Arterial complication of irreversible electroporation procedure for locally advanced pancreatic cancer

Abstract

Irreversible electroporation (IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable. We present the first case of acute superior mesenteric artery (SMA) occlusion secondary to pancreatic IRE procedure that has not been reported before in the literature. A 66-year-old man underwent neoadjuvant chemoradiotherapy for locally advanced pancreatic ductal adenocarcinoma. IRE procedure was applied to the patient during laparotomy under general anesthesia. After finishing the procedure, an acute intestinal ischemia was detected. A conventional vascular angiography was performed and a metallic stent was successfully placed to the SMA and blood flow was maintained. It is important to be careful in such cases of tumor involvement of SMA when evaluating for IRE procedure of pancreatic tumor.

Keywords: Irreversible electroporation; Mesenteric artery occlusion; Locally advanced pancreatic cancer; Superior mesenteric artery

Core tip: Irreversible electroporation (IRE) is a non-thermal ablation technique is a hope for patients who have unresectable locally advanced pancreatic carcinomas; especially, when any vascular surgical approach is impossible because of the tumor involvement. We encountered superior mesenteric artery occlusion after IRE procedure for locally advanced pancreatic cancer. We suggest that treating physicians should keep in mind that kind of mortal vascular complications of IRE. Stent placement via angiography could be the lifesaving treatment choice for vascular occlusions due to IRE procedure.