Esophageal varices are a significant complication of portal hypertension. Endoscopic variceal ligation (EVL) is one of the clinical standards for treating these varices and preventing their hemorrhage. Limitations of EVL include the risk of stricture formation and postband ulcer bleeding due to the damage caused to the esophageal mucosa, as well as the need for multiple endoscopic treatment sessions to eradicate the varices. The goal of this study is to develop a device and evaluate the technical feasibility of microwave ablation to seal esophageal varices, while preventing thermal damage to the surface mucosal tissue. A microwave applicator with a directional radiation pattern was developed for endoscopic ablation of esophageal varices. Electromagnetic and bioheat transfer computational models were employed to optimize the design of the microwave applicator and evaluate energy delivery strategies for this application. Experiments in ex vivo and in vivo tissue were employed to verify simulation results. Simulations predicted enhanced heating performance of the antenna using an angled monopole radiating element. Further, simulations indicate that while the endoscopic cap attenuated electric fields in tissue, it also enhanced surface cooling of tissue, increasing the likelihood of preserving mucosal tissue. Experiments in ex vivo tissue indicated the feasibility of sealing veins with 77 W microwave power delivered for 30 s. In vivo experiments demonstrated the ability to seal veins, while preserving surface tissue. This study demonstrated the technical feasibility of microwave thermal ablation for treating esophageal varices using a 2.45 GHz water-cooled directional microwave applicator.
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September 2017
Research-Article
Feasibility Assessment of Microwave Ablation for Treating Esophageal Varices
Jan Sebek,
Jan Sebek
Department of Electrical and Computer Engineering,
Kansas State University,
Manhattan, KS 66506;
Department of Circuit Theory,
Faculty of Electrical Engineering,
Czech Technical University in Prague,
Technicka 2,
Praha 6 166 27, Czech Republic
e-mail: sebekja4@fel.cvut.cz
Kansas State University,
Manhattan, KS 66506;
Department of Circuit Theory,
Faculty of Electrical Engineering,
Czech Technical University in Prague,
Technicka 2,
Praha 6 166 27, Czech Republic
e-mail: sebekja4@fel.cvut.cz
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Sergio Curto,
Sergio Curto
Department of Electrical and Computer Engineering,
Kansas State University,
Manhattan, KS 66506
e-mail: s.curto@erasmusmc.nl
Kansas State University,
Manhattan, KS 66506
e-mail: s.curto@erasmusmc.nl
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Jimmy Eaton-Evans,
Jimmy Eaton-Evans
School of Engineering and Informatics,
NUIG,
Galway H91 TK33, Ireland
e-mail: jeaton-evans@nuigalway.ie
NUIG,
Galway H91 TK33, Ireland
e-mail: jeaton-evans@nuigalway.ie
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Jonathan Bouchier-Hayes,
Jonathan Bouchier-Hayes
School of Engineering and Informatics,
NUIG,
Galway H91 TK33, Ireland
e-mail: Jonathan.BouchierHayes@bioinnovate.ie
NUIG,
Galway H91 TK33, Ireland
e-mail: Jonathan.BouchierHayes@bioinnovate.ie
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Giuseppe Ruvio,
Giuseppe Ruvio
School of Engineering and Informatics,
NUIG,
Galway H91 TK33, Ireland
e-mail: giuseppe.ruvio@nuigalway.ie
NUIG,
Galway H91 TK33, Ireland
e-mail: giuseppe.ruvio@nuigalway.ie
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Chanran Ganta,
Chanran Ganta
Department of Diagnostic Medicine and Pathobiology,
Kansas State University,
1800 Denison Avenue,
Manhattan, KS 66506
e-mail: ckganta@vet.ksu.edu
Kansas State University,
1800 Denison Avenue,
Manhattan, KS 66506
e-mail: ckganta@vet.ksu.edu
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Warren Beard,
Warren Beard
Department of Clinical Sciences,
Kansas State University,
1800 Denison Avenue,
Manhattan, KS 66506
e-mail: wbeard@ksu.edu
Kansas State University,
1800 Denison Avenue,
Manhattan, KS 66506
e-mail: wbeard@ksu.edu
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Navtej Buttar,
Navtej Buttar
Division of Gastroenterology and Hepatology,
Mayo Clinic,
200 1st Street SW,
Rochester, MN 55905
e-mail: buttar.navtej@mayo.edu
Mayo Clinic,
200 1st Street SW,
Rochester, MN 55905
e-mail: buttar.navtej@mayo.edu
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Louis Wong Kee Song,
Louis Wong Kee Song
Division of Gastroenterology and Hepatology,
Mayo Clinic,
200 1st Street SW,
Rochester, MN 55905
e-mail: wong.louis@mayo.edu
Mayo Clinic,
200 1st Street SW,
Rochester, MN 55905
e-mail: wong.louis@mayo.edu
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Punit Prakash
Punit Prakash
Department of Electrical and Computer Engineering,
Kansas State University,
Manhattan, KS 66506
e-mail: prakashp@ksu.edu
Kansas State University,
Manhattan, KS 66506
e-mail: prakashp@ksu.edu
Search for other works by this author on:
Jan Sebek
Department of Electrical and Computer Engineering,
Kansas State University,
Manhattan, KS 66506;
Department of Circuit Theory,
Faculty of Electrical Engineering,
Czech Technical University in Prague,
Technicka 2,
Praha 6 166 27, Czech Republic
e-mail: sebekja4@fel.cvut.cz
Kansas State University,
Manhattan, KS 66506;
Department of Circuit Theory,
Faculty of Electrical Engineering,
Czech Technical University in Prague,
Technicka 2,
Praha 6 166 27, Czech Republic
e-mail: sebekja4@fel.cvut.cz
Sergio Curto
Department of Electrical and Computer Engineering,
Kansas State University,
Manhattan, KS 66506
e-mail: s.curto@erasmusmc.nl
Kansas State University,
Manhattan, KS 66506
e-mail: s.curto@erasmusmc.nl
Jimmy Eaton-Evans
School of Engineering and Informatics,
NUIG,
Galway H91 TK33, Ireland
e-mail: jeaton-evans@nuigalway.ie
NUIG,
Galway H91 TK33, Ireland
e-mail: jeaton-evans@nuigalway.ie
Jonathan Bouchier-Hayes
School of Engineering and Informatics,
NUIG,
Galway H91 TK33, Ireland
e-mail: Jonathan.BouchierHayes@bioinnovate.ie
NUIG,
Galway H91 TK33, Ireland
e-mail: Jonathan.BouchierHayes@bioinnovate.ie
Giuseppe Ruvio
School of Engineering and Informatics,
NUIG,
Galway H91 TK33, Ireland
e-mail: giuseppe.ruvio@nuigalway.ie
NUIG,
Galway H91 TK33, Ireland
e-mail: giuseppe.ruvio@nuigalway.ie
Chanran Ganta
Department of Diagnostic Medicine and Pathobiology,
Kansas State University,
1800 Denison Avenue,
Manhattan, KS 66506
e-mail: ckganta@vet.ksu.edu
Kansas State University,
1800 Denison Avenue,
Manhattan, KS 66506
e-mail: ckganta@vet.ksu.edu
Warren Beard
Department of Clinical Sciences,
Kansas State University,
1800 Denison Avenue,
Manhattan, KS 66506
e-mail: wbeard@ksu.edu
Kansas State University,
1800 Denison Avenue,
Manhattan, KS 66506
e-mail: wbeard@ksu.edu
Navtej Buttar
Division of Gastroenterology and Hepatology,
Mayo Clinic,
200 1st Street SW,
Rochester, MN 55905
e-mail: buttar.navtej@mayo.edu
Mayo Clinic,
200 1st Street SW,
Rochester, MN 55905
e-mail: buttar.navtej@mayo.edu
Louis Wong Kee Song
Division of Gastroenterology and Hepatology,
Mayo Clinic,
200 1st Street SW,
Rochester, MN 55905
e-mail: wong.louis@mayo.edu
Mayo Clinic,
200 1st Street SW,
Rochester, MN 55905
e-mail: wong.louis@mayo.edu
Punit Prakash
Department of Electrical and Computer Engineering,
Kansas State University,
Manhattan, KS 66506
e-mail: prakashp@ksu.edu
Kansas State University,
Manhattan, KS 66506
e-mail: prakashp@ksu.edu
1Corresponding author.
Manuscript received January 19, 2017; final manuscript received June 19, 2017; published online July 18, 2017. Assoc. Editor: Rafael V. Davalos.
J. Med. Devices. Sep 2017, 11(3): 031013 (8 pages)
Published Online: July 18, 2017
Article history
Received:
January 19, 2017
Revised:
June 19, 2017
Citation
Sebek, J., Curto, S., Eaton-Evans, J., Bouchier-Hayes, J., Ruvio, G., Ganta, C., Beard, W., Buttar, N., Song, L. W. K., and Prakash, P. (July 18, 2017). "Feasibility Assessment of Microwave Ablation for Treating Esophageal Varices." ASME. J. Med. Devices. September 2017; 11(3): 031013. https://doi.org/10.1115/1.4037187
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