EFFECT OF INJECTION SPEED ON THE SPREAD OF ETHANOL DURING EXPERIMENTAL LIVER ETHANOL INJECTIONS

Rationale and Objectives. Percutaneous ethanol injection therapy may c ause serious complications, most likely due to the uncontrolled spread of ethanol. The authors changed the speed of the injection into postm ortem pig livers and examined the adverse spread of ethanol from the i njection site and the shape and size of the resulting lesion. Methods. One milliliter of 96% ethanol was injected into pig livers under sono graphic guidance at different speeds (0.075-0.91 mL/s). The spread (gr aded from I to III) and the volumes and shapes of the resulting lesion s seen after dissection were recorded and correlated with the injectio n speed. Results. When increasing the speed of the injections the larg e, grade III spread increased significantly (P < .01). The lesions cre ated by more rapid injection were less spherical than were those creat ed by slower injections (P = .08). The volumes of the lesions were not affected by the injection speed. Conclusion. This experimental model suggests that in percutaneous ethanol injection therapy, rapid injecti on (>0.3-0.4 mL/s) should be avoided to reduce the uncontrolled spread of ethanol. Spherical spreading of ethanol around the needle tip is b est achieved with slow injection.