Initial data on a novel endovascular radiofrequency catheter when used for arterial occlusion in liver cancer

BACKGROUND: To assess the safety and effectiveness of a newly designed endovascular radiofrequency (RF) catheter (VesCoag) when used for arterial occlusion in the management of liver cancer. METHODS: Patients considered for the study had either primary or secondary cancer of the liver, which was not suitable for initial surgical resection. The primary endpoint of the study was whether VesCoag could be manipulated into the target blood vessel and the secondary endpoint was whether on angiography the blood vessel had been sealed. RESULTS: VesCoag was used in 13 patients. The indications for treatment were metastatic disease in 4, hepatocellular carcinoma in 7, and intrahepatic cholangiocarcinoma in 2. In all cases, VesCoag was manipulated into the target vessel for activation. There were no technical problems such as vessel dissection or rupture. The average fluoroscopic time was 12.86 min and the mean duration of probe activation was 240 (range 20-600) seconds. The lowest wattage used was 2 W and the highest 120 W. In no cases was bipolar radiofrequency activation sufficient to produce vessel sealing, so monopolar mode was used throughout. There were four minor complications of pain. The angiographic endpoint of target vessel occlusion was achieved in 11 patients. In 12 out of 13 cases an additional endovascular therapeutic maneuver was performed after VesCoag activation. These additional therapies were chemoembolization n = 10, chemotherapy n = 1, and lipiodol n = 1. CONCLUSIONS: This early assessment of VesCoag shows it to be safe and fulfill its design remit of being able to produce precise occlusion of the targeted vessel.