A Comparison of Histotripsy and Percutaneous Cryoablation in a Chronic Healthy Swine Kidney Model

Allison B. Couillard, Annie M. Zlevor, Timothy J. Ziemlewicz, Meridith A. Kisting, Emily Knott, Annika E. Rossebo, Jim White, Meghan G. Lubner, Lori Mankowski Gettle, J. Louis Hinshaw, Lu Mao, William Stoffregen, John F. Swietlik, Erica Knavel-Koepsel, Lindsay Stratchko, E. Jason Abel, Zhen Xu, Fred T. Lee, Paul F. Laeseke

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To compare the safety and efficacy of histotripsy with cryoablation in a chronic human-scale normal porcine kidney model. Materials and Methods: Eighteen female domestic swine were divided evenly into histotripsy and cryoablation treatment arms. A planned 2–3 cm diameter treatment was performed under ultrasound (histotripsy) or ultrasound and computed tomography (CT) guidance (cryoablation). Contrast-enhanced CT and serum blood analysis were performed immediately postprocedure and on day 7, with either immediate killing (n = 3) or continued survival to day 30 (n = 6), at which time contrast-enhanced CT, serum blood analysis, and necropsy were performed. Animal welfare, treatment zone appearance, procedure-related adverse events, and histopathology of the treatment zones and surrounding tissues were assessed. Results: Histotripsy treatment zones (mean ±standard deviation diameters, 2.7 ± 0.12 × 2.4 ± 0.19 × 2.4 ± 0.26 cm; volume, 8.3 ± 1.9 cm3) were larger than cryoablation zones (mean diameters, 2.2 ± 0.19 × 1.9 ± 0.13 × 1.7 ± 0.19 cm; volume, 3.9 ± 0.8 cm3; P < .001). At 30 days, histotripsy and cryoablation treatment zone volumes decreased by 96% and 83% on CT, respectively (P < .001). Perirenal hematomas were present after 8 of 9 (89%) cryoablation (mean volume, 22.2 cm3) and 1 of 9 (11%, P < .001) histotripsy (volume, 0.4 cm3) procedures, with active arterial extravasation in 4 of 9 (44%) cryoablation and no histotripsy animals (P = .206). All 9 histotripsy animals and 5 of 9 (56%) cryoablation animals had collecting system debris (P = .042). Changes in serum creatinine were similar between the groups (P = .321). Conclusions: Other than a higher rate of bleeding after cryoablation, the safety and early efficacy of histotripsy and cryoablation were comparable for creating treatment zones in a chronic normal porcine kidney model.

Original languageEnglish (US)
Pages (from-to)1986-1996
Number of pages11
JournalJournal of Vascular and Interventional Radiology
Volume34
Issue number11
DOIs
StatePublished - Nov 2023

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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