Abstract
Background: Pancreatic cancers can involve large blood vessels early, making complete
resection technically challenging or impossible. A minimally invasive treatment that clears
vessels from encasing tumours could potentially enable curative surgery. We hypothesise
that Endovascular Photo-activated Ablation (EPA) of perivascular tumour tissue can create
a necrotic zone free of viable tumour between cancer and blood vessels, through which the
tumour could be resected. Methods: A dose escalation study was conducted in the normal
porcine model (n = 7). Under general anaesthesia, the animals were given a photo-activated
drug and photo-activation was provided by a prototype balloon catheter, positioned in a
major blood vessel within the pancreas, under angiographic guidance. Contrast-enhanced
CT scans were undertaken prior to and 1, 2, or 7 days following ablation. The animals were
Cancers 2025, 17, 3340 https://doi.org/10.3390/cancers17203340
Cancers 2025, 17, 3340 2 of 16
euthanised and the exposed tissue excised en bloc for histological examination. Results:
Five animals were euthanised after 2 days. On post-mortem, the histology confirmed
necrotic pancreas in the perivascular zone, which increased from zero to 15 mm around
the treated vessel, for increasing drug doses. Treated arteries showed necrotising arteritis,
without evidence of perforation or obstruction during the observation period, although
one animal was euthanised at 1 day, due to technical endovascular device issues and
obstruction. The lowest-dose animal euthanised at 7 days showed no lesions on pathology.
Conclusions: These proof-of-concept results demonstrate that EPA can produce pancreatic
perivascular necrosis in a large animal model. In a pancreatic cancer abutting a major
blood vessel, this procedure may be able to create a zone free of viable tumour, potentially
rendering these cancers operable, while preserving vessel integrity. These findings support
further research activities towards clinical translation.