Ethanol ablation

Raute-Kreinsen U. Morphology of necrosis and repair after transcoronary ethanol ablation of septal hypertrophy. Pathol Res Pract 2003 199 121-127. 

Ethanol ablation is used widely due to its ease of treatment, minimal and inexpensive therapeutic equipment required, and good cHnical results. Following percutaneous instillation, ethanol causes dehydration of thecy-toplasm and subsequent co-agulation necrosis, followed by fibrous reaction. Within neoplastic vessels, ethanol induces necrosis of endothehal cells and platelet aggregation, thus causing thrombosis and tissue ischemia. 

The main advantage of thermal ablation is the abihty to create a well-controlled focal thermal injury with minimal morbidity and mortality to date. Unlike alcoholization (ethanol ablation), thermal ablation creates a well-demarcated lesion. Radiofrequency is particularly useful as a tumor therapy, while alcoholization is preferred in palliative bone metastases pain management because of its simplicity and low cost. 

Chemical ablation is classified based on the used agent, such as ethanol, or acetic acid. By definition, chemical ablation induces coagulation necrosis and tumor ablation. Ethanol ablation is also called percutaneous ethanol instillation (PEI), percu-... 

Adson MA, Heerden van J, Adson MH, Wagner IS, Ilstrup DM (1984) Resection of hepatic metastases from colorectal cancer. Arch Surg 119 647-651 Amin Z, Lees WR, Bown SG (1993) Hepatocellular carcinoma CT appearance after percutaneous ethanol ablation therapy. Radiology 188 882-883 Ardalan B, Sridhar KS, Benedetto P et al (1991) A phase I, II study of high-dose 5-fluorouracil and high-dose leu-... 

If surgical resection is planned, ablation of entire lobar or main renal arteries can be performed with ethanol. This requires the use of a balloon occlusion catheter such as a single lumen Balloon Wedge-Pressure Catheter (Arrow International, Reading, PA) to prevent systemic spread of alcohol. Ethanol ablation should be performed within one or two days of the planned resection. This will help to avoid a prolonged post-embolization syndrome, idiich can be quite uncomfortable for patients and can reduce the risk of abscess formation from the ensuing infarction. 

Mulligan BD, Espinosa GA (1983) Bowel infarction complication of ethanol ablation of a renal tumor. Cardiovasc Intervent Radiol 6 55-57... 

Amin Z, Lees WR, Bown SG (1993) Hepatocellular carcinoma CT appearance after percutaneous ethanol ablation therapy. Radiology 188 882-883... 

Interconnects are formed into the desired shape using ceramic processing techniques. For example, bipolar plates with gas channels can be formed by tape casting a mixture of the ceramic powder with a solvent, such as trichloroethylene (TCE)-ethanol [90], Coating techniques, such as plasma spray [91] or laser ablation [92] can also be used to apply interconnect materials to the other fuel cell components. 

A profound complication of septal ablation is anterior Ml due to ethanol reflux from the septal perforator down the left anterior descending artery. This can be avoided by careful position of the balloon and angiographic monitoring. Other rare complications include coronary dissection, perforation, thrombosis, and spasm. 

Veselka J, Duchonova R, Prochazkova S, et al. Effects of varying ethanol dosing in percutaneous septal ablation for obstructive hypertrophic cardiomyopathy on early hemodynamic changes. Am J Cardiol 2005 95 675-678. 

Livraghi, T., Goldberg, S.N., Lazzaroni, F., Meloni, F., Solbiati, L., Gazelle, G.S. Small hepatocellular carcinoma Treatment with radiofrequency ablation versus ethanol injection. Radiology 1999 210 655-661... 

De Baere T, Lagrange C, Kuoch V, Morice P, Court B, Roche A (2000) Transcatheter ethanol renal ablation in 20 patients with persistent urine leaks an alternative to surgical nephrectomy. J Urol 164 1148-1152... 

For many patients suffering from liver tumors, surgery may represent the only curative approach for others only palliative, interventional techniques are available for local tumor control (e.g., cryotherapy, chemoembolization, ethanol injection, and radio frequency ablation). 

---