Exploratory study of pulsed electric field ablation on atherosclerotic plaque in a rabbit model

Objective: New understanding of the pathogenesis of atherosclerotic diseases has led to the emergence of new therapeutic approaches. We explored the potential therapeutic effects of pulsed field potential ablation (PFA), a non-thermal ablation technique with high tissue selectivity, on atherosclerotic plaques. Approach and Results: Carotid arteries of 30 high-fat rabbits were dilated with a balloon to obtain atherosclerotic plaques. PFA was administered on the carotid atherosclerotic plaques with 1000V/cm, 2000V/cm, and 1000V/cm ablation followed by rapamycin infusion. There were no visible changes in blood vessels after acute ablation, but apoptosis and polarity of cells were observed in atherosclerotic plaques. At 7 and 30 days after ablation, the density of lipid deposition in the plaque was significantly reduced, and multiple layers of new arranged anterograde smooth muscle cells appeared, replacing the original atherosclerotic plaque. The residual atherosclerotic structure is sandwiched between the new smooth muscle layer and the original smooth muscle layer, which makes vascular wall thicker and makes vascular wall elasticity increased. Rapamycin delays the vascular remodeling process. Conclusion: PFA ablation can reduce lipid deposition in atherosclerotic plaques, cause vascular remodeling, and enhance vascular elasticity. We believe that it may be a potential method for the treatment of atherosclerotic plaques. ### Competing Interest Statement The authors have declared no competing interest.