AUTHOR=Kim Song Hee , Jeong Seung , Kang Jeon Min , Park Yubeen , Ryu Dae Sung , Won Dong-Sung , Kim Ji Won , Zeng Chu Hui , Kim Hyung-Sik , Kim Hong Bae , Lee Sang Soo , Park Jung-Hoon 

TITLE=Image-guided stent-directed irreversible electroporation for circumferential ablation in the rat esophagus

JOURNAL=Frontiers in Bioengineering and Biotechnology

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.2022.934858

DOI=10.3389/fbioe.2022.934858

ISSN=2296-4185

ABSTRACT=Background: Irreversible electroporation (IRE) has been investigated in the alimentary tract; however, lack of dedicated electrode and insufficient tissue response made its application limited. The aim was to investigate the efficacy and safety of image-guided stent-directed IRE in the rat esophagus.

Methods: The bipolar self-expandable electrode (SE) was developed by the braiding technique. A finite element analysis was performed to validate optimal electrical field strength for the rat esophagus. Forty of 50 rats received stent-directed IRE and sacrificed at 10 hours, 3 days, 7 days, and 28 days of 10 each. The remaining ten rats underwent sham procedure. The outcomes of stent-directed IRE were assessed by esophagography and histological responses. 

Results: Stent-directed IRE was technically successful in all rats with mild muscle contraction. Heart rate dropped immediately and gradually recovered at 180 s. TUNEL and Caspase-3 with submucosal thickness significantly increased at 10 hours and Day 3 compared with the sham control (all p < 0.001). The thickness of epithelial layers with collagen deposition significantly decreased at 10 hours and Day 3 (all p < 0.001); however, increased at Day 7 compared with the sham control (all p < 0.05). The Ki67 positive deposition significantly increased at Days 3 and 7 compared with the sham control (all p < 0.001). All variables were similar with the sham control at Day 28.

Conclusion: Image-guided stent-directed IRE was effective and safe in the rat esophagus. It seems to be effectively and evenly induced cell death, and gradually recovered with cellular regeneration.