Self-Expandable Electrode Based on Chemically Polished Nickel-Titanium Alloy Wire for Treating Endoluminal Tumors Using Bipolar Irreversible Electroporation

Theapplication of irreversible electroporation (IRE)to endoluminalorgans is being investigated; however, the current preclinical evidenceand optimized electrodes are insufficient for clinical translation.Here, a novel self-expandable electrode (SE) made of chemically polishednickel-titanium (Ni-Ti) alloy wire for endoluminal IREis developed in this study. Chemically polished heat-treated Ni-Tialloy wires demonstrate increased electrical conductivity, reducedcarbon and oxygen levels, and good mechanical and self-expanding properties.Bipolar IRE using chemically polished Ni-Ti wires successfullyinduces cancer cell death. IRE-treated potato tissue shows irreversiblyand reversibly electroporated areas containing dead cells in an electricalstrength-dependent manner. In vivo study using an optimized electricfield strength demonstrates that endobiliary IRE using the SE evenlyinduces well-distributed mucosal injuries in the common bile duct(CBD) with the overexpression of the TUNEL, HSP70, and inflammatorycells without ductal perforation or stricture formation. This studydemonstrates the basic concept of the endobiliary IRE procedure, whichis technically feasible and safe in a porcine CBD as a novel therapeuticstrategy for malignant biliary obstruction. The SE is a promisingelectrical energy delivery platform for effectively treating endoluminalorgans.