Your subscribed feeds are not being updated automatically because this setting is turned off.
You've successfully subscribed to this feed!
Updated content can be viewed in Internet Explorer and other programs that use the Common Feed List.
Updated content can be viewed in Internet Explorer and other programs that use the Common Feed List.
You've successfully subscribed to this feed!
You are viewing a feed that contains frequently updated content. When you subscribe to a feed, it is added to the Common Feed List. Updated information from the feed is automatically downloaded to your computer and can be viewed in Internet Explorer and other programs. Learn more about feeds.
Παρασκευή, 15 Ιουλίου 2016, 10:25:10 πμ
Hepatic Thermal Ablation: Effect of Device and Heating Parameters on Local Tissue Reactions and Distant Tumor Growth.
Παρασκευή, 15 Ιουλίου 2016, 12:01:51 πμ | Velez E, Goldberg SN, Kumar G, Wang Y, Gourevitch S, Sosna J, Moon T, Brace CL, Ahmed M
Radiology. 2016 Jul 13;:152241
Authors: Velez E, Goldberg SN, Kumar G, Wang Y, Gourevitch S, Sosna J, Moon T, Brace CL, Ahmed M
Abstract
Purpose To determine whether variable hepatic microwave ablation (MWA) can induce local inflammation and distant pro-oncogenic effects compared with hepatic radiofrequency ablation (RFA) in an animal model. Materials and Methods In this institutional Animal Care and Use Committee-approved study, F344 rats (150 gm, n = 96) with subcutaneous R3230 breast adenocarcinoma tumors had normal non-tumor-bearing liver treated with RFA (70°C × 5 minutes), rapid higher-power MWA (20 W × 15 seconds), slower lower-power MWA (5 W × 2 minutes), or a sham procedure (needle placement without energy) and were sacrificed at 6 hours to 7 days (four time points; six animals per arm per time point). Ablation settings produced 11.4 mm ± 0.8 of coagulation for all groups. Distant tumor growth rates were determined to 7 days after treatment. Liver heat shock protein (HSP) 70 levels (at 72 hours) and macrophages (CD68 at 7 days), tumor proliferative indexes (Ki-67 and CD34 at 7 days), and serum and tissue levels of interleukin 6 (IL-6) at 6 hours, hepatocyte growth factor (HGF) at 72 hours, and vascular endothelial growth factor (VEGF) at 72 hours after ablation were assessed. All data were expressed as means ± standard deviations and were compared by using two-tailed t tests and analysis of variance for selected group comparisons. Linear regression analysis of tumor growth curves was used to determine pre- and posttreatment growth curves on a per-tumor basis. Results At 7 days, hepatic ablations with 5-W MWA and RFA increased distant tumor size compared with 20-W MWA and the sham procedure (5-W MWA: 16.3 mm ± 1.1 and RFA: 16.3 mm ± 0.9 vs sham: 13.6 mm ± 1.3, P < .01, and 20-W MWA: 14.6 mm ± 0.9, P < .05). RFA and 5-W MWA increased postablation tumor growth rates compared with the 20-W MWA and sham arms (preablation growth rates range for all arms: 0.60-0.64 mm/d; postablation: RFA: 0.91 mm/d ± 0.11, 5-W MWA: 0.91 mm/d ± 0.14, P < .01 vs pretreatment; 20-W MWA: 0.69 mm/d ± 0.07, sham: 0.56 mm/d ± 1.15; P = .48 and .65, respectively). Tumor proliferation (Ki-67 percentage) was increased for 5-W MWA (82% ± 5) and RFA (79% ± 5), followed by 20-W MWA (65% ± 2), compared with sham (49% ± 5, P < .01). Likewise, distant tumor microvascular density was greater for 5-W MWA and RFA (P < .01 vs 20-W MWA and sham). Lower-energy MWA and RFA also resulted in increased HSP 70 expression and macrophages in the periablational rim (P < .05). Last, IL-6, HGF, and VEGF elevations were seen in 5-W MWA and RFA compared with 20-W MWA and sham (P < .05). Conclusion Although hepatic MWA can incite periablational inflammation and increased distant tumor growth similar to RFA in an animal tumor model, higher-power, faster heating protocols may potentially mitigate such undesired effects. (©) RSNA, 2016.
PMID: 27409564 [PubMed - as supplied by publisher]
Retrograde Coronary Venous Ethanol Infusion for Ablation of Refractory Ventricular Tachycardia.
Παρασκευή, 15 Ιουλίου 2016, 12:01:51 πμ | Kreidieh B, Rodríguez-Mañero M, A Schurmann P, Ibarra-Cortez SH, Dave AS, Valderrábano M
Circ Arrhythm Electrophysiol. 2016 Jul;9(7)
Authors: Kreidieh B, Rodríguez-Mañero M, A Schurmann P, Ibarra-Cortez SH, Dave AS, Valderrábano M
Abstract
BACKGROUND: Radiofrequency ablation (RFA) of ventricular tachycardia (VT) can fail because of inaccessibility to the VT substrate. Transarterial coronary ethanol ablation can be effective but entails arterial instrumentation risk. We hypothesized that retrograde coronary venous ethanol ablation can be an alternative bail-out approach to failed VT RFA.
METHODS AND RESULTS: Out of 334 consecutive patients undergoing VT/premature ventricular contraction ablation, 7 patients underwent retrograde coronary venous ethanol ablation. Six out of 7 patients had failed RFA attempts (including epicardial in 3). Coronary venogram-guided venous mapping was performed using a 4F quadripolar catheter or an alligator-clip-connected angioplasty wire. Targeted veins included those with early presystolic potentials and pace-maps matching VT/premature ventricular contraction. An angioplasty balloon (1.5-2×6 mm) was used to deliver 1 to 4 cc of 98% ethanol into a septal branch of the anterior interventricular vein in 5 patients with left ventricular summit VT, a septal branch of the middle cardiac vein, and a posterolateral coronary vein (n=1 each). The clinical VT was successfully ablated acutely in all patients. There were no complications of retrograde coronary venous ethanol ablation, but 1 patient developed pericardial and pleural effusion attributed to pericardial instrumentation. On follow-up of 590±722 days, VT recurred in 4 out of 7 patients, 3 of whom were successfully reablated with RFA.
CONCLUSIONS: Retrograde coronary venous ethanol ablation is safe and feasible as a bail-out approach to failed VT RFA, particularly those originating from the left ventricular summit.
PMID: 27406606 [PubMed - in process]
Prediction of Post-interventional Outcome in Great Saphenous Vein Incompetence: The Role of Venous Plethysmography with Selective Superficial Vein Occlusion.
Παρασκευή, 15 Ιουλίου 2016, 12:01:51 πμ | Nelzén P, Skoog J, Lassvik C, Länne T, Zachrisson H
Eur J Vasc Endovasc Surg. 2016 Jul 9;
Authors: Nelzén P, Skoog J, Lassvik C, Länne T, Zachrisson H
Abstract
OBJECTIVE/BACKGROUND: To evaluate whether the outcome of radiofrequency ablation (RFA) treatment of great saphenous vein (GSV) incompetence may be predicted using strain-gauge plethysmography (SGP) with selective occlusion of the superficial venous system.
METHODS: Seventeen patients (20 limbs) underwent endovenous RFA treatment for GSV incompetence (Clinical Etiology Anatomy Pathophysiology classification C2-C5; "C-group"). Duplex ultrasound (DUS) and SGP were performed with selective occlusion of superficial veins before and after RFA. Selective superficial occlusion was validated, in a control group (C-group) of 12 patients (14 legs), by ascending phlebography. In the RFA group, the time taken to reach 50% and 90% (T50, T90) of maximum venous volume was measured, as well as relative maximal reflux rates (%EV/min). The methodological error and coefficient of variation (CV) were assessed.
RESULTS: Nineteen of 20 legs had complete post-operative GSV obliteration using DUS, and refilling times were improved after RFA (T50 11 ± 3 vs. 19 ± 3 s; p < .001; T90 27 ± 5 vs. 47 ± 6 s; p < .001). With SGP, the methodological error and CV for T50 were 4 s and 16%, respectively. Equivalence between pre-operative superficial occlusion and post-operative baseline measurements was achieved in 15 of 17 legs for T50, and 12 of 17 for T90 (three of the 20 legs were excluded due to treatment failure [n = 1], and untreated perforating veins [n = 2]). Mean differences (95% confidence interval) were within the equivalence ranges (T50 1 [-1 to 3] seconds; T90 -3 [-11 to 4] seconds). In the C-group superficial vein occlusion was possible in 12 of 14 legs. The remaining patient (two legs) showed incomplete superficial vein occlusion at ankle level (lipodermatosclerosis) and complete superficial vein occlusion at calf level.
CONCLUSION: SGP with standardized superficial venous occlusion seems to be a reliable method for identifying venous reflux and may be useful in predicting the results of successful RFA treatment.
PMID: 27405879 [PubMed - as supplied by publisher]
Safety and Advantages of Combined Resection and Microwave Ablation in Patients with Bilobar Hepatic Malignancies.
Παρασκευή, 15 Ιουλίου 2016, 12:01:51 πμ | Philips P, Scoggins CR, Rostas JK, McMasters KM, Martin RC
Int J Hyperthermia. 2016 Jul 12;:1-21
Authors: Philips P, Scoggins CR, Rostas JK, McMasters KM, Martin RC
Abstract
BACKGROUND: Multimodality approach has significantly improved outcomes for hepatic malignancies. Microwave ablation is often used in isolation or succession, and seldom in combination with resection. Potential benefits and pitfalls from combined resection and ablation therapy in patients with complex and extensive bilobar hepatic disease have not been well defined.
METHODS: Review of University of Louisville prospective Hepato-Pancreatico-Biliary Patients database was performed with multi-focal bilobar disease that underwent microwave ablation with resection or microwave alone were included.
RESULTS: One hundred and eight were treated with microwave alone (MWA,n = 108) or combination resection and ablation (CRA,n = 84) and were compared with similar disease-burden patients undergoing resection-alone (n = 84). The groups were comparable except that the MWA group was older (p = 0.0.02) and with higher comorbidities (diabetes, hepatitis). Resection group had larger tumors (4 vs. 3.2 & 3 cm) but the CRA group had more numerous lesions (4 vs. 3, 2.p = 0.002). Short-term outcomes including morbidity (47.6% vs. 43%,p = 0.0715) were similar between the CRA and resection-alone groups. Longer operative time (164 vs. 126 minutes, p = 0.003) and need for blood transfusion (p = 0.001) were independent predictors of complications. Survival analyses for colorectal metastasis patients (n = 158) demonstrated better OS(43.9 vs. 37.6 &30.5 months, p = 0.035), DFS (38 vs. 26.6, 16.9 months, p = 0.028) and LRFS(55.4 vs. 17, 22.9 months,p < 0.001) with resection-alone.
CONCLUSION: The use of microwave ablation in addition to surgical resection did not significantly increase the morbidities or short-term outcomes. In combination with systemic and other local forms of therapy, combined resection and ablation is a safe and effective procedure.
PMID: 27405728 [PubMed - as supplied by publisher]
Bipolar Radiofrequency Ablation of Typical Atrial Flutter.
Παρασκευή, 15 Ιουλίου 2016, 12:01:51 πμ | Futyma P, Futyma M, Maciołek M, Kułakowski P
J Cardiovasc Electrophysiol. 2016 Jul;27(7):874-5
Authors: Futyma P, Futyma M, Maciołek M, Kułakowski P
PMID: 27405451 [PubMed - in process]
Catheter ablation of premature ventricular contractions arising from left anterior fascicle guided by an earliest presystolic Purkinje potential.
Τετάρτη, 13 Ιουλίου 2016, 2:19:56 μμ | Wang YF, Xu Q, Luo HD, Yu JW, Qu BM, Wang LH
Int J Cardiol. 2016 Jul 5;221:280-282
Authors: Wang YF, Xu Q, Luo HD, Yu JW, Qu BM, Wang LH
PMID: 27404690 [PubMed - as supplied by publisher]
Concomitant cryoballoon ablation and percutaneous closure of left atrial appendage in patients with atrial fibrillation.
Τετάρτη, 13 Ιουλίου 2016, 2:19:56 μμ | Fassini G, Conti S, Moltrasio M, Maltagliati A, Tundo F, Riva S, Dello Russo A, Casella M, Majocchi B, Zucchetti M, Russo E, Marino V, Pepi M, Tondo C
Europace. 2016 Jul 11;
Authors: Fassini G, Conti S, Moltrasio M, Maltagliati A, Tundo F, Riva S, Dello Russo A, Casella M, Majocchi B, Zucchetti M, Russo E, Marino V, Pepi M, Tondo C
Abstract
AIMS: Pulmonary veins (PVs) isolation is the cornerstone of atrial fibrillation (AF) ablation and can be achieved either by conventional radiofrequency ablation or by cryoenergy. Left atrial appendage (LAA) closure has been proposed as alternative treatment to vitamin K antagonists (VKA). We aimed to evaluate the feasibility of combining cryoballoon (CB) ablation and LAA occlusion in patients with AF and a high thromboembolic risk or contraindication to antithrombotic therapy.
METHODS AND RESULTS: Thirty-five patients (28 males, 74 ± 2 years) underwent CB ablation. Left atrial appendage occlusion was carried out by using two occluder devices (Amplatz Cardiac Plug, ACP, St. Jude Medical, MN, USA, in 25 patients; Watchman, Boston Scientific, MA, USA, in 10 patients). Thirty patients (86%) had previous stroke/TIA episodes, 6 patients (17%) had major bleeding while on VKA therapy, and 7 patients (20%) had inherited bleeding disorders. Over the follow-up (24 ± 12 months), atrial arrhythmias recurred in 10 (28%) patients. Thirty patients (86%) had complete sealing; 5 patients (14%) showed a residual flow (<5 mm) at first transoesophageal echocardiography (TEE) check, while at 1-year TEE residual flow was detected in 3 patients. In 13 patients (37%), VKA therapy was immediately discontinued. Six patients (17%) received novel oral anticoagulants treatment and then discontinued 3 months thereafter. No device-related complications or clinical thromboembolic events occurred.
CONCLUSION: Combined CB ablation and LAA closure using different devices appears to be feasible in patients with non-valvular AF associated with high risk of stroke or contraindication to antithrombotic treatment.
PMID: 27402623 [PubMed - as supplied by publisher]
Endocardial radiofrequency ablation for septal hypertrophy.
Τετάρτη, 13 Ιουλίου 2016, 2:19:56 μμ | Szumowski Ł, Dąbrowski M, Tyczynski P, Kłopotowski M, Orczykowski M, Witkowski A
Kardiol Pol. 2016;74(7):700
Authors: Szumowski Ł, Dąbrowski M, Tyczynski P, Kłopotowski M, Orczykowski M, Witkowski A
PMID: 27401297 [PubMed - in process]
The vascular cooling effect in hepatic multipolar radiofrequency ablation leads to incomplete ablation ex vivo.
Τετάρτη, 13 Ιουλίου 2016, 2:19:56 μμ | Poch FG, Rieder C, Ballhausen H, Knappe V, Ritz JP, Gemeinhardt O, Kreis ME, Lehmann KS
Int J Hyperthermia. 2016 Jul 11;:1-8
Authors: Poch FG, Rieder C, Ballhausen H, Knappe V, Ritz JP, Gemeinhardt O, Kreis ME, Lehmann KS
Abstract
PURPOSE: Major limitations of conventional RFA are vascular cooling effects. However, vascular cooling effects are supposed to be less pronounced in multipolar RFA. The objective of this ex vivo study was a systematic evaluation of the vascular cooling effects in multipolar RFA.
MATERIALS AND METHODS: Multipolar RFA with three bipolar RFA applicators was performed ex vivo in porcine liver (applicator distance 20 mm, energy input 40 kJ). A saline-perfused glass tube ('vessel') was placed parallel to the applicators in order to simulate a natural liver vessel. Five applicator-to-vessel geometries were tested. A liquid-filled glass tube without perfusion was used as a dry run. Ablations were orthogonally cut to the applicators at a defined height. Cooling effects were analysed qualitatively and quantitatively along these cross sectional areas.
RESULTS: Thirty-six ablations were performed. A cooling effect could be seen in all ablations with perfused vessels compared to the dry run. While this cooling effect did not have any influence on the ablation areas (859-1072 mm(2) versus 958 mm(2) in the dry run, p > 0.05), it had a distinctive impact on ablation shape. A vascular cooling effect could be observed in all ablations with perfusion directly around the vessel independent of the applicator position compared to the dry run (p < 0.01).
CONCLUSIONS: A vascular cooling effect occurred in all multipolar RFA with simulated liver vessels ex vivo independent of the applicator-to-vessel geometry. While the cooling effect did not influence the total ablation area, it had a distinctive impact on the ablation shape.
PMID: 27400818 [PubMed - as supplied by publisher]
Circumferential ablation at the base of the left ventricular papillary muscles: A highly effective approach for ventricular arrhythmias originating from the papillary muscles.
Τρίτη, 12 Ιουλίου 2016, 2:30:37 μμ | Wo HT, Liao FC, Chang PC, Chou CC, Wen MS, Wang CC, Yeh SJ
Int J Cardiol. 2016 Jul 1;220:876-882
Authors: Wo HT, Liao FC, Chang PC, Chou CC, Wen MS, Wang CC, Yeh SJ
Abstract
BACKGROUND: Radiofrequency catheter ablation (RFCA) of ventricular arrhythmias (VAs) originating from the left ventricular (LV) papillary muscles (PMs) is challenging.
METHODS: We enrolled 16 consecutive patients who received RFCA for VAs from LV PMs. Three-dimensional electroanatomical mapping was used to construct activation and/or pace maps. RFCA was performed first at the earliest activation site or at the best matched site in the pace maps. When an acceleration or reduction in the incidence of VAs was observed during the first few seconds of the application, the ablation energy was delivered continuously for 60-120s. Additional ablation was then circumferentially delivered at the base of the PMs.
RESULTS: RFCA was successfully performed in all 16 patients with no cases of recurrence of VAs after a mean follow-up of 20±12months. VAs originated from the anterior (n=8) and posterior (n=8) PMs. Purkinje potentials were identified at the target sites in seven patients. All VAs were temporarily suppressed by one to two long-duration shots of RFCA at the initial targeted site, but recurrence was subsequently noted. In six patients, the QRS morphologies of the VAs changed after the initial RFCA. A subsequent circumferential approach with multiple ablations applied to the base of the PMs completely eliminated all VAs. In all but one patient, successful RFCA was achieved using an open-irrigated ablation catheter.
CONCLUSIONS: Circumferential RFCA at the base of the PMs overcame anatomical limitations, leading to a high success rate of RFCA for VAs from LV PMs.
PMID: 27400187 [PubMed - as supplied by publisher]
122 Pulse Modulation of the Occipital Nerve Using Focused High-Intensity Ultrasound Improves Mechanical Thresholds in a Chronic Migraine Rat Model.
Τρίτη, 12 Ιουλίου 2016, 2:30:37 μμ | Walling IT, Gee L, Neubauer P, Frith L, Williams E, Burdette C, Pilitsis JG
Neurosurgery. 2016 Aug;63 Suppl 1, CLINICAL NEUROSURGERY:150-151
Authors: Walling IT, Gee L, Neubauer P, Frith L, Williams E, Burdette C, Pilitsis JG
Abstract
INTRODUCTION: Chronic migraines (CM) afflict approximately 16.6% of adults and negatively impact quality of life. Furthermore, although some CM can be treated with steroids, occipital nerve block, radiofrequency therapy, or medical therapy, approximately 15% of patients remain refractory to treatment. We explore focused high-intensity ultrasound (HIU) as a therapy allowing for ablation or pulse modulation of the occipital nerve in a validated rodent model of CM.
METHODS: Male Sprague-Dawley rats received inflammatory media via an epidural cannula over 3 weeks to induce a CM state. HIU was applied over the occiput to (1) ablate (n = 10) or (2) pulse modulate (n = 3) the occipital nerve. Mechanical thresholds assessed during peak headache, immediately after HIU, 24 hours post-HIU, and 48 hours post-HIU using vonFrey filaments in the forepaw, hind paw, and periorbital regions. Mechanical thresholds obtained also compared to CM rats receiving electrical occipital nerve stimulation (ONS) (n = 9) in a prior study.
RESULTS: Ablation of the occipital nerve using HIU at 10 W for 3 minutes increased forepaw (P = .09) and periorbital region (P < .05, n = 10) mechanical thresholds. Pulse modulation of the occipital nerve using HIU also increased mechanical thresholds in the forepaw of CM rodents the day of and 24 hours following HIU application (P < .05, n = 2-3 rats [only two rats were tested on 2 days time point]). Pulse modulation of the occipital nerve can also produce similar improvements in mechanical thresholds to ablative focused HIU or ONS.
CONCLUSION: Our results suggest that focused HIU may be an effective noninvasive treatment for refractory CM. Furthermore, by using pulse modulation instead of ablative settings, mechanical thresholds can be improved without causing damage to the occipital nerves, avoiding the aversive side effects of ablation. Future studies should address whether this noninvasive treatment is ideal and reliably effective for medically refractory CM patients.
PMID: 27399401 [PubMed - as supplied by publisher]
Percutaneous CT-guided Radiofrequency Ablation for Lymph Node Oligometastases from Hepatocellular Carcinoma: A Propensity Score-matching Analysis.
Τρίτη, 12 Ιουλίου 2016, 2:30:37 μμ | Pan T, Xie QK, Lv N, Li XS, Mu LW, Wu PH, Zhao M
Radiology. 2016 Jul 11;:151807
Authors: Pan T, Xie QK, Lv N, Li XS, Mu LW, Wu PH, Zhao M
Abstract
Purpose To assess the effectiveness and safety of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) for lymph node (LN) oligometastases from hepatocellular carcinoma (HCC). Materials and Methods This retrospective study was approved by the institutional ethics committee, and all patients provided written informed consent. From January 2004 to December 2013, 119 consecutive patients with HCC and LN oligometastases (115 men [mean age, 51.3 years; age range, 16-83 years] and four women [mean age, 38.2 years; age range, 23-47 years]) were included in this study. A matched cohort composed of 46 patients from each group was selected after adjustment with propensity score matching. The median follow-up time was 14.0 months in the RFA group and 13.8 months in the non-RFA group. The overall survival (OS), local control rate, and complications were evaluated. Survival curves were constructed with the Kaplan-Meier method and compared by using the log-rank test. Results Eighty-seven patients had LN metastases located in the regional site, and 32 patients had LN metastases in the distant site. No significant differences were observed in the baseline characteristics between groups after propensity score matching adjustment. The RFA group showed higher 6-month and 1-year OS rates compared with the non-RFA group (87.0% and 58.3% vs 62.4% and 17.9%, respectively; P = .001). The 3-month local control rate after RFA was 84.4%, including complete response in 71.1% of patients and partial response in 13.3%. The complications of RFA were short-term abdominal pain and self-limited local hematoma, which occurred in 10 patients (21.7%) and five patients (10.9%), respectively. Conclusion Percutaneous CT-guided RFA may be a safe and effective treatment for the LN oligometastases generated by HCC. (©) RSNA, 2016.
PMID: 27399327 [PubMed - as supplied by publisher]
Kill two birds with one stone: curing accessory pathways and premature ventricular contractions with one ablation.
Τρίτη, 12 Ιουλίου 2016, 2:30:37 μμ | Wang Z, Ma J, Ying Z, Bian C
Clin Case Rep. 2016 Jun;4(6):572-5
Authors: Wang Z, Ma J, Ying Z, Bian C
Abstract
Radiofrequency catheter ablation has been used for treating cardiac arrhythmias, such as premature ventricular contractions and accessory pathway. We report two cases with successful ablation of left-sided accessory pathways and premature ventricular contractions from mitral annulus with one ablation. To our knowledge, no similar reports have been found so far.
PMID: 27398200 [PubMed]
Right ventricular thrombus formation in a patient with arrhythmogenic right ventricular dysplasia following radiofrequency ablation.
Τρίτη, 12 Ιουλίου 2016, 2:30:37 μμ | Kemmner S, Lesevic H, Reents T, Schunkert H, Burgdorf C
Clin Case Rep. 2016 Jun;4(6):554-7
Authors: Kemmner S, Lesevic H, Reents T, Schunkert H, Burgdorf C
Abstract
A middle-aged female suffering from ARVD presented for routine follow-up 8 weeks after right ventricular radiofrequency ablation of recurring ventricular tachycardia. Echocardiography revealed two right ventricular thrombi in the scar area of right ventricular radiofrequency ablation. Ablation-related thromboembolic events should be considered as possible complication in patients suffering from ARVD.
PMID: 27398195 [PubMed]
The Outcome of Radiofrequency Ablation of Metastatic Liver Tumors.
Τρίτη, 12 Ιουλίου 2016, 2:30:37 μμ | Thamtorawat S, Rojwatcharapibarn S, Tongdee T, Siriapisith T
J Med Assoc Thai. 2016 Apr;99(4):424-32
Authors: Thamtorawat S, Rojwatcharapibarn S, Tongdee T, Siriapisith T
Abstract
OBJECTIVE: To determine outcome of radiofrequency ablation (RFA) in metastatic liver tumor and to evaluate related factors of residual or local tumor recurrences.
MATERIAL AND METHOD: With Institutional Review Board approval, we retrospectively reviewed RFA procedure between June 2006 and September 2013. Fifty-seven metastatic nodules in 36 patients were treated. The primary tumors were colorectal carcinoma (n = 30), neuroendocrine tumor (n = 2), gallbladder carcinoma (n = 1), adenocarcinoma of head of pancreas (n = 1), and gastrointestinal stromal tumor (n = 2). Tumor characteristics, RFA techniques, success rate, complication, and follow-up imaging were reviewed and recorded Clinical outcome and overall survival were analyzed.
RESULTS: Complete ablation were found in 48/57 nodules (84.2%). The mean follow-up time was 17.9 ± 13.1 months (range, 1 to 47 months). Local tumor recurrence were noted in 12/57 nodules (21.1%), which mean time to recurrence was 8.3 ± 3.8 months (2 to 15 months). Residual tumor was associate with tumor larger than 3 cm (p = 0.009). The 1-, 3-, and 5-year overall survival rates were 93.6%, 56.2%, and 20%, respectively. Median overall survival was 37.8 ± 10.9 months. Major complication rate occurred about 5.3%.
CONCLUSION: Radiofrequency ablation is effective and feasible method to treat small metastatic liver tumor Tumor size larger than 3 cm is significant risk factor of residual tumor. Tumor in high-risk location is not associated either incomplete ablation or local tumor recurrence.
PMID: 27396228 [PubMed - in process]
Modified Maze Procedure for Atrial Fibrillation as an Adjunct to Elective Cardiac Surgery: Predictors of Mid-Term Recurrence and Echocardiographic Follow-Up.
Τρίτη, 12 Ιουλίου 2016, 2:30:37 μμ | Loardi C, Alamanni F, Veglia F, Galli C, Parolari A, Zanobini M
  |
Related Articles |
Tex Heart Inst J. 2015 Aug;42(4):341-7
Authors: Loardi C, Alamanni F, Veglia F, Galli C, Parolari A, Zanobini M
Abstract
The radiofrequency maze procedure achieves sinus rhythm in 45%-95% of patients treated for atrial fibrillation. This retrospective study evaluates mid-term results of the radiofrequency maze-performed concomitant to elective cardiac surgery-to determine sinus-rhythm predictive factors, and describes the evolution of patients' echocardiographic variables. From 2003 through 2011, 247 patients (mean age, 64 ± 9.5 yr) with structural heart disease (79.3% mitral disease) and atrial fibrillation underwent a concomitant radiofrequency modified maze procedure. Patients were monitored by 24-hour Holter at 3, 6, 12, and 24 months, then annually. Eighty-four mitral-valve patients underwent regular echocardiographic follow-up. Univariate and multivariate analysis for risk factors of maze failure were identified. The in-hospital mortality rate was 1.2%. During a median follow-up of 39.4 months, the late mortality rate was 3.6%, and pacemaker insertion was necessary in 26 patients (9.4%). Sinus rhythm was present in 63% of patients at the latest follow-up. Predictive factors for atrial fibrillation recurrence were arrhythmia duration (hazard ratio [HR]=1.296, P=0.045) and atrial fibrillation at hospital discharge (HR=2.03, P=0.019). The monopolar device favored maze success (HR=0.191, P <0.0001). Left atrial area and indexed left ventricular end-diastolic volume showed significant decrease both in sinus rhythm and atrial fibrillation patients. Early sinus rhythm conversion was associated with improved left ventricular ejection fraction. Concomitant radiofrequency maze procedure provided remarkable outcomes. Shorter preoperative atrial fibrillation duration, monopolar device use, and prompt treatment of arrhythmia recurrences increase the midterm success rate. Early sinus rhythm restoration seems to result in better left ventricular ejection fraction recovery.
PMID: 26413016 [PubMed - indexed for MEDLINE]
Severe Renal Artery Stenosis After Renal Sympathetic Denervation.
Τρίτη, 12 Ιουλίου 2016, 2:30:37 μμ | Diego-Nieto A, Cruz-Gonzalez I, Martin-Moreiras J, Rama-Merchan JC, Rodriguez-Collado J, Sanchez-Fernandez PL
 |
Related Articles |
JACC Cardiovasc Interv. 2015 Sep;8(11):e193-4
Authors: Diego-Nieto A, Cruz-Gonzalez I, Martin-Moreiras J, Rama-Merchan JC, Rodriguez-Collado J, Sanchez-Fernandez PL
PMID: 26404211 [PubMed - indexed for MEDLINE]
Displaying
17
http://ift.tt/2a78ggr
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου