摘要
To the Editor:Irreversible electroporation(IRE)is a promising ablative technique for hepatobiliary cancers.IRE has unique advantages,including no detrimental heat sink effect[1]and no injury of the surrounding tissues[2].For lesions in complex areas,bile duct[3],and large blood vessels[4],IRE has been developed as an alternative to thermal ablation such as radiofrequency and microwave.The IRE tumor ablative technique combines cell biology and pulsed high-voltage engineering.Repeated high-voltage,high-frequency and transient pulses can create irreversible electroporation in the phospholipid bilayer of the cell membrane and nuclear envelope,resulting in cell apoptosis.Compared with radiofrequency ablation and microwave ablation[5],IRE does not cause damage to important vessels and ducts.IRE has some unique shortcomings in delivering high currents,which has limited its clinical applications in the past.In animal and clinical studies,side effects including muscle contraction,procedural hypertension,and arrhythmia are frequently reported[6].However,during the ablation process,if the pulse is synchronized with the heart rhythm,the risk of arrhythmia is reduced.Sufficient muscle relaxant eliminates muscle contraction.Still,arrhythmia[7],hypertension[8],and myocardial infarction[9]are potential risks requiring proper precautions.These adverse events are mostly moderate and self-limiting,but they may have serious consequences for patients with coronary artery disease.Due to the potential risks,patients with a history of cardiovascular disease are not recommended for IRE treatment.
基金
supported by grants from the National S&T Ma-jor Project of China (2018ZX10301201)
National Natural Sci-ence Foundation of China (82027803)。
