Hemostatic efficacy of ultrasound-guided microwave ablation puncture technology for traumatic liver hemorrhage and its potential battlefield applicability_West China Medical Journal

Authors：

 PENG Bibo ¹ , LI Shengnan ¹ , YANG Guirong ¹ , HE Lusi ¹ , SONG Huina ¹ , GAO Yongyan ²

1. Outpatient Department, the Third Medical Center of PLA General Hospital, Beijing 100039, P. R. China;
2. Department of Ultrasound, the Third Medical Center of PLA General Hospital, Beijing 100039, P. R. China;

Corresponding?author：

PENG Bibo, Email: pengbibo0610@126.com

Keywords：

Battlefield trauma care; liver hemorrhage; ultrasound-guided; microwave ablation; microbubble contrast

DOI：

10.7507/1002-0179.202509329

Video：

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Objective To examine the hemostatic efficacy of ultrasound-guided microwave ablation puncture technology for traumatic liver hemorrhage and assess its potential applicability within battlefield settings. Methods A randomized controlled animal trial was conducted utilizing 24 miniature pigs (weight 30-50 kg) meeting laboratory animal standards. A model of multiple liver injuries was created. Animals were randomly allocated into two groups: a microbubble contrast group (n=12, injected with SonoVue 0.1 mL/kg) and a normal saline control group (n=12). Under simulated battalion-level field rescue conditions, ultrasound-guided microwave ablation hemostasis for liver lacerations was performed using a KY2000 microwave therapy system (power 60 W). The ultrasound localization duration, puncture duration, hemostasis duration, and hemodynamic parameter alterations were recorded. Postoperative anatomical observation and pathological examination of the liver were conducted. Results There was no statistically significant difference in the ultrasound exploration time, hemostasis duration of para-diaphragmatic and para-gallbladder between the two groups (P>0.05). The hemostasis duration of para-hepatic artery in the microbubble contrast group was shorter than that in the control group (5.50±0.50 vs. 9.67±0.85; P<0.001). After hemostasis, the hemoglobin [(98.19±17.32) vs. (60.67±15.61) g/L; P<0.001], and packed cell volume [(0.34±0.03)% vs. (0.28±0.09)%; P<0.001] were higher than the control group; lymphocyte percentage [(61.09±5.16)% vs. (67.12±6.78)%; P<0.001] was lower than the control group. The pathological examination results showed that, a characteristic spindle-shaped zone of coagulative necrosis within the ablation area. Electron microscopy demonstrated ultrastructural alterations in hepatocytes, including mitochondrial cristae disruption. Conclusions Ultrasound-guided microwave ablation puncture technology enables rapid and effective control of liver hemorrhage, thereby demonstrating potential for battlefield utilization. Future efforts should prioritize the integrated development of ultrasound and microwave apparatuses, alongside stringent definition of battlefield indications.

Citation： PENG Bibo, LI Shengnan, YANG Guirong, HE Lusi, SONG Huina, GAO Yongyan. Hemostatic efficacy of ultrasound-guided microwave ablation puncture technology for traumatic liver hemorrhage and its potential battlefield applicability. West China Medical Journal, 2025, 40(11): 1771-1776. doi: 10.7507/1002-0179.202509329 Copy

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4.	Choi TW, Chung JW, Kwon Y. Modified design of x-ray protective clothing to enhance radiation protection for interventional radiologists. Med Phys, 2023, 50(6): 3825-3832.
5.	Zhao Y, Chard Dunmall LS, Cheng Z, et al. Natural products targeting glycolysis in cancer. Front Pharmacol, 2022, 13: 1036502.
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8.	Zhang Y, Wang MY, Wang LK, et al. Preliminary study of 3D printing technology for extracorporeal positioning guide assisted ultrasound-guided microwave ablation of the liver. Expert Rev Med Devices, 2023, 20(12): 1227-1233.
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11.	Dubecq C, Dubourg O, Morand G, et al. Point-of-care ultrasound for treatment and triage in austere military environments. J Trauma Acute Care Surg, 2021, 91(2S Suppl 2): S124-S129.
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13.	Kahr Rasmussen N, Andersen TT, Carlsen J, et al. Simulation-based training of ultrasound-guided procedures in radiology -a systematic review. Ultraschall Med, 2019, 40(5): 584-602.
14.	Chung CY, Scalea TM. Damage control surgery: old concepts and new indications. Curr Opin Crit Care, 2023, 29(6): 666-673.
15.	Zafa J, Zafa T, Zafa H, et al. Design, development and microwave inter-comparison of dual slot antenna configurations for localized hepatic tumor management. Australas Phys Eng Sci Med, 2015, 38(4): 593-601.
16.	Seidman SJ, Guag JW. Adhoc electromagnetic compatibility testing of non-implantable medical devices and radio frequency identification. Biomed Eng Online, 2013, 12: 71.
17.	Kuo RYL, Harrison C, Curran TA, et al. Artificial intelligence in fracture detection: a systematic review and meta-analysis. Radiology, 2022, 304(1): 50-62.
18.	Russo RM, Schmitt J, Gage CP, et al. Scoping review and recommendation to establish standardized best practices for resuscitative endovascular balloon occlusion of the aorta in combat casualties: a North Atlantic Treaty Organization exploratory team report. J Trauma Acute Care Surg, 2025, 99(3S Suppl 1):S164-S169.

1. Yang J, Cheng D, Hofer I, et al. Intraoperative high tidal volume ventilation and postoperative acute respiratory distress syndrome in liver transplant. Transplant Proc, 2022, 54(3): 719-725.
2. Ahmad S. Neurological complications of COVID-19 in children. Pediatr Ann, 2021, 50(6): e259-e263.
3. Lam W, Oh J, Davey MG. Turing patterning and upper limb development. J Hand Surg Eur Vol, 2022, 47(10): 1085-1088.
4. Choi TW, Chung JW, Kwon Y. Modified design of x-ray protective clothing to enhance radiation protection for interventional radiologists. Med Phys, 2023, 50(6): 3825-3832.
5. Zhao Y, Chard Dunmall LS, Cheng Z, et al. Natural products targeting glycolysis in cancer. Front Pharmacol, 2022, 13: 1036502.
6. Smolock AR, Shaw C. Hepatic microwave ablation in challenging locations. Semin Intervent Radiol. 2019, 36(5): 392-397.
7. Fulgenzi CAM, D'Alessio A, Airoldi C, et al. Comparative efficacy of novel combination strategies for unresectable hepatocellular carcinoma: a network metanalysis of phase Ⅲ trials. Eur J Cancer, 2022, 174: 57-67.
8. Zhang Y, Wang MY, Wang LK, et al. Preliminary study of 3D printing technology for extracorporeal positioning guide assisted ultrasound-guided microwave ablation of the liver. Expert Rev Med Devices, 2023, 20(12): 1227-1233.
9. de Saint Victor M, Crake C, Coussios CC, et al. Properties, characteristics and applications of microbubbles for sonothrombolysis. Expert Opin Drug Deliv, 2014, 11(2): 187-209.
10. Liu L, Hu E, Yu K, et al. Recent advances in materials for hemostatic management. Biomater Sci, 2021, 9(22): 7343-7378.
11. Dubecq C, Dubourg O, Morand G, et al. Point-of-care ultrasound for treatment and triage in austere military environments. J Trauma Acute Care Surg, 2021, 91(2S Suppl 2): S124-S129.
12. Loo T, Hunt J, Grodberg D, et al. Clinical and psychosocial outcomes associated with a tele-behavioral health platform for families: retrospective study. JMIR Form Res, 2023, 7: e43600.
13. Kahr Rasmussen N, Andersen TT, Carlsen J, et al. Simulation-based training of ultrasound-guided procedures in radiology -a systematic review. Ultraschall Med, 2019, 40(5): 584-602.
14. Chung CY, Scalea TM. Damage control surgery: old concepts and new indications. Curr Opin Crit Care, 2023, 29(6): 666-673.
15. Zafa J, Zafa T, Zafa H, et al. Design, development and microwave inter-comparison of dual slot antenna configurations for localized hepatic tumor management. Australas Phys Eng Sci Med, 2015, 38(4): 593-601.
16. Seidman SJ, Guag JW. Adhoc electromagnetic compatibility testing of non-implantable medical devices and radio frequency identification. Biomed Eng Online, 2013, 12: 71.
17. Kuo RYL, Harrison C, Curran TA, et al. Artificial intelligence in fracture detection: a systematic review and meta-analysis. Radiology, 2022, 304(1): 50-62.
18. Russo RM, Schmitt J, Gage CP, et al. Scoping review and recommendation to establish standardized best practices for resuscitative endovascular balloon occlusion of the aorta in combat casualties: a North Atlantic Treaty Organization exploratory team report. J Trauma Acute Care Surg, 2025, 99(3S Suppl 1):S164-S169.

West China Medical Journal

Hemostatic efficacy of ultrasound-guided microwave ablation puncture technology for traumatic liver hemorrhage and its potential battlefield applicability

Abstract Full text Figures/Tables Video References Cited by

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