• Kai S Lehmann, Franz G M Poch, Christian Rieder, Andrea Schenk, Andrea Stroux, Bernd B Frericks, Ole Gemeinhardt, Christoph Holmer, Martin E Kreis, Jörg P Ritz, and Urte Zurbuchen.
• Department of General and Vascular Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.
• J Hepatobiliary Pancreat Sci. 2016 Aug 1; 23 (8): 508-16.

BackgroundThe present paper aims to assess the lower threshold of vascular flow rate on the heat sink effect in bipolar radiofrequency ablation (RFA) ex vivo.MethodsGlass tubes (vessels) of 3.4 mm inner diameter were introduced in parallel to bipolar RFA applicators into porcine liver ex vivo. Vessels were perfused with flow rates of 0 to 1,500 ml/min. RFA (30 W power, 15 kJ energy input) was carried out at room temperature and 37°C. Heat sink effects were assessed in RFA cross sections by the decrease in ablation radius, area and by a high-resolution sector planimetry.ResultsFlow rates of 1 ml/min already caused a significant cooling effect (P ≤ 0.001). The heat sink effect reached a maximum at 10 ml/min (18.4 mm/s) and remained stable for flow rates up to 1,500 ml/min.ConclusionsMinimal vascular flows of ≥1 ml/min cause a significant heat sink effect in hepatic RFA ex vivo. A lower limit for volumetric flow rate was not found. The maximum of the heat sink effect was reached at a flow rate of 10 ml/min and remained stable for flow rates up to 1,500 ml/min. Hepatic inflow occlusion should be considered in RFA close to hepatic vessels.© 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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