanking), taking a new or previously failed class I or III antiarrhythmic drug at higher dose after blanking, or direct current cardioversion after blanking. At 30 centers, 277 patients with paroxysmal atrial fibrillation (61.5±10.3 years of age; 64.3% male) in the pivotal cohort underwent PFA. More than 25% of the procedures were performed without fluoroscopy. Median (Q1, Q3) pulmonary vein isolation procedure, fluoroscopy, and transpired PFA application times were 81.0 (61.0, 112.0), 7.1 (0.00, 14.3), and 31.0 (24.8, 40.9) minutes, respectively. The primary adverse event rate was 2.9% (8 of 272), with the most common complication being pericardial tamponade. The 12-month primary effectiveness end point was 74.6%. The 1-year freedom from atrial fibrillation, atrial tachycardia, or atrial flutter recurrence rate after blanking was 75.4%. Substantial improvements in quality of life were observed as early as 3 months after the procedure, concurrent with a reduction in multiple health care use measures. AdmIRE confirmed the safety and effectiveness of the variable-loop PFA catheter, with short procedure and PFA application times and low fluoroscopy exposure. URL: https://www.clinicaltrials.gov; Unique identifier: NCT05293639.

2D geochemical imaging of biogenic marine carbonates using LA-TOF-ICP-MS at 1 and 2 μm pixel resolution

Many applications at the forefront of the study of the chemical composition of marine carbonates require in-situ micro-scale geochemical imaging. Such analyses are, however, challenging, requiring analytical techniques that are either expensive with limited accessibility (e.g. synchrotron X-Ray spectroscopy and secondary ion mass spectrometry), or time-consuming and able to only analyse a limited range of elements (e.g. electron microprobe). Laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) as a tool for generating 2D images has grown in popularity, yet many analytical issues remain when generating high-spatial resolution geochemical images using this approach. Here we employ the imageGEO193 (ESL) fast wash-out laser ablation system coupled to the Nu Instruments Vitesse Time-of-Flight (TOF) ICP mass spectrometer, with its near-full mass spectra capabilities, to generate 2D geochemical images of a range of biogenic carbonates at ≤2 μm pixel resolution (pixel widths of either 1 or 2 μm) and at an unprecedented speed (200 pixels/s). We demonstrate sensitivity of ∼100 cps/μg g−1 at low mass rising to ∼1000 cps/μg g−1 at high mass based on analyses of reference materials JCp-1 (carbonate) and NIST SRM612 (silicate) with 1 μm wide square laser beams, and accuracy of ±7 % for elements present at concentrations >0.5 μg g−1 based on analyses of carbonate reference material JCt-1. By applying our quantitative method to a range of biogenic carbonates (coral skeletons, coralline algae, foraminifera), we demonstrate that considerable but coherent micron-scale compositional variability is the norm for nearly all quantified elements, including: Mg, Sr, Ba and U. This approach therefore has great potential to provide valuable insights into biomineralisation mechanisms and “vital effects”, ultimately facilitating more robust reconstructions of past environments.

Urologist-Administered MRI-Guided Transurethral Ultrasound Ablation of the Prostate Using a Mobile Treatment Center: A Case Series

Introduction: Transurethral ultrasound ablation (TULSA) relies on real-time MRI to precisely control the treatment of prostate cancer and avoid side effects. To overcome limited urologist access to MRI, we present a case series on the first use of a mobile TULSA treatment center. Methods: Clinical outcomes were retrospectively reviewed from our institutional database. A mobile MRI scanner was installed next to a surgical hospital, equipped with the ablation system and MRI-compatible anesthesia. Manufacturer testing confirmed that mobile TULSA continued to meet the requirements of fixed installations. Patients underwent preoperative assessment of candidacy for anesthesia and treatment in a mobile MRI setting. Positioning, anesthesia induction, and device placement were performed in the MRI scanner room. The intended ablation zone was delineated by the urologist using magnetic resonance images acquired with treatment devices in place. Ablation was controlled by the treatment software and monitored by the urologist using real-time MRI. A Foley catheter was placed for postoperative drainage; the patients awoke in the mobile MRI before transfer to postanesthesia care unit. Results: Six patients underwent TULSA in the mobile treatment unit, with no intraoperative complications. The median procedure time was 3.2 hours, with workflow improvements during equipment setup, patient positioning, and treatment planning. Contrast-enhanced images confirmed devascularization of the index lesion and successful nerve sparing. Six-month follow-up demonstrated promising PSA and MRI findings, and improvements in lower urinary tract symptoms. Conclusions: TULSA can be safely administered by urologists using a mobile MRI treatment center. Mobile MRI units could be used to expand patient access to TULSA.

Design of a Conformal Ablation System Based on Independent Control of Radiofrequency Electrode Arrays

This study aims to develop an independent control system for radiofrequency electrode arrays, intended for the conformal ablation of unwanted tissues. Unlike traditional single radiofrequency voltage applications, this study employs high-frequency transformer isolation and radiofrequency load matching technologies to divide the radiofrequency signal source into eight independent groups. Each group operates at the same phase and frequency but with different voltage values. Experimental results indicate that the designed system can independently output various combinations of radiofrequency signals. The actual output voltage has a relative error controlled within 6%, the frequency error is less than 0.5%, and the phase difference among the groups is less than 1°. In the biomimetic tissue heating experiments, it is found that by controlling the voltage of each electrode within the electrode array, ablation of different shapes can be achieved, and the ablation depth is positively correlated with the applied radiofrequency voltage.

Transgenic zebrafish as a model for investigating diabetic peripheral neuropathy: investigation of the role of insulin signaling.

Diabetic peripheral neuropathy (DPN), a complication of diabetes mellitus (DM), is a neurodegenerative disorder that results from hyperglycemic damage and deficient insulin receptor (IR) signaling in peripheral nerves, triggered by failure of insulin production and insulin resistance. IR signaling plays an important role in nutrient metabolism and synaptic formation and maintenance in peripheral neurons. Although several animal models of DPN have been developed to identify new drug candidates using cytotoxic reagents, nutrient-rich diets, and genetic manipulations, a model showing beneficial effects remains to be established. In this study, we aimed to develop a DPN animal model using zebrafish to validate the effects of drug candidates on sensory neuropathy through in vivo imaging during the early larval stage. To achieve this, we generated Tg (ins:gal4p16);Tg (5uas:epNTR-p2a-mcherry) zebrafish using an enhanced potency nitroreductase (epNTR)-mediated chemogenetic ablation system, which showed highly efficient ablation of pancreatic β-cells following treatment with low-dose metronidazole (MTZ). Using in vivo live imaging, we observed that sensory nerve endings and postsynaptic formation in the peripheral lateral line (PLL) were defective, followed by a disturbance in rheotaxis behavior without any locomotory behavioral changes. Despite defects in sensory nerves and elevated glucose levels, both reactive oxygen species (ROS) levels, a primary cause of DPN, and the number of ganglion cells, remained normal. Furthermore, we found that the activity of mTOR, a downstream target of IR signaling, was decreased in the PLL ganglion cells of the transgenic zebrafish. Our data indicates that peripheral neuropathy results from the loss of IR signaling due to insulin deficiency rather than hyperglycemia alone.

The Effect of Hyperconjugation and Hydrogen Bonding on the Conformers of Methylated Monosaccharides.

The conformational landscapes of four 1-O-methylated monosaccharides-methyl a-glucose, methyl b-glucose, methyl a-galactose, and methyl b-galactose-were characterized using jet-cooled broadband rotational spectroscopy, supported by density functional theory calculations. A newly designed, simple pulsed nozzle assembly was used to introduced the sugar samples into a jet expansion without thermal degradation, eliminating the need for a complex and expensive laser ablation system. Ten conformers were experimentally identified by assigning their rotational spectra, and the intricate methyl internal rotation splittings were analysed. Notably, methylation alters the directionality of intramolecular hydrogen bonding of a-galactose highlighting its impact on structural preference. Natural bond orbital, intrinsic bond strength, and non-covalent interaction analyses were conducted to explore the interplay between hydrogen bonding and hyperconjugation. A set of σ to σ* neutral hyperconjugative interactions were found to override a strong hydrogen bond, driving a preference for the gauche conformers.

Abstract C077: Functional Dissection of the Highly Plastic Basal Cell State in Pancreatic Cancer

Abstract Pancreatic ductal adenocarcinoma (PDAC) is a treatment-refractory malignancy with a dismal prognosis. Targeting cancer cell plasticity—the capacity to adapt to cell-extrinsic pressure via non-genetic mechanisms—is a promising therapeutic strategy, yet cell states within PDAC harboring high plasticity remain poorly understood. Using genetically engineered mouse models driven by oncogenic KrasG12D and loss of p53 (“KPC” model), we profiled primary PDAC tumors using single-cell RNA sequencing and single cell ATAC sequencing. We identified a cancer cell differentiation state that co-expresses both epithelial and mesenchymal programs and has a distinct epigenetic landscape with accessible chromatin across gene sets that mark cancer cell states with divergent phenotypes, suggesting that this cell state is primed for cell state switching. Notably, this high-plasticity cell state (HPCS) signature aligns with a "basal" signature in human PDAC, which associates with poor prognosis and chemoresistance. To functionally interrogate the HPCS in PDAC progression, we developed a novel lineage-tracing and ablation system. Lineage-tracing experiments revealed that the HPCS has a robust capacity for differentiation into epithelial and mesenchymal states, indicating that the HPCS is functionally plastic and acts as a source of fixed malignant states. Strikingly, targeted elimination of the HPCS over short time periods resulted in tumor collapse, underscoring a critical role in tumor maintenance. Further, we found that the HPCS is highly dependent on KRAS activity, with acute KRAS inhibitor treatment leading to a selective depletion of the HPCS. Taken together, our data indicates that PDAC harbors a striking dependency on the HPCS and encourages therapeutic approaches aimed at eradicating this critical subset of cancer cells. Citation Format: Anupriya Singhal, Hannah C. Styers, Jonathan Rub, Zhuxuan Li, Zeynep Tarcan, Jill Hallin, Olca Basturk, Rona Yaeger, James G. Christensen, Doron Betel, Yan Yan, Elisa de Stanchina, Tuomas Tammela. Functional Dissection of the Highly Plastic Basal Cell State in Pancreatic Cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr C077.

Synthesis of Sn-ZnO nanostructures on MgO by hybrid pulsed laser ablation and RF magnetron sputtering tandem system for CO gas-sensing application

An exceptional method of incorporating Sn ions into Zinc Oxide (ZnO) using a tandem system of Pulsed Laser Deposition (PLD) and Radio-Frequency Magnetron Sputtering (RFMS) to synthesize and functionalize ZnO nanostructures is demonstrated in this study for gas-sensing application. The RFMS power was varied up to 50 W to sputter a pure Sn metal target, while simultaneously or successively growing ZnO nanostructures on a templated MgO < 0001 > substrate and on an Au-plated Al2O3 gas sensor, via PLD process at the substrate temperature of 700 °C in 100–500 millitorr oxygen/argon gas background. The morphologies of the grown Sn-ZnO nanostructures were characterized by Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM), and X-ray Diffraction (XRD), and while their chemical/oxidation states and optical properties were analyzed by X-ray photospectroscopy (XPS) and photoluminescence (PL), respectively. For simultaneous deposition, the resulting (0002)-dominated 2D grain-like ZnO nanostructures were influenced by the interaction of the dynamic PLD plasma with static RFMS plasma at different powers. For successive growth, at 50 W-RF power, a remarkable increase in the sensor response to 50-ppm carbon monoxide (CO) gas was observed at 250 °C, which could be attributed to the creation of more adsorption sites in the Sn-ZnO depletion region caused by the replacement of some Zn sites with Sn ions in the ZnO matrix. This study, therefore, exhibits the viability of this hybrid system to design, synthesize, and functionalize Sn-ZnO nanomaterials, either by simultaneous/successive deposition, for gas-sensing applications.

769. CLINICAL EVALUATION OF CRYOBALLOON ABLATION FOR BARRETTS OESOPHAGUS: A UK FIRST MULTI-CENTRE EXPERIENCE

Abstract Introduction The Cryoballoon Focal Ablation System (CbFAS) (Pentax Medical Inc) is an innovative device designed for the endoscopic ablation of Barrett's-related neoplasia. This system has been shown to provide advantages such as reduced stricture rates and improved patient tolerance compared to the conventional standard of care, radiofrequency ablation (RFA). We report early outcomes from a prospective UK first multi-centre registry of consecutive patients who underwent Cryoablation for the endoscopic eradication (EET) of Barrett’s-related neoplasia. Methods Patients were prospectively enrolled from two tertiary referral centres for Barrett’s Oesophagus (BE). Inclusion criteria included patients with a BE segment no longer than 5cm with histologically-proven dysplasia on biopsy or endoscopic resection specimens suitable for EET of BE after MDT review. Cryoablation sessions were conducted at 3-month intervals until endoscopic eradication was complete. The standardised protocol involved administering 8 seconds per ablation for all enrolled patients with the CbFAS. Our primary outcome was complete eradication of BE. Secondary outcomes included the number of ablations performed, adverse events, device malfunction, stricture rate, patient tolerance, and endoscopist satisfaction which was evaluated using a 10-point Likert scale (1=poor, 10=excellent). Results Between January 2020 and December 2023, a total of 16 patients (35 treatment sessions) were treated. The median BE length was C0M2. Complete eradication of BE was achieved in 89% (8/9) of patients who had completed treatment. No instances of device malfunction or intraoperative adverse events were recorded. A stricture rate of 12.5% (2/16) was observed, both of which were successfully managed through endoscopic dilatation. All patients were recorded as tolerating the procedure well with sedation. The median endoscopist satisfaction score was 9 (+/- 2.4) with only one recorded instance of difficulty attributed to balloon positioning. Conclusions These preliminary results from the UK cryoablation registry suggest that cryoablation with the CbFAS is a safe and effective therapy for BE-related dysplasia. The stricture rate appears to be comparable to that observed with RFA and similar studies. With the planned enrolment of further centres and suitable patients, this registry will further enhance our understanding of the long-term efficacy and safety profile of cryoablation using the CbFAS.

In vivo electrical properties of the healthy liver and the hepatic tumor in a mouse model between 1 Hz and 1 MHz during a thermal treatment

Objective: Understansding the changing patterns of in vivo electrical properties for the target tissue is crucial for the accurate temperature monitoring and the treatment efficacy in thermal therapy. Our research aims to investigate the changing patterns and the reversibility of in vivo electrical properties for both healthy livers and liver tumors in a mouse model over a frequency range of 1 Hz to 1 MHz at temperatures between 30 °C to 90 °C. Methods and materials: The mice were anesthetized and the target organ was exposed. An 808-nm near-infrared laser was employed as the heating source to heat the organ in vivo. The four-needle electrode, connected to an impedance analyzer, was utilized to obtain the impedance at varying temperatures, which were monitored by a thermocouple. Results: The findings indicated a gradual decline in impedance with an increase in temperature. Furthermore, the impedance was normalized to that at 30 °C, and the real part of the normalized impedance was defined as the k-values, which range from 0 to 1. The results demonstrated a linear correlation between k-values and temperatures (R2 > 0.9 for livers and R2 > 0.8 for tumors). Significant differences were observed between livers and tumors at 1, 10 and 50 kHz (p < 0.05). Additionally, it was demonstrated that the electrical properties could be reversed when the temperature was below or equal to 45 °C. Conclusion: We believe that these results will contribute to the advancement of radiofrequency ablation systems and the development of techniques for temperature monitoring during liver thermal treatment.

Ablation resistance and mechanical properties of C/C-HfC-SiC composites with a bulletproof-like layer

Two structural designs are based on the arapaima fish scale structure to enhance the performance of composites. A double-layer SiC/PyC coating was deposited to modify C/C-HfC-SiC composites by chemical vapor deposition. The introduction of PyC coating reduced the porosity and roughness of composites. Ar-O2-Al2O3 plasma ablation system was used to assess the composites. The composites with arapaima fish scale structure showed good flexural and ultra-temperature particle erosion resistance. The samples with the introduction of PyC layer showed higher flexural strength of 220 MPa, which is 40.13 % higher than that of without. After ablation 40 s, the linear ablation rates decreased from 5.95 μm/s to −4.6 μm/s. This study provides new ideas to develop C/C composites with improved ablation-resistant and mechanical properties.

Safety and efficacy of a novel transbronchial radiofrequency ablation system for lung tumours: One year follow-up from the first multi-centre large-scale clinical trial (BRONC-RFII).

Radiofrequency ablation (RFA) is an emerging treatment of lung cancer, yet it is accompanied by certain safety concerns and operational limitations. This first multi-centre, large-scale clinical trial aimed to investigate the technical performance, efficacy and safety of an innovative transbronchial RFA system for lung tumours. The study enrolled patients with malignant lung tumours who underwent transbronchial RFA using an automatic saline microperfusion system between January 2021 and December 2021 across 16 medical centres. The primary endpoint was the complete ablation rate. The performance and safety of the technique, along with the 1-year survival rates, were evaluated. This study included 126 patients (age range: 23-85 years) with 130 lung tumours (mean size: 18.77 × 14.15 mm) who had undergone 153 transbronchial RFA sessions, with a technique success rate of 99.35% and an average ablation zone size of 32.47 mm. At the 12-month follow-up, the complete ablation rate and intrapulmonary progression-free survival rates were 90.48% and 88.89%, respectively. The results of patients with ground-glass nodules (GGNs) were superior to those of the patients with solid nodules (12-month complete ablation rates: solid vs. pure GGN vs. mixed GGN: 82.14% vs. 100% vs. 96.08%, p = 0.007). No device defects were reported. Complications such as pneumothorax, haemoptysis, pleural effusion, pulmonary infection and pleural pain were observed in 3.97%, 6.35%, 8.73%, 11.11% and 10.32% of patients, respectively. Two subjects died during the follow-up period. Transbronchial RFA utilizing an automatic saline microperfusion system is a viable, safe and efficacious approach for the treatment for lung tumours, particularly for patients with GGNs.

Tissue Radiologic and Pathologic Response to Biphasic Pulsed Electric Field Technology in a Porcine Model

PurposeTo evaluate the radiologic, pathologic, and safety characteristics of a commercially available pulsed electric field (PEF) ablation system in a porcine model. Materials and MethodsMonopolar biphasic PEF ablation was delivered to the liver, kidney, and longissimus dorsi muscle through a single needle via a percutaneous or open approach with the Aliya System (Galvanize Therapeutics, Redwood City, California). Six animals were ablated and evaluated in 2 cohorts (Day 3 and Day 28). Muscle, kidney, and liver were ablated in each animal. Intraprocedural cone-beam computed tomography (CT), follow-up weekly CT, blood serology, gross pathology, and histopathology were performed to characterize the radiographic evolution and tissue response. ResultsThere were no adverse events and no findings of electrocardiographic abnormalities, and serologic values returned to baseline by Day 28. Ablation zones were visible on noncontrast CT images during follow-up. Most identified zones became radiographically smaller over time, with some fully resolved by Day 28. The relative decrease in gross ablation zone volume in the liver and skeletal muscle was 20% and 26%, respectively, whereas kidney sites grew by 22%. Ablation sites were focal and contained within the intended target tissue without extension to nontarget tissues or collateral structures. ConclusionsThe biphasic PEF system evaluated here resulted in a safe and predictable ablation response, with preservation of structural tissues in an animal model, offering an alternative to thermal ablative modalities, particularly near critical structures.

Effects of laser ablation of olivine on chamber optical window transmission loss and its recovery

Optical windows play a crucial role in laser ablation systems by protecting delicate components inside the chamber while allowing the transmission of laser energy. However, material buildup during the laser ablation process can lead to a significant loss of optical transmission over time. In this work, material deposition on the optical window by laser ablation of olivine using two laser systems operating at 30 kHz, 1 mJ pulse energy, and 20 Hz, 9.6 mJ pulse energy was performed and its impact on the window’s transmission properties, laser-induced breakdown spectroscopy (LIBS) signal, and window recovery is presented. Ablation at 30 kHz with 1 mJ pulses for 10 min resulted in substantial particle deposition on the window, causing a significant drop in transmission. Transmission of clean window dropped abruptly from 90% to nearly 0% (in the UV region from 200 to 300 nm) and 35% (at 600 nm) affecting the LIBS signal. In contrast, ablation at 20 Hz with 9.6 mJ pulses for 5 min showed no material deposition or transmission loss. Additionally, the study demonstrated that the same laser system used for ablation could be employed to remove the deposited material from the window, facilitating its recovery. Laser cleaning of the window at 30 kHz and 12 W average power restored the transmission values from 39% to 62% at 400 nm in the UV region, with potential for further improvement through parameter optimization. In addition, the identification of the hydroxyl group in olivine, which is relevant to NASA’s terahertz heterodyne spectrometer for in situ resource utilization project for the validation of water molecules is presented.