Historical review of irreversible electroporation in medicine

The objective of this chapter is to present a historical review of the field of irreversible electroporation (IRE) in the context of its medical applications. Although relevant scientific observations were made since the 18 th century, the electroporation phenomenon was not identified as an increase of membrane permeability until mid 20 th century. After that, multiple applications of reversible electroporation emerged in vitro (DNA electrotransfer) and in vivo (electrogenetherapy and electrochemotherapy). Irreversible electroporation was tested commercially in the 60s as a bactericidal method for liquids and foods but its use in the context of medical applications was not studied until the early 2000s as an ablative method. The cell destruction mechanism of IRE is not based on thermal damage and this fact provides to IRE an important advantage over other physical ablation methods: the extracellular scaffolding, including the vessels, is preserved. Several surgical applications are now under study or even under clinical trial: ablation of hepatocarcinomas, ablation of prostate tumors, treatment of atrial fibrillation and treatment of vascular occurrences such as restenosis and atherosclerotic processes.