The Experimental Study Of Safety And Effectiveness After Ablation In Perivascular Tissue By CT-guided Nanoknife

ObjectiveTo investigate the long-term changes of renal after ablation of kidneys in experimental miniature pigs by percutaneous Nanoknife, and to analyse the safety and effectiveness of ablation in perivascular tissue.MethodsTen Bama miniature pigs were used in experiment, six pigs were randomly selected and numbered. Each side kidney of every pig was randomly selected as experimental group, the contralateral as control group. Nanoknife ablation probe was placed into pre-treatment renal parenchyma of experimental groups by CT guided percutaneous puncture technology following the preoperative planning, the control groups did not take any treatment measures. After irreversible electroporation ablation in the experimental group, bilateral renal CT perfusion imaging were carried out respectively immediately, two weeks, four weeks, eight weeks, sixteen weeks after ablation,. Renal perfusion parameters including renal blood flow (BF), blood volume (BV), peak enhancement (PE), time to peak (TTP)were analyzed, and statistical analysis was performed. Each side kidney of the remaining four pigs was randomly selected. Nanoknife ablation probe was placed into pre-treatment renal parenchyma of experimental groups by CT guided percutaneous puncture technology. Enhanced CT scan were carried out respectively immediately, two weeks, four weeks, eight weeks, sixteen weeks after ablation. And an experimental pig were randomly killed for pathological analysis after each scan. All remaining experiment pigs were sacrificed for pathological analysis after sixteen weeks. Results Six miniature pigs were punctured successfully, and renal CT perfusion imaging of six randomly selected pigs were carried out in each time successfully. Immediately after ablation, BV, BF, PE values of experimental group were lower, TTP was higher than those of the control group (all P<0.05), meanwhile,2 weeks,4 weeks,8 weeks,16 weeks after ablation, the statistical analysis of BV, BF, PE and TTP showed no significant difference in both groups (all P>0.05). CT enhancement scan of the remaining four pigs showed local reduced enhancement areas immediately after ablation; Pathology showed glomerular structure was damaged immediately After ablation, renal tubular epithelial cell apoptosis were abserved, vascular and tubular structure were substantially integrated. CT enhancement scan showed the ablation areas were no significant difference with non-ablated areas 2 weeks,4 weeks,8 weeks,16 weeks after ablation, no damage of collection systems were abserved; Pathology showed fibrosis and a small amount of regeneration of renal tubular epithelial cells were visible on later.ConclusionRenal perfusion can be reduced after kidney Nanoknife ablation in the acute phase, but restore 2 weeks after ablation. The effects of nano knife ablation of kidney on renal perfusion are temporary and reversible. Histological analysis shows that kidney damage can be repaired gradually with time. The ablation of perivascular tissue by Nanoknife has good safety and effectiveness, and Nanoknife can be used as a minimally invasive approach to treat renal tumors.