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Sample records for underwent percutaneous radiofrequency

  1. Percutaneous radiofrequency thermal lumbar sympathectomy and its clinical use

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    J. Pernak (Jamina)

    1988-01-01

    textabstractPercutaneous radiofrequency thermolesion techniques are commonly used in the treatment of chronic pain in different pain syndromes. There are many reports describing techniques of percutaneous radiofrequency thermolesion for denervation of central & spinal nerves (Mullan 1963), 1965,

  2. Treatment of refractory idiopathic supraorbital neuralgia using percutaneous pulsed radiofrequency.

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    Luo, Fang; Lu, Jingjing; Ji, Nan

    2018-02-26

    No ideal therapeutic method currently exists for refractory idiopathic supraorbital neuralgia patients who don't respond to conservative therapy, including medications and nerve blocks. Pulsed radiofrequency is a neuromodulation technique that does not produce sequelae of nerve damage after treatment. However, the efficacy of percutaneous pulsed radiofrequency for the treatment of refractory idiopathic supraorbital neuralgia is still not clear. The purpose of our study was to evaluate the efficacy and safety of pulsed radiofrequency treatment of the supraorbital nerve for refractory supraorbital neuralgia patients. We prospectively investigated the long-term effects of ultrasound-guided percutaneous pulsed radiofrequency in the treatment of 22 refractory idiopathic supraorbital neuralgia patients. A reduction of verbal pain numerical rating scale score of more than 50% was used as the standard of effectiveness. The effectiveness rates at different time points within two years were calculated. After a single pulsed radiofrequency treatment, the effectiveness rate at one and three months was 77%, and the rates at six months, one year, and two years were 73%, 64%, and 50%, respectively. Except for a small portion of patients (23%) who experienced mild upper eyelid ecchymosis that gradually disappeared after approximately two weeks, no obvious complications were observed. In conclusion, the results of our study demonstrate that for patients with refractory idiopathic supraorbital neuralgia, percutaneous pulsed radiofrequency may be an effective and safe treatment choice. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  3. Efficacy of percutaneous intraductal radiofrequency ablation combined with biliary stenting in treatment of malignant biliary obstruction

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    ZHANG Kai

    2015-05-01

    Full Text Available ObjectiveTo investigate the safety and feasibility of percutaneous intraductal radiofrequency ablation (palliative therapy in the treatment of malignant obstructive jaundice. MethodsThis study included 20 patients with unresectable malignant obstructive jaundice, who were treated in the First Affiliated Hospital of Zhengzhou University from January 2013 to March 2014. Nine of them (test group underwent percutaneous intraductal radiofrequency ablation plus metallic biliary stent placement. The other 11 similar cases (control group underwent metallic biliary stent placement alone after successful percutaneous transhepatic cholangiography. Operative complications and remission of jaundice were observed, and the stent patency after at 3 and 6 months after operation was evaluated and compared between the two groups. ResultsAll patients were followed completely by outpatient or telephone. The stent patency rate at 3 months after operation was 9/9 in the test group and 8/11 in the control group (χ2=2.888, P=0.218, and the stent patency rates at 6 months were 7/8 and 3/11, respectively (χ2=6.739, P=0.02. During follow-up, one case in the test group died of gastrointestinal bleeding at 113 d after operation; one case in the control group died of liver failure at 57 d after operation and one case died of disseminated intravascular coagulation at 142 d. ConclusionPercutaneous intraductal radiofrequency ablation is safe and feasible in the treatment of malignant biliary obstruction, and the preliminary efficacy in prolonging the patency of self-expanding metallic stent is satisfactory. However, this therapy needs to be further verified via large-sample randomized controlled studies.

  4. Percutaneous Intraductal Radiofrequency Ablation is a Safe Treatment for Malignant Biliary Obstruction: Feasibility and Early Results

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    Mizandari, Malkhaz [Tbilisi State Medical University, Department of Radiology (Georgia); Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk; Xi Feng [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Ao Guokun [The 309 Hospital of Chinese PLA, Department of Radiology (China); Kyriakides, Charis [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Dickinson, Robert [Imperial College London, Department of Bioengineering (United Kingdom); Nicholls, Joanna; Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom)

    2013-06-15

    Purpose. Previous clinical studies have shown the safety and efficacy of this novel radiofrequency ablation catheter when used for endoscopic palliative procedures. We report a retrospective study with the results of first in man percutaneous intraductal radiofrequency ablation in patients with malignant biliary obstruction. Methods. Thirty-nine patients with inoperable malignant biliary obstruction were included. These patients underwent intraductal biliary radiofrequency ablation of their malignant biliary strictures following external biliary decompression with an internal-external biliary drainage. Following ablation, they had a metal stent inserted. Results. Following this intervention, there were no 30-day mortality, hemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the 39 patients, 28 are alive and 10 patients are dead with a median survival of 89.5 (range 14-260) days and median stent patency of 84.5 (range 14-260) days. One patient was lost to follow-up. All but one patient had their stent patent at the time of last follow-up or death. One patient with stent blockage at 42 days postprocedure underwent percutaneous transhepatic drain insertion and restenting. Among the patients who are alive (n = 28) the median stent patency was 92 (range 14-260) days, whereas the patients who died (n = 10) had a median stent patency of 62.5 (range 38-210) days. Conclusions. In this group of patients, it appears that this new approach is feasible and safe. Efficacy remains to be proven in future, randomized, prospective studies.

  5. CT-guided percutaneous radiofrequency denervation of the sacroiliac joint

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    Gevargez, A.; Schirp, S.; Braun, M. [Department of Radiology and Microtherapy, University of Witten/Herdecke, Bochum (Germany); Groenemeyer, D. [Department of Radiology and Microtherapy, University of Witten/Herdecke, Bochum (Germany); EFMT Development and Research Center for Microtherapy, Bochum (Germany)

    2002-06-01

    Defining the origin of low back pain is a challenging task. Among a variety of factors the sacroiliac joint (SIJ) is a possible pain generator, although precise diagnosis is difficult. Joint blocks may reduce pain, but are, in cases, of only temporary effect. This study was conducted to evaluate CT-guided percutaneous radiofrequency denervation of the sacroiliac joint in patients with low back pain. The procedure was performed on 38 patients who only temporarily responded to CT-guided SIJ blocks. The denervation was carried out in the posterior interosseous sacroiliac ligaments and on the dorsal rami of the fifth spinal nerve. All interventions were carried out under CT guidance as out-patient therapies. Three months after the therapy, 13 patients (34.2%) were completely free of pain. Twelve patients (31.6%) reported on a substantial pain reduction, 7 patients (18.4%) had obtained a slight and 3 patients (7.9%) no pain reduction. The data of 3 patients (7.9%) was missing. There were no intra- or postoperative complications. Computed tomography-guided percutaneous radiofrequency denervation of the sacroiliac joint appears safe and effective. The procedure may be a useful therapeutic modality, especially in patients with chronic low back pain, who only temporarily respond to therapeutic blocks. (orig.)

  6. CT-guided percutaneous radiofrequency denervation of the sacroiliac joint

    International Nuclear Information System (INIS)

    Gevargez, A.; Schirp, S.; Braun, M.; Groenemeyer, D.

    2002-01-01

    Defining the origin of low back pain is a challenging task. Among a variety of factors the sacroiliac joint (SIJ) is a possible pain generator, although precise diagnosis is difficult. Joint blocks may reduce pain, but are, in cases, of only temporary effect. This study was conducted to evaluate CT-guided percutaneous radiofrequency denervation of the sacroiliac joint in patients with low back pain. The procedure was performed on 38 patients who only temporarily responded to CT-guided SIJ blocks. The denervation was carried out in the posterior interosseous sacroiliac ligaments and on the dorsal rami of the fifth spinal nerve. All interventions were carried out under CT guidance as out-patient therapies. Three months after the therapy, 13 patients (34.2%) were completely free of pain. Twelve patients (31.6%) reported on a substantial pain reduction, 7 patients (18.4%) had obtained a slight and 3 patients (7.9%) no pain reduction. The data of 3 patients (7.9%) was missing. There were no intra- or postoperative complications. Computed tomography-guided percutaneous radiofrequency denervation of the sacroiliac joint appears safe and effective. The procedure may be a useful therapeutic modality, especially in patients with chronic low back pain, who only temporarily respond to therapeutic blocks. (orig.)

  7. [Percutaneous CT guided radio-frequency ablation of osteoid osteoma and osteoblastoma].

    Science.gov (United States)

    Liberman, Boaz; Gerniak, Alexander; Eshed, Iris; Chechick, Ahron; Weiss, Israel; Shabshin, Noga

    2010-08-01

    Osteoid osteoma (OO) is a benign osteoblastic bone lesion that causes severe local pain mainly at night, and usually responds to oral administration of NSAID. The lesion is located around the proximal thigh in more than 50% of the cases. Osteoblastoma is similar to OO in their histopathology features, but emerges frequently in the spine, and has a larger diameter than OO. Percutaneous CT-guided radiofrequency ablation (RFA) is becoming the treatment of choice for osteoid osteoma and non-aggressive osteoblastoma in the last decade. During the period 2005-2009, 38 patients were diagnosed with osteoid osteoma (n = 34), and osteoblastoma (n = 4). A total of 34 patients were treated with RFA using a water-cooled, variable ablation size tip. Two patients underwent an open procedure, and 2 had spontaneous remission. Thirty three patients (97%) reported complete remission of their pain after a single treatment; one patient needed a second RFA treatment, and reported full remission of his symptoms after the 2nd treatment. Percutaneous CT-guided radiofrequency ablation of osteoid osteoma and non-aggressive osteoblastoma is simple, safe, and reliable. Meticulous placement of the probe inside the tumor, and the usage of water-cooled, variable ablation size tip, improves the overall outcome and decrease complication rates.

  8. Percutaneous treatment of bone tumors by radiofrequency thermal ablation

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    Ruiz Santiago, Fernando, E-mail: ferusan@ono.com [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Mar Castellano Garcia, Maria del; Guzman Alvarez, Luis [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Martinez Montes, Jose Luis [Department of Traumatology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Ruiz Garcia, Manuel; Tristan Fernandez, Juan MIguel [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain)

    2011-01-15

    We present our experience of the treatment of bone tumors with radiofrequency thermal ablation (RFTA). Over the past 4 years, we have treated 26 cases (22 benign and 4 malignant) using CT-guided RFTA. RFTA was the sole treatment in 19 cases and was combined with percutaneous cementation during the same session in the remaining seven cases. Our approach to the tumors was simplified, using a single point of entrance for both RFTA and percutaneous osteoplasty. In the benign cases, clinical success was defined as resolution of pain within 1 month of the procedure and no recurrence during the follow-up period. It was achieved in 19 out of the 21 patients in which curative treatment was attempted. The two non-resolved cases were a patient with osteoid osteoma who developed a symptomatic bone infarct after a symptom-free period of 2 months and another with femoral diaphysis osteoblastoma who suffered a pathological fracture after 8 months without symptoms. The procedure was considered clinically successful in the five cases (4 malign and 1 benign) in which palliative treatment was attempted, because there was a mean ({+-}SD) reduction in visual analogue scale (VAS) pain score from 9.0 {+-} 0.4 before the procedure to <4 during the follow-up period.

  9. Percutaneous treatment of bone tumors by radiofrequency thermal ablation

    International Nuclear Information System (INIS)

    Ruiz Santiago, Fernando; Mar Castellano Garcia, Maria del; Guzman Alvarez, Luis; Martinez Montes, Jose Luis; Ruiz Garcia, Manuel; Tristan Fernandez, Juan MIguel

    2011-01-01

    We present our experience of the treatment of bone tumors with radiofrequency thermal ablation (RFTA). Over the past 4 years, we have treated 26 cases (22 benign and 4 malignant) using CT-guided RFTA. RFTA was the sole treatment in 19 cases and was combined with percutaneous cementation during the same session in the remaining seven cases. Our approach to the tumors was simplified, using a single point of entrance for both RFTA and percutaneous osteoplasty. In the benign cases, clinical success was defined as resolution of pain within 1 month of the procedure and no recurrence during the follow-up period. It was achieved in 19 out of the 21 patients in which curative treatment was attempted. The two non-resolved cases were a patient with osteoid osteoma who developed a symptomatic bone infarct after a symptom-free period of 2 months and another with femoral diaphysis osteoblastoma who suffered a pathological fracture after 8 months without symptoms. The procedure was considered clinically successful in the five cases (4 malign and 1 benign) in which palliative treatment was attempted, because there was a mean (±SD) reduction in visual analogue scale (VAS) pain score from 9.0 ± 0.4 before the procedure to <4 during the follow-up period.

  10. Percutaneous Endovascular Radiofrequency Ablation for Malignant Portal Obstruction: An Initial Clinical Experience

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    Wu, Tian-Tian, E-mail: matthewwu1979@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Li, Hu-Cheng, E-mail: hucheng-li-surgery@126.com [The 307th Hospital of PLA, General Surgery Department (China); Zheng, Fang, E-mail: fang-zheng-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Ao, Guo-Kun, E-mail: guokun-ao-radiology@126.com; Lin, Hu, E-mail: hu-lin-radiology@126.com [The 309th Hospital of PLA, Radiology Department (China); Li, Wei-Min, E-mail: weimin-li-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China)

    2016-07-15

    PurposeThe Habib™ VesOpen Catheter is a new endovascular radiofrequency ablation (RFA) device used to treat malignant portal obstruction. The purpose of this study was to evaluate the clinical feasibility and safety of RFA with this device.MethodsWe collected the clinical records and follow-up data of patients with malignant portal obstruction treated with percutaneous endovascular portal RFA using the Habib™ VesOpen Catheter. Procedure-related complications, improvement of symptoms, portal patency, survival, and postoperative biochemical tests were investigated.ResultsThe 31 patients enrolled in the study underwent 41 successful endovascular portal RFA procedures. Patients were divided into a portal-stenting (PS) group (n = 13), which underwent subsequent portal stenting with self-expandable metallic stents, and a non-stenting (NS) group (n = 18), which did not undergo stenting. No procedure-related abdominal hemorrhage or portal rupture occurred. Postablation complications included abdominal pain (n = 26), fever (n = 13), and pleural effusion (n = 15). Improvements in clinical manifestations were observed in 27 of the 31 patients. Of the 17 patients experiencing portal restenosis, 10 underwent successful repeat RFA. The rate of successful repeat RFA was significantly higher in the NS group than in the PS group. Median portal patency was shorter in the PS group than in the NS group. No mortality occurred during the 4 weeks after percutaneous endovascular portal RFA.ConclusionsPercutaneous endovascular portal RFA is a feasible and safe therapeutic option for malignant portal obstruction. Prospective investigations should be performed to evaluate clinical efficacy, in particular, the need to evaluate the necessity for subsequent portal stenting.

  11. The Mid-Term Results of Patients who Underwent Radiofrequency Atrial Fibrillation Ablation Together with Mitral Valve Surgery

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    Abdurrahim Çolak

    Full Text Available Abstract Objetive: Saline-irrigated radiofrequency ablation, which has been widely used for surgical treatment of atrial fibrillation in recent years, is 80-90% successful in achieving sinus rhythm. In our study, our surgical experience and mid-term results in patients who underwent mitral valve surgery and left atrial radiofrequency ablation were analyzed. Methods: Forty patients (15 males, 25 females; mean age 52.05±9.9 years; range 32-74 underwent surgery for atrial fibrillation associated with mitral valvular disease. All patients manifested atrial fibrillation, which started at least six months before the surgical intervention. The majority of patients (36 patients, 90% were in NYHA class III; 34 (85% patients had rheumatic heart disease. In addition to mitral valve surgery and radiofrequency ablation, coronary artery bypass, DeVega tricuspid annuloplasty, left ventricular aneurysm repair, and left atrial thrombus excision were performed. Following discharge from the hospital, patients' follow-up was performed as outpatient clinic examinations and the average follow-up period of patients was 18±3 months. Results: While the incidence of sinus rhythm was 85.3% on the first postoperative day, it was 80% during discharge and 71% in the 1st year follow-up examination. Conclusion: Radiofrequency ablation is an effective method when it is performed by appropriate surgical technique. Its rate for returning to sinus rhythm is as high as the rate of conventional surgical procedure.

  12. Bleeding after percutaneous radiofrequency ablation: Successful treatment with transcatheter embolization

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    Carrafiello, Gianpaolo [Vascular and Interventional Radiology, Department of Radiology, University of Insubria, 21100 Varese (Italy)]. E-mail: gcarraf@tin.it; Lagana, Domenico [Vascular and Interventional Radiology, Department of Radiology, University of Insubria, 21100 Varese (Italy)]. E-mail: donlaga@gmail.com; Ianniello, Andrea [Vascular and Interventional Radiology, Department of Radiology, University of Insubria, 21100 Varese (Italy)]. E-mail: ianand@libero.it; Craparo, Giuseppe [Vascular and Interventional Radiology, Department of Radiology, University of Insubria, 21100 Varese (Italy)]. E-mail: crapgiu@libero.it; Recaldini, Chiara [Vascular and Interventional Radiology, Department of Radiology, University of Insubria, 21100 Varese (Italy)]. E-mail: chiarec@libero.it; Lumia, Domenico [Vascular and Interventional Radiology, Department of Radiology, University of Insubria, 21100 Varese (Italy)]. E-mail: domenicolumia@gmail.com; Dionigi, Gianlorenzo [Department of General Surgery, University of Insubria, 21100 Varese (Italy)]. E-mail: gianlorenzodionigi@uninsubria.it; Cuffari, Salvatore [Service of Anaesthesiology, University of Insubria, 21100 Varese (Italy)]. E-mail: domi7@libero.it; Fugazzola, Carlo [Vascular and Interventional Radiology, Department of Radiology, University of Insubria, 21100 Varese (Italy)]. E-mail: radiovarese@libero.it

    2007-02-15

    Purpose: This knowledge will provide an ability to earlier detect bleeding complications after radiofrequency ablation (RFA), to manage these complications appropriately with endovascular procedures and minimize the sequelae. Materials and methods: From 2002 to 2005, 96 patients with 150 hepatic tumours underwent 126 RFA sessions. Fifty-eight patients had HCC, 34 had liver colorectal metastases and 4 had cholangiocellular carcinoma. Sixty-one patients were men and 35 were women (mean age 69.82 years, age range 39-89). The lesions number ranged from 1 to 7 per patients (mean 1.6 nodules) with a mean diameter of 28.5 mm (range 80-10 mm). Seventy-seven patients underwent a single ablative session, 13 patients underwent 2 sessions, 4 patients underwent 3 sessions and 2 patients underwent 4 sessions. The number of tumours treated in each ablative session was 1 in 106, 2 in 18 and 4 in 2 patients. Results: Two cases of serious haemorrhages occurred after the procedures in two patients treated for liver metastases. An endovascular embolization was proposed for both patients using polyvinyl-alcohol and micro-coils. The absence of bleeding was first confirmed during angiography and then by CT performed the day after the angiographic procedure. Conclusion: Transarterial embolization (TAE) represents the treatment of choice in the management of iatrogenic bleeding after RFA since it is minimally invasive, have a high success rate and a low incidence of complications compared to the more complex and dangerous surgical or laparoscopic options in patients who are often haemodynamically unstable and therefore at high anaesthetic and surgical risk.

  13. 4-year experience with percutaneous US-guided radiofrequency ablation of kidney tumors

    International Nuclear Information System (INIS)

    Salagierska-Barwinska, A.; Salagierski, M.; Salagierski, M.

    2007-01-01

    The past decades have significantly changed the diagnosis and management of kidney tumors. There is a growing trend for a less invasive therapeutic approach. The study seeks to present our experience with a number of patients who underwent percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) of renal masses. From July 2002 to December 2006, RFA was carried out in 55 selected patients with an enhancing kidney tumor on computed tomography (CT). The procedure was performed under conscious sedation. The patients were at risk for surgery or had a remaining kidney. Monopolar Cool-tip Tyco or bipolar Celon Olympus RFA devices under US-guidance (convex 3.5 MHz) were used. Abdominal 3-phase multi-slice computed tomography (MSCT) was performed 3, 6 and 12 months post RFA and once yearly thereafter. At a mean follow up of 25 months (range, 6-53 months), 52 of the 55 tumors showed no contrast enhancement on CT. Three incompletely ablated tumors were successfully treated with the second RFA. There were no major complications in any procedure and intervention was well tolerated. So far we have observed one metastasis to a homolateral adrenal gland which was revealed on MSCT. Percutaneous RFA is a minimally invasive technique which appears to be a promising alternative for patients with small renal tumors. 3-phase MSCT improves the imaging of renal masses, enabling not only optimal treatment planning but also a reliable monitoring of tumor destruction after RFA. (author)

  14. Percutaneous radiofrequency treatment of osteoid osteoma using cool-tip electrodes

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    Martel, Jose [Departamento de Diagnostico por Imagen, Fundacion Hospital Alcorcon, Avda. de Budapest s/n, 28922 Alcorcon, Madrid (Spain)]. E-mail: jmartel@fhalcorcon.es; Bueno, Angel [Departamento de Diagnostico por Imagen, Fundacion Hospital Alcorcon, Avda. de Budapest s/n, 28922 Alcorcon, Madrid (Spain); Ortiz, Eduardo [Departamento de Cirugia ortopedica, Fundacion Hospital Alcorcon, Madrid (Spain)

    2005-12-15

    Objectives: To report our experience with percutaneous cool-tip radiofrequency ablation of osteoid osteomas and to evaluate clinical outcome. Methods and material: Forty-one patients with clinically and radiologically suspected osteoid osteoma were seen over a 48-month period (27 males and 14 females with a mean age of 18.7 years; range 5-43 years). Thirty-eight patients were treated by computed tomography (CT)-guided percutaneous radiofrequency ablation. The procedure was performed under regional or general anaesthesia. After location of the nidus, a 14G-bone biopsy needle is introduced into the nidus. Sampling is performed with a 17G-bone biopsy needle using a coaxial technique. The radiofrequency needle with a 10 mm active tip (cool-tip) is inserted through the biopsy needle and is connected to the radiofrequency generator for 6-8 min. Results: Primary success was obtained in 37 patients (97%) with a 100% secondary success rate. All patients are currently pain-free. No major complications occurred. Patients could resume unrestricted normal activity within 24 h. Conclusions: Percutaneous radiofrequency ablation of osteoid osteomas is an efficient and safe method that can be considered the procedure of choice for most cases.

  15. Effect of percutaneous renal sympathetic nerve radiofrequency ablation in patients with severe heart failure.

    Science.gov (United States)

    Dai, Qiming; Lu, Jing; Wang, Benwen; Ma, Genshan

    2015-01-01

    This study aimed to investigate the clinical feasibility and effects of percutaneous renal sympathetic nerve radiofrequency ablation in patients with heart failure. A total of 20 patients with heart failure were enrolled, aged from 47 to 75 years (63±10 years). They were divided into the standard therapy (n = 10), and renal nerve radiofrequency ablation groups (n = 10). There were 15 males and 5 female patients, including 8 ischemic cardiomyopathy, 8 dilated cardiomyopathy, and 8 hypertensive cardiopathy. All of the patients met the criteria of New York Heart Association classes III-IV cardiac function. Patients with diabetes and renal failure were excluded. Percutaneous renal sympathetic nerve radiofrequency ablation was performed on the renal artery wall under X-ray guidance. Serum electrolytes, neurohormones, and 24 h urine volume were recorded 24 h before and after the operation. Echocardiograms were performed to obtain left ventricular ejection fraction at baseline and 6 months. Heart rate, blood pressure, symptoms of dyspnea and edema were also monitored. After renal nerve ablation, 24 h urine volume was increased, while neurohormone levels were decreased compared with those of pre-operation and standard therapy. No obvious change in heart rate or blood pressure was recorded. Symptoms of heart failure were improved in patients after the operation. No complications were recorded in the study. Percutaneous renal sympathetic nerve radiofrequency ablation may be a feasible, safe, and effective treatment for the patients with severe congestive heart failure.

  16. Percutaneous Vertebroplasty for Pain Management in Patients with Multiple Myeloma: Is Radiofrequency Ablation Necessary?

    International Nuclear Information System (INIS)

    Orgera, Gianluigi; Krokidis, Miltiadis; Matteoli, Marco; Varano, Gianluca Maria; La Verde, Giacinto; David, Vincenzo; Rossi, Michele

    2014-01-01

    PurposeThis study was designed to investigate the added role of radiofrequency ablation (RFA) to vertebroplasty on the pain management of patients with multiple myeloma (MM).MethodsThirty-six patients (51–82 years) with vertebral localization of MM were randomly divided into two groups: 18 patients (group A) who underwent RFA and then vertebroplasty, and 18 patients (group B) who underwent only vertebroplasty. Primary endpoints were technical success and pain relief score rate measured by the visual analogue pain scores (VAS) and Roland–Morris Questionnaire (RMQ); secondary endpoint was the amount of administered analgesia. Survival and complications were compared.ResultsTechnical success was 100 % in both groups. The VAS score (at 24 h and 6 weeks postprocedure) decreased in equal manner for both groups from a mean of 9.1–3.4 and 2.0 for group A and from a mean of 9.3–3.0 and 2.3 for group B; RMQ mean score was 19.8 for group A and 19.9 for group B and decreased to a mean of 9.6 and 8.2 for group A and 9.5 and 8.7 for group B. The amount of medication was equally decreased in the two groups. No statistically significant difference was noted. No major complication occurred and two patients died from other causes.ConclusionsThe use of percutaneous vertebroplasty alone appears to be effective for the pain management of the patients with vertebral involvement of multiple myeloma. The use of RFA that includes cost and time does not offer any clear added benefit on the midterm pain management of such patients

  17. Percutaneous Vertebroplasty for Pain Management in Patients with Multiple Myeloma: Is Radiofrequency Ablation Necessary?

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    Orgera, Gianluigi [Sapienza Rome University, Department of Radiology, S. Andrea Hospital (Italy); Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com [Cambridge University Hospitals NHS Trust, Department of Radiology (United Kingdom); Matteoli, Marco; Varano, Gianluca Maria [Sapienza Rome University, Department of Radiology, S. Andrea Hospital (Italy); La Verde, Giacinto [Sapienza Rome University, Department of Medical Oncology, S. Andrea Hospital (Italy); David, Vincenzo; Rossi, Michele [Sapienza Rome University, Department of Radiology, S. Andrea Hospital (Italy)

    2013-05-08

    PurposeThis study was designed to investigate the added role of radiofrequency ablation (RFA) to vertebroplasty on the pain management of patients with multiple myeloma (MM).MethodsThirty-six patients (51–82 years) with vertebral localization of MM were randomly divided into two groups: 18 patients (group A) who underwent RFA and then vertebroplasty, and 18 patients (group B) who underwent only vertebroplasty. Primary endpoints were technical success and pain relief score rate measured by the visual analogue pain scores (VAS) and Roland–Morris Questionnaire (RMQ); secondary endpoint was the amount of administered analgesia. Survival and complications were compared.ResultsTechnical success was 100 % in both groups. The VAS score (at 24 h and 6 weeks postprocedure) decreased in equal manner for both groups from a mean of 9.1–3.4 and 2.0 for group A and from a mean of 9.3–3.0 and 2.3 for group B; RMQ mean score was 19.8 for group A and 19.9 for group B and decreased to a mean of 9.6 and 8.2 for group A and 9.5 and 8.7 for group B. The amount of medication was equally decreased in the two groups. No statistically significant difference was noted. No major complication occurred and two patients died from other causes.ConclusionsThe use of percutaneous vertebroplasty alone appears to be effective for the pain management of the patients with vertebral involvement of multiple myeloma. The use of RFA that includes cost and time does not offer any clear added benefit on the midterm pain management of such patients.

  18. Chemoembolisation combined with percutaneous radiofrequency ablation in the treatment of primary angiosarcoma of the liver

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    Nunes, Thiago Franchi; Barbosa, Fabio Colagrossi Paes; Miiji, Luciana Nakao Odashiro; de Souza, Luiz Gustavo Orlandi

    2013-01-01

    Angiosarcoma of the liver is a rare disease; however, it ranks as the third most common primary liver malignancy. Diagnosis is difficult and prognosis is very poor. After the onset of clinical symptoms, the disease often progresses rapidly, decreasing the chances of curative treatment. We report the case of an 83-year-old male patient who presented with postprandial fullness. Upper abdominal ultrasound showed a hypervascular mass in segment 6 of the liver. The results of anatomopathological examination and immunohistochemistry were compatible with the diagnosis of primary angiosarcoma of the liver. Patient refused surgery (haepatectomy), and treatment was then initiated with transarterial chemoembolisation, followed by percutaneous radiofrequency ablation. The patient is currently cured based on clinical and radiological evidence. This case report is the first in the literature to describe the combined use of transarterial chemoembolisation with percutaneous radiofrequency ablation in the treatment of primary angiosarcoma of the liver. PMID:23704445

  19. Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

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    Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Doros, Attila [Semmelweis University, Radiology Unit, Department of Transplantation and Surgery (Hungary); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom)

    2013-07-11

    PurposeThe major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter.MethodsNine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal–external biliary drainage.ResultsAll nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50–488) days and a median stent patency of 102.5 (range 50–321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation.ConclusionsIn this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

  20. Percutaneous osteoid osteoma treatment with combination of radiofrequency and alcohol ablation

    International Nuclear Information System (INIS)

    Akhlaghpoor, S.; Tomasian, A.; Arjmand Shabestari, A.; Ebrahimi, M.; Alinaghizadeh, M.R.

    2007-01-01

    Aim: To assess the efficacy of percutaneous osteoid osteoma treatment using a combination of radiofrequency ablation (RFA) and alcohol ablation with regard to technical and long-term clinical success. Materials and methods: From December 2001 to November 2004, RFA and subsequent alcohol ablation was performed on 54 patients with osteoid osteoma, diagnosed clinically using radiography, computed tomography (CT) and symptoms. Under general anaesthesia, treatment was performed via percutaneous access under thin section (2 mm) spiral CT guidance in all cases with an 11 G radiofrequency-compatible coaxial needle and 2 mm coaxial drill system and 1.0 cm active tip 17 G non-cooled radiofrequency needle. RFA was performed at 90 o C for a period of 6 min. After needle removal, 0.5-1.0 ml absolute alcohol (99.8% concentration) was injected directly into the nidus using a 20 G needle. Patients were discharged within 24 h and followed up clinically (at 1 week, 1 month and every 3 months thereafter). Results: The technical success rate was 100%. Complications occurred in two patients consisting of local mild cellulitis in entry site and peripheral small zone paresthesia on the anterior part of leg. The follow-up period range was 13-48 months (mean ± SD, 28.2 ± 7.4 months). Prompt pain relief and return to normal activities were observed in 52 of 54 patients. Recurrent pain occurred in two patients after a 1 and 3 months period of being pain free, respectively; a second RFA and alcohol ablation was performed achieving successful results. Primary and secondary clinical success rates were 96.3% (52/54 patients) and 100% (2/2 patients), respectively. Conclusion: Percutaneous osteoid osteoma treatment with combination of radiofrequency and alcohol ablation is safe, effective and minimally invasive with high primary and secondary success rates. Persistent or recurrent lesions can be effectively re-treated

  1. Percutaneous radiofrequency ablation for spinal osteoid osteoma and osteoblastoma.

    Science.gov (United States)

    Wang, Ben; Han, Song Bo; Jiang, Liang; Yuan, Hui Shu; Liu, Chen; Zhu, Bin; Liu, Zhong Jun; Liu, Xiao Guang

    2017-07-01

    We sought to verify the efficacy and safety of RFA in spinal OO and osteoblastomas (OB) (Enneking Stage 2, S2). We retrospectively reviewed patients treated in our hospital. Surgical resection was indicated for Enneking Stage 3 OB. RFA indications for spinal OO and OB (S2) were no neurological deficits, complete bone cortex around the lesion on computed tomography (CT), and cerebrospinal fluid between a lesion and the spinal cord/nerve root on magnetic resonance imaging. Abundant cerebrospinal fluid (more than 1.0 mm) between the lesion and nerve root/spinal cord was preferred to prevent neurological damage by heat. Otherwise, surgery was recommended. The minimum follow-up was 24 months. Ten patients were treated with CT-guided percutaneous RFA, including three with OB and seven with OO. No patients had neurological deficits or scoliosis. In OO patients, the average visual analog scale (VAS) scores were 7.6/10 (range 6-10) before RFA. In OB cases, the VAS scores were 8, 7, and 9 before RFA. Nine patients had a one-stage biopsy and then RFA, and one patient had a two-stage procedure (biopsy before RFA). The average RFA time for OO was 10 min (range 4-12). In the three OB cases, the RFA time was 12, 12, and 24 min. The time of the whole produce was 98 min (range 65-130 min). All 10 patients were followed-up. The average follow-up time of OO was 46.6 months (range 24-66). Six patients were free of pain, except one who suffered occasional pain with VAS 2/10. The three OB cases were free of pain at 24, 26, and 26 months. CT-guided percutaneous RFA is a safe and effective treatment for spinal OO and S2 OB, especially in lesions with no neurological deficits and intact cortical bone. Cerebrospinal fluid around the lesion is an appropriate indication for percutaneous RFA.

  2. Benign thyroid nodules treatment using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA).

    Science.gov (United States)

    Mauri, Giovanni; Cova, Luca; Monaco, Cristian Giuseppe; Sconfienza, Luca Maria; Corbetta, Sabrina; Benedini, Stefano; Ambrogi, Federico; Milani, Valentina; Baroli, Alberto; Ierace, Tiziana; Solbiati, Luigi

    2016-11-15

    To evaluate the reduction over time of benign thyroid nodules treated using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA) by the same equipe. Ninety patients (age 55.6 ± 14.1 years) underwent ablation for benign thyroid nodule causing compression/aesthetic dissatisfaction from 2011. Fifty-nine (age 55.8 ± 14.1 years) underwent RFA and 31 (age 55.2 ± 14.2 years) PLA, ultrasound guided. Technical success, complications, duration of ablation and treatment, energy deployed, volumetric percentage reduction at 1, 6 and 12 months were derived. A regression model for longitudinal measurements was used with random intercept and random slope. Values are expressed as mean ± standard deviation or N (%). Technical success was always obtained. No major complications occurred. Mean ablation time was 30.1 ± 13.8 vs. 13.9 ± 5.9 min (p < .0001) and mean energy deployment was 5422.3 ± 2484.5 J vs. 34 662.7 ± 15 812.3 J in PLA vs. RFA group. Mean volume reduced from 20.3 ± 16.4 ml to 13.17 ± 10.74 ml (42% ± 17% reduction) at 1st month, 8.7 ± 7.4 ml (60% ± 15% reduction) at 6th month and 7.1 ± 7.7 ml (70%% ± 16% reduction) at 12th month, in PLA group, and from 32.7 ± 19.5 ml to 17.2 ± 12.9 ml (51%±15% reduction) at 1st month, 12.8 ± 9.6 ml (64 ± 14% reduction) at 6th month and 9.9 ± 9.2 ml (74% ± 14% reduction) at 12th month in RFA group. No difference in time course of the relative volume reduction between the two techniques was found. RFA and PLA are similarly feasible, safe and effective in treating benign thyroid nodules when performed by the same equipe. RFA is faster than PLA but require significantly higher energy.

  3. Percutaneous Hepaticojejunostomy Using a Radiofrequency Wire for Management of a Postoperative Bile Leak

    Energy Technology Data Exchange (ETDEWEB)

    Close, Orrie N. [University of Pittsburgh School of Medicine, Interventional Radiology, Department of Radiology (United States); Akinwande, Olaguoke [Johns Hopkins University, Division of Interventional Radiology (United States); Varma, Rakesh K.; Santos, Ernesto; Kim, Hyun S., E-mail: kevin.kim@yale.edu [University of Pittsburgh School of Medicine, Interventional Radiology, Department of Radiology (United States)

    2017-01-15

    Postoperative biliary complications following extensive hepatic resections are complex, often requiring a multidisciplinary team approach. We describe a case of a free bile duct leak following extended right hepatectomy and surgical hepaticojejunostomy treated with percutaneous transhepatic hepaticojejunostomy in which a radiofrequency guidewire was used to gain enteral access. A modified internal/external biliary catheter was left in place. The patient was enrolled in a benign biliary stricture protocol, and 8 months later, the catheter was removed following a normal cholangiogram and biliary manometric perfusion testing. At 3-month follow-up after catheter removal, the patient is asymptomatic with no clinical, biochemical, or radiographic evidence of biliary leak or obstruction.

  4. Evaluation of the safety and efficacy of percutaneous radiofrequency ablation for treating multiple breast fibroadenoma.

    Science.gov (United States)

    Li, Ping; Xiao-Yin, Tang; Cui, Dan; Chi, Jia-Chang; Wang, Zhi; Wang, Tao; Qi, Xing-Xing; Zhai, Bo

    2016-12-01

    This study was conducted to evaluate the safety and efficacy of ultrasound (US)-guided percutaneous radiofrequency ablation (RFA) for multiple breast fibroadenoma as an alternative to surgical resection. Sixty-five patients with multiple breast fibroadenoma accepted general anesthesia and US-guided percutaneous RFA in our hospital from September 2014 to January 2016. Contrast-enhanced US (CEUS) was used immediately after operation to determine whether the tumor was ablated completely. The complete ablation rate (CAR) and the change of focal volume were evaluated by CEUS at the 1st month and the 3rd month after operation. All the patients were diagnosed by needle biopsy. Among all the patients, 256 nodules were found. Forty-six nodules (17.96%) were located fibroadenoma.

  5. Prognostic Impact of the Geriatric Nutritional Risk Index on Long-Term Outcomes in Patients Who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Hassan, Ahmed; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-06-01

    Malnutrition has been identified as an important predictor of poor clinical outcomes in patients with heart failure. The aim of this study is to examine the prognostic impact of nutritional status in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). The impact of nutrition, assessed using the geriatric nutritional risk index (GNRI) calculated by serum albumin and body mass index, was evaluated in 2,853 patients with CAD who underwent their first PCI between 2000 and 2011. Patients were assigned to tertiles based on their GNRI levels. The incidences of all-cause death and cardiac death were assessed. The median GNRI values were 101 (interquartile range 95 to 106). Lower GNRI levels were associated with older age and higher prevalence of acute coronary syndrome and chronic kidney disease. During the median follow-up period of 7.4 years, Kaplan-Meier curves showed ongoing divergence in rates of mortality among tertiles (GNRI nutritional status was associated with long-term clinical outcomes in CAD patients after PCI. Evaluation of GNRI carries important prognostic information and may guide the therapeutic approach to such patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. The Results of Ultrasonography-Guided Percutaneous Radiofrequency Ablation in Hyperparathyroid Patients in Whom Surgery Is Not Feasible

    Energy Technology Data Exchange (ETDEWEB)

    Sormaz, Ismail Cem, E-mail: icsormaz@gmail.com [Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery (Turkey); Poyanlı, Arzu, E-mail: arzupoyanli@yahoo.com [Istanbul University, Istanbul Faculty of Medicine, Department of Radiology (Turkey); Açar, Sami, E-mail: acarrsami@gmail.com [Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery (Turkey); İşcan, Ahmet Yalın, E-mail: yaliniscan@gmail.com [Fatih Sultan Mehmet Research and Education Hospital, Department of General Surgery (Turkey); Ozgur, İlker, E-mail: dr.ilkerozgur@gmail.com; Tunca, Fatih, E-mail: drfatihtunca@yahoo.com; Senyürek, Yasemin Giles, E-mail: yasemin.senyurek@gmail.com [Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery (Turkey)

    2017-04-15

    BackgroundThe aim of the study was to evaluate the results of ultrasonography (US)-guided percutaneous radiofrequency ablation (RFA) in hyperparathyroid patients who refused surgery or had high surgical risks.Patients and MethodsFive patients with hyperparathyroidism (HPT) underwent US-guided RFA for a single hyperfunctioning parathyroid lesion. Post-ablation serum calcium and parathormone (PTH) assays were performed. All patients underwent imaging studies 6 months after the ablation to visualize the post-ablation change in the size of the treated parathyroid lesions.ResultsAll patients were normocalcemic on the post-ablation 1st day and 6th month. The post-ablation PTH levels were normal in three patients but remained elevated in two patients. The size of the parathyroid lesion was ≥30 mm in the two patients with elevated PTH, whereas the lesion was smaller than 30 mm in those with normal post-ablation PTH values.ConclusionAlthough this is a limited case series, it demonstrates the potential feasibility of RFA for HPT. Benefits were achieved particularly in patients with small parathyroid lesions.

  7. The Results of Ultrasonography-Guided Percutaneous Radiofrequency Ablation in Hyperparathyroid Patients in Whom Surgery Is Not Feasible

    International Nuclear Information System (INIS)

    Sormaz, Ismail Cem; Poyanlı, Arzu; Açar, Sami; İşcan, Ahmet Yalın; Ozgur, İlker; Tunca, Fatih; Senyürek, Yasemin Giles

    2017-01-01

    BackgroundThe aim of the study was to evaluate the results of ultrasonography (US)-guided percutaneous radiofrequency ablation (RFA) in hyperparathyroid patients who refused surgery or had high surgical risks.Patients and MethodsFive patients with hyperparathyroidism (HPT) underwent US-guided RFA for a single hyperfunctioning parathyroid lesion. Post-ablation serum calcium and parathormone (PTH) assays were performed. All patients underwent imaging studies 6 months after the ablation to visualize the post-ablation change in the size of the treated parathyroid lesions.ResultsAll patients were normocalcemic on the post-ablation 1st day and 6th month. The post-ablation PTH levels were normal in three patients but remained elevated in two patients. The size of the parathyroid lesion was ≥30 mm in the two patients with elevated PTH, whereas the lesion was smaller than 30 mm in those with normal post-ablation PTH values.ConclusionAlthough this is a limited case series, it demonstrates the potential feasibility of RFA for HPT. Benefits were achieved particularly in patients with small parathyroid lesions.

  8. Percutaneous ultrasound-guided radiofrequency ablation for kidney tumors in patients with surgical risk

    International Nuclear Information System (INIS)

    Salagierski, Marek; Salagierski, Maciej; Sosnowski, Marek; Salagierska-Barwinska, Anna

    2006-01-01

    The aim of this study was to describe our experience with percutaneous ultrasound-guided radiofrequency ablation of kidney tumors. From July 2002 to August 2005, 45 radiofrequency ablations (RFA) in 42 selected patients with kidney tumor were performed. The patients had either contraindications to surgery procedures or had a solitary kidney. The average tumor size was 37.5 mm (range, 18-59 mm) with the mean age of 68 years (range, 28-83 years). RFA were performed based on radiographic findings. Needle biopsy was made only twice. Monopolar Cool-tip Tyco or bipolar Celon Olympus radiofrequency devices were used. The procedure was performed under conscious sedation with local anesthesia. Treatment efficacy was assessed by computed tomography and by Doppler ultrasound. The absence of contrast enhancement on computed tomography was considered to be a successful treatment. The average follow up was 14 months (range, 3-36 months). In 42 tumors (93%), total absence of contrast enhancement was obtained after the initial RFA and in three tumors (7%) after the second ablation session. There were no complications following 41 procedures, including all ablations in small (<35 mm) renal masses. In four procedures, minor complications were observed. All patients are alive. There has been no need for chronic hemodialysis and, until now, we have not observed any local recurrences with the exception of one metastasis to an ipsilateral adrenal gland. RFA of kidney tumors is a promising alternative treatment which could be considered for patients who are not suitable for surgery. (author)

  9. Percutaneous radiofrequency lung ablation combined with transbronchial saline injection: an experimental study in swine.

    Science.gov (United States)

    Kawai, T; Kaminou, T; Sugiura, K; Hashimoto, M; Ohuchi, Y; Adachi, A; Fujioka, S; Ito, H; Nakamura, K; Ihaya, T; Ogawa, T

    2010-02-01

    To evaluate the efficacy of radiofrequency lung ablation with transbronchial saline injection. The bilateral lungs of eight living swine were used. A 13-gauge bone biopsy needle was inserted percutaneously into the lung, and 1 ml of muscle paste was injected to create a tumor mimic. In total, 21 nodules were ablated. In the saline injection group (group A), radiofrequency ablation (RFA) was performed for 11 nodules after transbronchial saline injection under balloon occlusion with a 2-cm active single internally cooled electrode. In the control group (group B), conventional RFA was performed for 10 nodules as a control. The infused saline liquid showed a wedge-shaped and homogeneous distribution surrounding a tumor mimic. All 21 RFAs were successfully completed. The total ablation time was significantly longer (13.4 +/- 2.8 min vs. 8.9 +/- 3.5 min; P = 0.0061) and the tissue impedance was significantly lower in group A compared with group B (73.1 +/- 8.8 Omega vs. 100.6 +/- 16.6 Omega; P = 0.0002). The temperature of the ablated area was not significantly different (69.4 +/- 9.1 degrees C vs. 66.0 +/- 7.9 degrees C; P = 0.4038). There was no significant difference of tumor mimic volume (769 +/- 343 mm(3) vs. 625 +/- 191 mm(3); P = 0.2783). The volume of the coagulated area was significantly larger in group A than in group B (3886 +/- 1247 mm(3) vs. 2375 +/- 1395 mm(3); P = 0.0221). Percutaneous radiofrequency lung ablation combined with transbronchial saline injection can create an extended area of ablation.

  10. CT-guided percutaneous radiofrequency ablation of hepatic malignancies located in unusual regions under general anesthesia

    International Nuclear Information System (INIS)

    Pan Jie; Chen Shaohui; Lu Xin; Mao Yilei; Sang Xinting; Chen Fang; Li Yumei; Huang Yuguang; Jin Zhengyu

    2010-01-01

    Objective: To discuss the feasibility of CT-guided percutaneous radiofrequency ablation (RFA) of liver malignancies located in unusual regions under general anesthesia, and to assess its clinical value. Methods: Eighteen patients with a total of 26 malignant hepatic lesions were enrolled in this study. The lesions were located at diaphragmatic surface, hepatic hilum, hepatic subcapsular site,side of inferior vena cava, side of gallbladder or near by colon. Transcatheter arterial chemoembolization was performed in all patients, which was followed by CT-guided percutaneous RFA under general anesthesia. The time used for puncturing and the time used for putting the needles to the scheduled sites were recorded. A follow-up for 115 months was conducted. The complications and the therapeutic results were observed. Results: For all patients,the procedure of puncture and needle placement was completed in 1-3 minutes. A total of 35 RFA procedures were conducted for 26 lesions. No severe complications occurred. Complete necrosis was observed in 20 tumors and partial necrosis in 6 tumors. Conclusion: The result of this study indicates that CT-guided percutaneous RFA under general anesthesia is a feasible technique for the treatment of liver malignancies located at unusual regions. This technique is very helpful for reducing the manipulating difficulty and lowing the complication risk of RFA procedures. (authors)

  11. Management of pain on hallux valgus with percutaneous intra-articular Pulse-Dose Radiofrequency.

    Science.gov (United States)

    Masala, Salvatore; Fiori, Roberto; Calabria, Eros; Raguso, Mario; de Vivo, Dominique; Cuzzolino, Alessandro; Simonetti, Giovanni

    2017-01-01

    The purpose of our study was to investigate the role of intra-articular pulse-dose radiofrequency in management of painful hallux valgus refractory to conservative therapies. Between November 2010 and April 2012, 51 patients (15 male, 36 female) with a median age of 71.4 years were included in our clinical trial. Under fluoroscopic guidance we introduced a 22 gauge 10 cm length cannula by a percutaneous access in the first metatarsophalangeal joint and its tip was placed intra-articularly. After removing the spindle, a radiofrequency needle with a 5 mm active tip was introduced. The following parameters were used: 1200 pulses at high voltage (45 V) with 20 msec duration followed by 480 msec silent phases. A great reduction in pain intensity was documented at 1 week, 1 month and 3 months after procedures. Pain intensity increased between 5 and 8 months after treatments, so we performed a second procedure in all patients between 7 months and 9 months since the first treatment. Also in this case we obtained a great reduction of pain intensity in the first 3 months after the procedure. Pain intensity returned at preprocedural values after 9 months after second procedure. No complications were observed. Our experience shows pulse-dose radiofrequency is a safe, repeatable and effective technique for managing patients with symptomatic hallux valgus in the short and medium term. Pulse-dose radiofrequency may improve pain control and quality of life in patients with hallux valgus refractory to conservative therapies. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  12. Long-term prognosis and clinical characteristics of young adults (≤40 years old) who underwent percutaneous coronary intervention.

    Science.gov (United States)

    Konishi, Hirokazu; Miyauchi, Katsumi; Kasai, Takatoshi; Tsuboi, Shuta; Ogita, Manabu; Naito, Ryo; Katoh, Yoshiteru; Okai, Iwao; Tamura, Hiroshi; Okazaki, Shinya; Daida, Hiroyuki

    2014-09-01

    Limited data exist regarding the long-term prognosis of percutaneous coronary intervention (PCI) in young adults. The aim of this study was to retrospectively assess the long-term clinical outcomes in young patients who underwent PCI. Between 1985 and 2011, 7649 consecutive patients underwent PCI, and data from 69 young adults (age ≤40 years) and 4255 old adults (age ≧65 years) were analyzed. A Cox proportional hazards regression analysis was used to determine the independent predictors of a composite endpoint that included all-cause death and acute coronary syndrome (ACS) during the follow-up period. The mean age of the 69 young patients was 36.1±4.9 years, and 96% of them were men. Approximately 30% were current smokers, and their body mass index (BMI) was 26.7±5.0kg/m(2). The prevalence of diabetes and hypertension was 33% and 48%, respectively. All patients had ≥1 conventional cardiovascular risk factor. At a median follow-up of 9.8 years, the overall death rate was 5.8%, and new-onset ACS occurred in 8.7%. Current smoking was an independent predictor of the composite endpoint (hazard ratio 4.46, confidence interval 1.08-19.1, p=0.04) for young adults. Current smoking and obesity (high BMI) are the important clinical characteristics in young Japanese coronary heart disease patients who undergo PCI. The long-term prognosis in young patients is acceptable, but current smoking is a significant independent predictor of death and the recurrence of ACS in young Japanese coronary heart disease patients who are obese. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  13. Is Antibiotic Prophylaxis for Percutaneous Radiofrequency Ablation (RFA) of Primary Liver Tumors Necessary? Results From a Single-Center Experience

    International Nuclear Information System (INIS)

    Bhatia, Shivank S.; Spector, Seth; Echenique, Ana; Froud, Tatiana; Suthar, Rekha; Lawson, Ivy; Dalal, Ravi; Dinh, Vy; Yrizarry, Jose; Narayanan, Govindarajan

    2015-01-01

    PurposeThe purpose of this study was to evaluate need for antibiotic prophylaxis for radiofrequency ablation (RFA) of liver tumors in patients with no significant co-existing risk factors for infection.Materials and MethodsFrom January 2004 to September 2013, 83 patients underwent 123 percutaneous RFA procedures for total of 152 hepatocellular carcinoma (HCC) lesions. None of the patients had pre-existing biliary enteric anastomosis (BEA) or any biliary tract abnormality predisposing to ascending biliary infection or uncontrolled diabetes mellitus. No pre- or post-procedure antibiotic prophylaxis was provided for 121 procedures. Data for potential risk factors were reviewed retrospectively and analyzed for the frequency of infectious complications, including abscess formation.ResultsOne patient (1/121 (0.8 %) RFA sessions) developed a large segment 5 liver abscess/infected biloma communicating with the gallbladder 7 weeks after the procedure, successfully treated over 10 weeks with IV and PO antibiotic therapy and percutaneous catheter drainage. This patient did not receive any antibiotics prior to RFA. During the procedure, there was inadvertent placement of RFA probe tines into the gallbladder. No other infectious complications were documented.ConclusionThese data suggest that the routine use of prophylactic antibiotics for liver RFA is not necessary in majority of the patients undergoing liver ablation for HCC and could be limited to patients with high-risk factors such as the presence of BEA or other biliary abnormalities, uncontrolled diabetes mellitus, and large centrally located tumors in close proximity to central bile ducts. Larger randomized studies are needed to confirm this hypothesis

  14. Is Antibiotic Prophylaxis for Percutaneous Radiofrequency Ablation (RFA) of Primary Liver Tumors Necessary? Results From a Single-Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Bhatia, Shivank S., E-mail: sbhatia1@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States); Spector, Seth, E-mail: sspector@med.miami.edu [University of Miami, Department of Surgery, VA Hospital (Veterans Affairs Medical Center) (United States); Echenique, Ana, E-mail: aechenique@med.miami.edu; Froud, Tatiana, E-mail: tfroud@med.miami.edu; Suthar, Rekha, E-mail: rsuthar@med.miami.edu; Lawson, Ivy, E-mail: i.lawson1@med.miami.edu; Dalal, Ravi, E-mail: rdalal@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States); Dinh, Vy, E-mail: vdinh@med.miami.edu [VA Hospital (Veterans Affairs Medical Center), Department of Medicine (United States); Yrizarry, Jose, E-mail: jyrizarr@med.miami.edu; Narayanan, Govindarajan, E-mail: gnarayanan@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States)

    2015-08-15

    PurposeThe purpose of this study was to evaluate need for antibiotic prophylaxis for radiofrequency ablation (RFA) of liver tumors in patients with no significant co-existing risk factors for infection.Materials and MethodsFrom January 2004 to September 2013, 83 patients underwent 123 percutaneous RFA procedures for total of 152 hepatocellular carcinoma (HCC) lesions. None of the patients had pre-existing biliary enteric anastomosis (BEA) or any biliary tract abnormality predisposing to ascending biliary infection or uncontrolled diabetes mellitus. No pre- or post-procedure antibiotic prophylaxis was provided for 121 procedures. Data for potential risk factors were reviewed retrospectively and analyzed for the frequency of infectious complications, including abscess formation.ResultsOne patient (1/121 (0.8 %) RFA sessions) developed a large segment 5 liver abscess/infected biloma communicating with the gallbladder 7 weeks after the procedure, successfully treated over 10 weeks with IV and PO antibiotic therapy and percutaneous catheter drainage. This patient did not receive any antibiotics prior to RFA. During the procedure, there was inadvertent placement of RFA probe tines into the gallbladder. No other infectious complications were documented.ConclusionThese data suggest that the routine use of prophylactic antibiotics for liver RFA is not necessary in majority of the patients undergoing liver ablation for HCC and could be limited to patients with high-risk factors such as the presence of BEA or other biliary abnormalities, uncontrolled diabetes mellitus, and large centrally located tumors in close proximity to central bile ducts. Larger randomized studies are needed to confirm this hypothesis.

  15. Which patients will benefit from percutaneous radiofrequency ablation of colorectal liver metastases? Critically appraised topic.

    LENUS (Irish Health Repository)

    McGrane, Siobhan

    2012-02-03

    In clinical radiology, there are numerous examples of new techniques that were initially enthusiastically promoted and then subsequently abandoned when early promise was not realized in routine patient care. Appropriateness of new or established interventional radiology techniques to specific clinical conditions must be determined from clinical experience, from communication with experts in the field and\\/or careful review of available medical literature, and on an individual patient basis by means of review of clinical notes and diagnostic imaging studies. For patients with liver neoplasms, regional techniques such as radiofrequency ablation (RFA) have been developed and are now the subject of ongoing research. This article describes the utilization of Evidence-Based Practice (EBP) techniques as a means of deciding the appropriateness of percutaneous RFA in treating colorectal liver metastases (CLM).

  16. Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment.

    Science.gov (United States)

    Mauri, Giovanni; Porazzi, Emanuele; Cova, Luca; Restelli, Umberto; Tondolo, Tania; Bonfanti, Marzia; Cerri, Anna; Ierace, Tiziana; Croce, Davide; Solbiati, Luigi

    2014-04-01

    To assess the clinical and the economic impacts of intraprocedural use of contrast-enhanced ultrasound (CEUS) in patients undergoing percutaneous radiofrequency ablation for small (impact, cost effectiveness, and budget, organisational and equity impacts were evaluated and compared with standard treatment without intraprocedural CEUS using the health technology assessment approach. Intraprocedural CEUS detected incomplete ablation in 34/93 (36.5 %) patients, who underwent additional treatment during the same session. At 24-h, complete ablation was found in 88/93 (94.6 %) patients. Thus, a second session of treatment was spared in 29/93 (31.1 %) patients. Cost-effectiveness analysis revealed an advantage for the use of intraprocedural CEUS in comparison with standard treatment (4,639 vs 6,592) with a 21.9 % reduction of the costs to treat the whole sample. Cost per patient for complete treatment was  4,609 versus  5,872 respectively. The introduction of intraprocedural CEUS resulted in a low organisational impact, and in a positive impact on equity Intraprocedural use of CEUS has a relevant clinical impact, reducing the number of re-treatments and the related costs per patient. • CEUS allows to immediately asses the result of ablation. • Intraprocedural CEUS decreases the number of second ablative sessions. • Intraprocedural CEUS may reduce cost per patient for complete treatment. • Use of intraprocedural CEUS may reduce hospital budget. • Its introduction has low organisational impact, and relevant impact on equity.

  17. Relationship between Sensory Stimulation and Side Effects in Percutaneous Radiofrequency Treatment of the Trigeminal Ganglion.

    Science.gov (United States)

    Koning, Mark V; Koning, Nick J; Koning, Henk M; van Kleef, Maarten

    2014-09-01

    The objective of this study was to determine the efficacy of percutaneous radiofrequency (RF) treatment of the trigeminal ganglion for treating patients with trigeminal neuralgia, to determine which patients have a long-term benefit, and to evaluate the effect of RF parameters. A retrospective study in 28 consecutive patients in combination with a follow-up questionnaire (n = 26, 93% response). An initial treatment effect of 89% was observed, 60% sustained at 12-month follow-up. Major side effects were hypesthesia (56%), dry eye (20%), and masseter muscle weakness (12%). A lower sensory stimulation threshold during treatment was associated with better patient satisfaction (P = 0.016), improved pain relief (P = 0.039), and trended toward more hypesthesia (P = 0.077). This low-volume study reported treatment effects in an older population that were similar to previous studies. Only a higher incidence of hypesthesia was detected by long-term follow-up. This study supported the high efficiency of RF treatment, but there was a high level of side effects. Most notable, low sensory stimulation was associated with increased hypesthesia, whereas higher stimulation levels yielded less effectiveness. Further investigation of an optimal sensory stimulation range for percutaneous RF treatment of the trigeminal ganglion was found to be warranted. © 2013 World Institute of Pain.

  18. Early diffuse recurrence of hepatocellular carcinoma after percutaneous radiofrequency ablation: analysis of risk factors

    International Nuclear Information System (INIS)

    Lee, Hee Young; Rhim, Hyunchul; Lee, Min Woo; Kim, Young-sun; Choi, Dongil; Park, Min Jung; Kim, Young Kon; Kim, Seong Hyun; Lim, Hyo Keun

    2013-01-01

    To evaluate the risk factors affecting early diffuse recurrence within 1 year of percutaneous ultrasound-guided radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Out of 146 patients who received transcatheter arterial chemoembolisation (TACE) for treatment of recurrent HCC after percutaneous ultrasound-guided RFA, we selected 23 patients with early diffuse recurrence. Early diffuse recurrence was defined as three or more new recurrent HCCs within 1 year of initial RFA. As a control group, we selected 23 patients, matched exactly for age and sex, in which there was no local tumour progression or new recurrence after RFA. To analyse the risk factors, we examined patient factors and tumour factors. Recurrent tumours occurred from 30 to 365 days after RFA (median time, 203 days). Univariate analysis indicated that larger tumour size and poorly defined margin were significant risk factors (P < 0.05). Multivariate analysis indicated that poorly defined margin was a significant risk factor (P < 0.05). Larger tumour size and poorly defined margin may be risk factors for early diffuse recurrence of HCC within 1 year of RFA. Tumours with such risk factors should be treated with a combination of TACE to minimise the potential for therapeutic failure. (orig.)

  19. Therapeutic response assessment of percutaneous radiofrequency ablation for hepatocellular carcinoma: Utility of contrast-enhanced agent detection imaging

    International Nuclear Information System (INIS)

    Kim, Chan Kyo; Choi, Dongil; Lim, Hyo K.; Kim, Seung Hoon; Lee, Won Jae; Kim, Min Ju; Lee, Ji Yeon; Jeon, Yong Hwan; Lee, Jongmee; Lee, Soon Jin; Lim, Jae Hoon

    2005-01-01

    Purpose: To assess the utility of contrast-enhanced agent detection imaging (ADI) in the assessment of the therapeutic response to percutaneous radiofrequency (RF) ablation in patients with hepatocellular carcinoma (HCC). Materials and methods: Ninety patients with a total of 97 nodular HCCs (mean, 2.1 ± 1.3 cm; range, 1.0-5.0 cm) treated with percutaneous RF ablation under the ultrasound guidance were evaluated with contrast-enhanced ADI after receiving an intravenous bolus injection of a microbubble contrast agent (SH U 508A). We obtained serial contrast-enhanced ADI images during the time period from 15 to 90 s after the initiation of the bolus contrast injection. All of the patients underwent a follow-up four-phase helical CT at 1 month after RF ablation, which was then repeated at 2-4 month intervals during a period of at least 12 months. The results of the contrast-enhanced ADI were compared with those of the follow-up CT in terms of the presence or absence of residual unablated tumor and local tumor progression in the treated lesions. Results: On contrast-enhanced ADI, technical success was obtained in 94 (97%) of the 97 HCCs, while residual unablated tumors were found in three HCCs (3%). Two of the three tumors that were suspicious (was not proven) for incomplete ablation were subjected to additional RF ablation. The remaining one enhancing lesion that was suspicious of a residual tumor on contrast-enhanced ADI was revealed to be reactive hyperemia at the 1-month follow-up CT. Therefore; the diagnostic concordance between the contrast-enhanced ADI and 1-month follow-up CT was 99%. Of the 94 ablated HCCs without residual tumors on both the contrast-enhanced ADI and 1-month follow-up CT after the initial RF ablation, five (5%) had CT findings of local tumor progression at a subsequent follow-up CT. Conclusion: Despite its limitations in predicting local tumor progression in the treated tumors, contrast-enhanced ADI is potentially useful for evaluating the

  20. Ultrasonography-guided percutaneous radiofrequency ablation of hepatocellular carcinomas: A feasibility scoring system for planning sonography

    Energy Technology Data Exchange (ETDEWEB)

    Rhim, Hyunchul, E-mail: rhimhc@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choi, Dongil; Kim, Young-sun; Lim, Hyo K. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choe, Bong-Keun [Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    Purpose: This study was designed to evaluate whether a feasibility scoring system for planning sonography is a reliable predictor of a safe and complete ablation in ultrasonography (US)-guided percutaneous radiofrequency ablation (RFA) of hepatocellular carcinomas (HCCs). Materials and methods: We retrospectively evaluated the therapeutic outcomes of 108 consecutive patients (M:F, 78:30; mean age, 57.4 years) with a single nodular HCC (mean diameter, 2.0 cm) treated by percutaneous RFA. All patients were assessed for the feasibility of performing an RFA at planning sonography prior to the ablation. The feasibility scoring system consisted of five categories: the safe electrode path (P); the vital organs adjacent to the RFA zone (O); tumor size (S); tumor conspicuity (C); and the heat-sink effect (H). Each category was divided into a four-point scale [1-4]. If a score of 4 in any category was determined, the patient was not considered to be a suitable candidate for percutaneous RFA. We assessed if the score of each category, safety score (P + O), and curability score (S + C + H) correlated with a safe and complete ablation using the chi-squared test and likelihood ratio test for trend. Results: The technical success rate was 100% (108/108) based on CT images obtained immediately after ablation. There was no 30-day mortality after RFA. There were major complications (one case of severe vasovagal reflex, one case of hemoperitoneum and one case of a pseudoaneurysm) in three (2.7%) patients, and minor complications (one case of a biloma, one case of subsegmental infarction and one case of abscess) in three (2.7%) patients. Post-ablation syndrome as a side effect was noted in 38 (35.1%) of 108 patients. The primary technique effectiveness rate at 1 month was 95.1% (105/108). Local tumor progression was noted in eight (7.6%) of 105 patients during the follow-up period (range, 3.0-11.5 months; median, 5.8 months; mean, 5.7 months). There was no significant single category

  1. Percutaneous radiofrequency ablation with transarterial embolization is useful for treatment of stage 1 renal cell carcinoma with surgical risk. Results at 2-year mean follow up

    International Nuclear Information System (INIS)

    Arima, Kiminobu; Yamakado, Kouichirou; Kinbara, Hiroyuki; Nakatsuka, Atsuhiro; Takeda, Kan; Sugimura, Yoshiki

    2007-01-01

    Despite laparoscopic partial nephrectomy and laparoscopic cryotherapy being performed lately, an even less invasive treatment would be desirable in high-risk patients. Under local anesthesia with intravenous (i.v.) sedation, we were able to perform percutaneous radiofrequency ablation (RFA) combined with renal arterial embolization for unresectable stage 1 (T1NoMo) renal cell carcinoma (RCC). We evaluated the feasibility, safety and therapeutic effects of this technique after a 2-year mean follow up. Thirty-one patients who were not candidates for surgery underwent RFA for 36 stage 1 RCC. Twenty-eight tumors were percutaneously ablated 6 days after the tumor vessels were embolized. Dynamic contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) were performed to evaluate treatment at completion. Tumor enhancement was eliminated after two RFA sessions in all tumors. Thirty tumors remained free of enhancement during a mean follow-up period of 24.3 months. There were no major complications related to the procedures though one instance of pyonephrosis, two of subcapsular hematomas, one of retroperitoneal hemorrhage and one of nausea were seen after RFA. Two patients died of other diseases (id est (i.e.) colon cancer and cerebral bleeding) 20 and 26 months after RFA treatment. One patient had a local recurrence of tumor and underwent re-RFA. The recurrence rate of RCC after successful RFA was 2.8%. There was no recurrence in patients who had tumors of less than 4 cm after RFA at a mean follow-up period of 24.3 months. Local control was achieved in 100% of T1NoMo tumors including the recurrence case that underwent re-RFA. The result of the present study at 2-year mean follow up showed percutaneous RFA was a feasible, safe and promising therapy for the treatment of unresectable stage 1 RCC, especially those smaller than 4 cm. (author)

  2. Percutaneous CT-Guided Sympathicolysis with Radiofrequency for the Treatment of Palmar Hyperhidrosis.

    Science.gov (United States)

    García-Barquín, Paula; Aquerreta Beola, Jesús Dámaso; Bondía Gracía, José María; España Alonso, Agustín; Pérez Cajaraville, Juan; Bartolomé Leal, Pablo; Bastarrika, Gorka

    2017-06-01

    To evaluate the benefits of computed tomography (CT)-guided percutaneous sympathicolysis with radiofrequency in patients with primary palmar hyperhidrosis (PPHH) in terms of safety, patient satisfaction, and short- and long-term efficacy. A total of 139 procedures in 108 patients (mean age, 29.89 y ± 10.94), including 50 men and 58 women, with PPHH and therapy-resistance of nonsurgical treatments were retrospectively analyzed. Treatment was performed bilaterally at T2, T3, and T4 levels, reaching 90°C during 8 minutes. Technical success, immediate efficacy, and presence of complications were analyzed. For follow-up, the Hyperhidrosis Disease Severity Scale was used to evaluate the hyperhidrosis before, at one month, and in the long-term through a survey of 42 patients. Patients' satisfaction and complications were also recorded. The technical success rate was 98.56%. The increase in palmar skin temperature was 4.88°C ± 1.85. A total of 85.3% of participants had completely dry hands immediately after treatment. The mean follow-up time was 41.34 months (range, 6-62 mo). One month after treatment, the response rate was 77.38% (P hyperhidrosis at long-term follow-up. Percutaneous CT-guided sympathicolysis is a safe and effective technique for the treatment of PPHH and can be considered as a second choice in patients in whom other nonsurgical therapeutic options have failed, despite the compensatory hyperhidrosis rates. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  3. Intrahepatic recurrence after percutaneous radiofrequency ablation of hepatocellular carcinoma: Analysis of the pattern and risk factors

    International Nuclear Information System (INIS)

    Kim, Young-sun; Rhim, Hyunchul; Cho, On Koo; Koh, Byung Hee; Kim, Yongsoo

    2006-01-01

    Purpose: To evaluate the pattern and risks for intrahepatic recurrence after percutaneous radiofrequency (RF) ablation for hepatocellular carcinoma (HCC). Materials and methods: We studied 62 patients with 72 HCCs (≤4 cm) who were treated with percutaneous RF ablation. The mean follow-up period was 19.1 months (6.0-49.1). We assessed the incidence and cumulative disease-free survival of local tumor progression (LTP) and intrahepatic distant recurrence (IDR). To analyze the risk factors, we examined the following, for the LTP: (1) tumor diameter, (2) contact with vessels, (3) degree of approximation to hepatic hilum, (4) contact with hepatic capsule, (5) presence of ablative safety margin, (6) degree of benign periablational enhancement and (7) serum alpha-fetoprotein; for the IDR: (1) severity of hepatic disease, (2) presence of HBsAg, (3) serum alpha-fetoprotein, (4) whether RF ablation was the initial treatment and (5) multiplicity of tumor for IDR. Results: The incidence of overall recurrence, LTP and IDR was 62.9%, 26.4% and 53.2%, respectively. The cumulative disease-free survival rates were 52%, 82% and 56% at 1 year, 26%, 63% and 30% at 2 years, respectively. Univariate analysis showed that the significant risk factors for LTP were: a tumor with a diameter >3 cm, contact of HCC with a vessel and an insufficient safety margin (p 3 cm and insufficient safety margin were independent factors. Only the increased serum alpha-fetoprotein was a significant risk factor for IDR (p 3 cm) with high serum alpha-fetoprotein should be treated more aggressively because of higher risk for recurrence

  4. Ultrasound-guided percutaneous radiofrequency ablation of liver tumors: How we do it safety and completely

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woong; Shin, Sang Soo; Heo, Suk Hee; Hong, Jun Hyung; Lim, Hyo Soon; Seon, Hyun Ju; Hur, Young Hoe; Park, Chang Hwan; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2015-12-15

    Ultrasound-guided percutaneous radiofrequency (RF) ablation has become one of the most promising local cancer therapies for both resectable and nonresectable hepatic tumors. Although RF ablation is a safe and effective technique for the treatment of liver tumors, the outcome of treatment can be closely related to the location and shape of the tumors. There may be difficulties with RF ablation of tumors that are adjacent to large vessels or extrahepatic heat-vulnerable organs and tumors in the caudate lobe, possibly resulting in major complications or treatment failure. Thus, a number of strategies have been developed to overcome these challenges, which include artificial ascites, needle track ablation, fusion imaging guidance, parallel targeting, bypass targeting, etc. Operators need to use the right strategy in the right situation to avoid the possibility of complications and incomplete thermal tissue destruction; with the right strategy, RF ablation can be performed successfully, even for hepatic tumors in high-risk locations. This article offers technical strategies that can be used to effectively perform RF ablation as well as to minimize possible complications related to the procedure with representative cases and schematic illustrations.

  5. Percutaneous radiofrequency ablation of osteoid osteomas. Technique and results; Perkutane Radiofrequenzablation von Osteoidosteomen. Technik und Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Bruners, P.; Penzkofer, T. [Lehrstuhl fuer Angewandte Medizintechnik, Helmholtz Inst. fuer Biomedizinische Technik, RWTH Aachen (Germany); Guenther, R. W.; Mahnken, A. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum RWTH Aachen (Germany)

    2009-08-15

    Purpose: Osteoid osteoma is a benign primary bone tumor that typically occurs in children and young adults. Besides local pain, which is often worse at night, prompt relief due to medication with acetylsalicylic acid (ASS) is characteristic for this bone lesion. Because long-term medication with ASS does not represent an alternative treatment strategy due to its potentially severe side effects, different minimally invasive image-guided techniques for the therapy of osteoid osteoma have been developed. In this context radiofrequency (RF) ablation in particular has become part of the clinical routine. The technique and results of image-guided RF ablation are compared to alternative treatment strategies. Materials and Methods: Using this technique, an often needle-shaped RF applicator is percutaneously placed into the tumor under image guidance. Then a high-frequency alternating current is applied by the tip of the applicator which leads to ionic motion within the tissue resulting in local heat development and thus in thermal destruction of the surrounding tissue including the tumor. Results: The published primary and secondary success rates of this technique are 87 and 83%, respectively. Surgical resection and open curettage show comparable success rates but are associated with higher complication rates. In addition image-guided RF ablation of osteoid osteomas is associated with low costs. (orig.)

  6. Percutaneous radiofrequency ablation: relationship between different probe types and procedure time on length and extent of osteonecrosis in dog long bones

    Energy Technology Data Exchange (ETDEWEB)

    Martel, J.; Bueno, A. [Fundacion Hospital Alcorcon, Departamento de Diagnostico por Imagen, Alcorcon, Madrid (Spain); Dominguez, M.P. [Fundacion Hospital Alcorcon, Departamento de Patologia, Alcorcon, Madrid (Spain); Llorens, P.; Quiros, J.; Delgado, C. [Universidad Complutense, Facultad de Veterinaria, Madrid (Spain)

    2008-02-15

    We have been using radiofrequency ablation for the percutaneous treatment of osteoid osteoma since 2001. Frequently, lesions are located near the joint surface, involve the vertebral body or are close to major nerves. We seek to determine whether radiofrequency ablation (RFA) can be used safely in these cases. A total of 65 lesions were induced in 4 dogs. Each dog underwent RFA on the diaphysis of long bones, as well as femoral and humeral heads. Four different sessions were carried out by using 1- and 2-cm probes with or without a cool-tip system and by varying the timing of the procedure. Plain film, CT, and MRI were obtained. All bone samples were examined histologically. The dogs' activity after the procedure was normal. No pathologic fractures occurred despite unrestricted activity of the animals. Cortical bone was always respected; therefore, articular cartilage has not been damaged. Radiological findings were characteristic. There were no significant differences in lesion size, probe type, and the duration of the procedure. The mean lesion diameter perpendicular to the electrode was 18.5 mm. Our study confirms the insulative effect of cortical bone. RFA can be safely performed close to the joint surface without damaging the cartilage. (orig.)

  7. Percutaneous radiofrequency ablation (RFA) or robotic radiosurgery (RRS) for salvage treatment of colorectal liver metastases

    Energy Technology Data Exchange (ETDEWEB)

    Stintzing, Sebastian; Hendrich, Saskia; Heinemann, Volker [Dept. of Medical Oncology and Comprehensive Cancer Center, Klinikum Grosshadern, LMU, Munich (Germany)], E-mail: sebastian.stintzing@med.uni-muenchen.de; Grothe, Alexander; Trumm, Christoph G. [Dept. of Clinical Radiology, Univ. Hospital Grosshadern, LMU Munich, Munich (Germany); Hoffmann, Ralf-Thorsten [Dept. and Policlinics of Diagnostic Radiology, Universitaetsklinikum Carl Gustav Carus Dresden (Germany); Rentsch, Markus [Dept. of Surgery, Univ. Hospital Grosshadern, LMU Munich, Munich (Germany); Fuerweger, Christoph; Muacevic, Alexander [European Cyberknife Center Munich, Munich (Germany)

    2013-06-15

    Background. Stereotactic radiation therapy is an evolving modality to treat otherwise unresectable liver metastases. In this analysis, two local therapies: 1) single session robotic radiosurgery (RRS) and 2) percutaneous radiofrequency ablation (RFA) were compared in a total of 60 heavily pretreated colorectal cancer patients. Methods. Thirty patients with a total of 35 colorectal liver metastases not qualifying for surgery that were treated in curative intent with RRS were prospectively followed. To compare efficacy of both treatment modalities, patients treated with RFA during the same period of time were matched according to number and size of the treated lesions. Local tumor control, local disease free survival (DFS), and freedom from distant recurrence (FFDR) were analyzed for effi cacy. Treatment-related side effects were recorded for comparison. Results. The median diameter of the treated lesions was 33 mm (7-53 mm). Baseline characteristics did not differ significantly between the groups. One- and two-year local control rates showed no signifi cant difference but favored RRS (85% vs. 65% and 80% vs. 61%, respectively). A signifi cantly longer local DFS of patients treated with RRS compared to RFA (34.4 months vs. 6.0 months; p 0.001) was found. Both, median FFDR (11.4 months for RRS vs. 7.1 months for RFA p=0.25) and the recurrence rate (67% for RRS and 63% for RFA, p>0.99) were comparable. Conclusion. Single session RRS is a safe and effective method to treat colorectal liver metastases. In this analysis, a trend towards longer DFS was seen in patients treated with RRS when compared to RFA.

  8. Percutaneous Radiofrequency Ablation with Multiple Electrodes for Medium-Sized Hepatocellular Carcinomas

    Science.gov (United States)

    Lee, Jung; Yoon, Jung-Hwan; Lee, Jae Young; Kim, Se Hyung; Lee, Jeong Eun; Han, Joon Koo; Choi, Byung Ihn

    2012-01-01

    Objective To prospectively evaluate the safety and short-term therapeutic efficacy of switching monopolar radiofrequency ablation (RFA) with multiple electrodes to treat medium-sized (3.1-5.0 cm), hepatocellular carcinomas (HCC). Materials and Methods In this prospective study, 30 patients with single medium-sized HCCs (mean, 3.5 cm; range, 3.1-4.4 cm) were enrolled. The patients were treated under ultrasonographic guidance by percutaneous switching monopolar RFA with a multichannel RF generator and two or three internally cooled electrodes. Contrast-enhanced CT scans were obtained immediately after RFA, and the diameters and volume of the ablation zones were then measured. Follow-up CT scans were performed at the first month after ablation and every three months thereafter. Technical effectiveness, local progression and remote recurrence of HCCs were determined. Results There were no major immediate or periprocedural complications. However, there was one bile duct stricture during the follow-up period. Technical effectiveness was achieved in 29 of 30 patients (97%). The total ablation time of the procedures was 25.4 ± 8.9 minutes. The mean ablation volume was 73.8 ± 56.4 cm3 and the minimum diameter was 4.1 ± 7.3 cm. During the follow-up period (mean, 12.5 months), local tumor progression occurred in three of 29 patients (10%) with technical effectiveness, while new HCCs were detected in six of 29 patients (21%). Conclusion Switching monopolar RFA with multiple electrodes in order to achieve a sufficient ablation volume is safe and efficient. This method also showed relatively successful therapeutic effectiveness on short-term follow up for the treatment of medium-sized HCCs. PMID:22247634

  9. CT-guided percutaneous radiofrequency ablation of osteoid osteoma: Our experience in 87 patients

    Directory of Open Access Journals (Sweden)

    Anurag Chahal

    2017-01-01

    Full Text Available Purpose: To evaluate the technical and clinical success of radiofrequency ablation of osteoid osteoma and analyze the factors responsible for clinical success. We also tried to investigate the role of follow-up computed tomography (CT imaging. Materials and Methods: This is a prospective study approved by the institute's ethics committee involving 87 patients with appendicular osteoid osteoma. CT-guided radio frequency ablation was performed using a bipolar ablation system. Patients were followed up over 15.4 (4–24 months for pain, and clinical success/failure was determined using established criteria. Patients with clinical failure were taken for repeat ablation. Follow-up CT was obtained at 6 months and correlated with clinical success. Procedural scans were later reviewed for technical success in a blinded manner and correlated with clinical success along with other imaging and patient characteristics. Results: Mean pre-procedure visual analog scale (VAS score was 7.0 ± 0.8. Primary success rate after single session was 86.2%(75/87 patients, and overall success rate after one/two sessions was 96.6%(84/87. No major complications were noted. Technical success rate was 89.7%(78/87. All 9 patients who had a suboptimal needle positioning had recurrence where as three patients had recurrence despite technical success. None of the imaging characteristics or history of prior intervention was significantly associated with clinical success. Follow-up CT showed advanced bone healing in 48 lesions, and was confined to the treatment success group. Alternately, minimal/absent bone healing was seen in all (12 patients of primary treatment failure and 27 patients with treatment success. Conclusions: CT-guided percutaneous radio frequency ablation is a safe and highly effective treatment for osteoid osteomas even in recurrent and residual cases. Technical success is the most important parameter affecting the outcome. Post radio frequency ablation CT

  10. Percutaneous radiofrequency ablation for a recurrent metastasis after resection of liver metastases from an ileal clear-cell sarcoma: Long-term local tumor control.

    Science.gov (United States)

    Seo, Jung Wook

    2017-12-01

    Clear-cell sarcomas (CCSs) in the gastrointestinal tract are extremely rare and aggressive tumors. We present the first case of a CCS arising in the ileum and metastasizing to the liver; our patient was a 60-year-old man. After the resection of the CCS and the liver metastases, a new liver metastasis developed, which was treated via percutaneous radiofrequency ablation only. At the 5-year follow-up, the ablated region was stable without local tumor progression. Percutaneous radiofrequency ablation is a viable local treatment option for recurrent metastases from an ileal CCS if they are detected when small and at an early stage in follow-up studies.

  11. The prevention and treatment of biliary complications occurred after CT-guided percutaneous radiofrequency ablation for hepatic neoplasms

    International Nuclear Information System (INIS)

    Li Jianjun; Zheng Jiasheng; Cui Xiongwei; Cui Shichang; Sun Bin

    2011-01-01

    Objective: To discuss the prevention and treatment of biliary complications occurred after CT-guided percutaneous radiofrequency ablation (RFA) for hepatic neoplasms. Methods: A total of 1136 patients, including 920 males and 216 females, with hepatic neoplasms were enrolled in this study. The hepatic tumors consisted of primary hepatocellular carcinoma (n=1037), hepatic metastasis (n=83) and hepatic cavernous hemangioma (n=16). The diameters of the tumors ranged from 0.5 to 16 cm. A total of 1944 RFA procedures were carried out in all patients. Results: Thirty-five patients developed biliary complication (35/1944, 1.80%). Twelve patients developed asymptomatic bile duct dilatation and no special treatment was given. Obstructive jaundice occurred in two patients and percutaneous transhepatic cholangiocholecystic drainage (PTCD) together with subsequent inner stent implantation had to be carried out. Eighteen patients developed biloma, and liver abscess formation secondary to biloma infection occurred in seven of them. Percutaneous transhepatic biloma drainage (PTBD) was adopted in all these patients. One patient suffered from obstructive jaundice complicated by biloma, and both PTCD and PTBD combined with inner stent implantation were simultaneously performed. One patient had the biloma secondary to obstructive jaundice, and PTCD followed by PTBD was conducted in turn. One patient developed obstructive jaundice secondary to biloma, and PTBD followed by PTCD was employed in turn. Conclusion: Obstructive jaundice and biloma are severe biliary complications occurred after CT-guided percutaneous radiofrequency ablation for hepatic tumors, and PTCD and/or PTBD should be carried out without delay to treat these complications. The clinical symptoms can be relieved, or even completely disappear, after treatment. (authors)

  12. Various complications of percutaneous radiofrequency ablation for hepatic tumors: radiologic findings and technical tips.

    Science.gov (United States)

    Kwon, Heon-Ju; Kim, Pyo Nyun; Byun, Jae Ho; Kim, Kyoung Won; Won, Hyung Jin; Shin, Yong Moon; Lee, Moon-Gyu

    2014-11-01

    Radiofrequency ablation is a safe and effective treatment for primary and secondary liver malignancies and has a low complication rate; however, there are various radiofrequency ablation-related complications which can occur from the thorax to the pelvis. Although most of these complications are usually minor and self-limited, they may become fatal if diagnosis and treatment are delayed. It is important for radiologists performing radiofrequency ablation to have a perspective regarding the possible radiofrequency ablation-related complications and their risk factors as well as the radiologic findings for their timely detection and increase of the treatment efficacy, and thereby encouraging the use of the radiofrequency ablation technique. This article illustrates the various imaging features of common and rare radiofrequency ablation-related complications as well as offers technical tips in order to avoid these complications. © The Foundation Acta Radiologica 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. Percutaneous radiofrequency ablation of lung metastases from colorectal carcinoma under C-arm cone beam CT guidance.

    Science.gov (United States)

    Amouyal, G; Pernot, S; Déan, C; Cholley, B; Scotté, F; Sapoval, M; Pellerin, O

    2017-11-01

    The aim of this study was to assess the feasibility, safety and efficacy of percutaneous radiofrequency ablation of lung metastases from colorectal carcinoma using C-arm cone beam computed tomography (CBCT) guidance. This single-center prospective observational study was performed from August 2013 to August 2016, and included consecutive patients referred for radiofrequency ablation of lung metastases from colorectal cancer. Radiofrequency ablation procedures were performed under C-arm CBCT guidance. Feasibility was assessed by probe accuracy placement, time to accurate placement and number of C-arm CBCT acquisitions to reach the target lesion. Safety was assessed by the report of adverse event graded using the common terminology criteria for adverse events (CTCAE-V4.0). Efficacy was assessed by metastases response rate using RECIST 1.1 and 18 FDG-PET-CT tumor uptake at 6months. Fifty-four consecutive patients (32 men, 22 women) with a mean age of 63±8 (SD) years (range: 51-81years) with a total of 56 lung metastasis from colorectal metastases were treated in a single session. The mean tumor diameter was 25.6±4.5 (SD)mm (range: 17-31mm). Median time to insert the needle into the target lesion was 10min (range: 5-25min). Median number of needles repositioning and C-arm CBCT acquisition per patient was 1 (range: 0-3) and 4 (range: 3-6) respectively. The accuracy for radiofrequency ablation probe placement was 2±0.2 (SD)mm (range: 0-9mm). Pneumothorax requiring chest tube placement occurred in one patient (CTCAE-V4.0 grade 3). At 6months, all patients were alive with tumor response rate of -27% and had no significant activity on the 18 FDG-PET CT follow-up. Percutaneous radiofrequency ablation of lung metastases from colorectal cancer under C-arm CBCT guidance is feasible and safe, with immediate and short-term results similar to those obtained using conventional CT guidance. Copyright © 2017 Éditions françaises de radiologie. Published by Elsevier Masson SAS

  14. Role of percutaneous ultrasonographic guided radiofrequency ablation in the management of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Mohamed Ahmed Youssef

    2014-06-01

    Conclusion: Radiofrequency thermal ablation is a simple, effective and less expensive technique with a low morbidity compared with surgical treatment. Radiofrequency thermal ablation can produce significant long-term survival rates and excellent local control for cirrhotic patients with early stage, unresectable HCC.

  15. Diagnostic Ability of Percutaneous Needle Biopsy Immediately After Radiofrequency Ablation for Malignant Lung Tumors: An Initial Experience

    International Nuclear Information System (INIS)

    Hasegawa, Takaaki; Kondo, Chiaki; Sato, Yozo; Inaba, Yoshitaka; Yamaura, Hidekazu; Kato, Mina; Murata, Shinichi; Onoda, Yui; Kuroda, Hiroaki; Sakao, Yukinori; Yatabe, Yasushi

    2016-01-01

    PurposeTo evaluate the safety and diagnostic ability of percutaneous needle biopsy performed immediately after lung radiofrequency ablation (RFA).Materials and MethodsFrom May 2013 to April 2014, percutaneous needle biopsy was performed immediately after RFA for 3 patients (2 men and 1 woman, aged 57–76 years) who had lung tumors measuring 1.3–2.6 cm in diameter. All patients had prior history of malignancy, and all tumors were radiologically diagnosed as malignant. Obtained specimens were pathologically classified using standard hematoxylin and eosin staining.ResultsWe completed three planned sessions of RFA followed by percutaneous needle biopsy, all of which obtained tumor tissue that could be pathologically diagnosed. Two tumors were metastatic from renal clear cell carcinoma and rectal adenocarcinoma, respectively; one tumor was primary lung adenocarcinoma. There was no death or major complication related to the procedures. Although pneumothorax occurred in two patients, these resolved without the need for aspiration or chest tube placement. Tumor seeding was not observed, but 21 months after the procedure, one case developed local tumor progression that was treated by additional RFA.ConclusionPathologic diagnosis was possible by needle biopsy immediately after RFA for lung tumors. This technique may reduce the risks and efforts of performing biopsy and RFA on separate occasions.

  16. Diagnostic Ability of Percutaneous Needle Biopsy Immediately After Radiofrequency Ablation for Malignant Lung Tumors: An Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Takaaki, E-mail: t-hasegawa@aichi-cc.jp [Aichi Cancer Center Hospital, Department of Diagnostic and Interventional Radiology (Japan); Kondo, Chiaki [Aichi Cancer Center Hospital, Department of Pathology and Molecular Diagnosis (Japan); Sato, Yozo; Inaba, Yoshitaka; Yamaura, Hidekazu; Kato, Mina; Murata, Shinichi; Onoda, Yui [Aichi Cancer Center Hospital, Department of Diagnostic and Interventional Radiology (Japan); Kuroda, Hiroaki; Sakao, Yukinori [Aichi Cancer Center Hospital, Department of Thoracic Surgery (Japan); Yatabe, Yasushi [Aichi Cancer Center Hospital, Department of Pathology and Molecular Diagnosis (Japan)

    2016-08-15

    PurposeTo evaluate the safety and diagnostic ability of percutaneous needle biopsy performed immediately after lung radiofrequency ablation (RFA).Materials and MethodsFrom May 2013 to April 2014, percutaneous needle biopsy was performed immediately after RFA for 3 patients (2 men and 1 woman, aged 57–76 years) who had lung tumors measuring 1.3–2.6 cm in diameter. All patients had prior history of malignancy, and all tumors were radiologically diagnosed as malignant. Obtained specimens were pathologically classified using standard hematoxylin and eosin staining.ResultsWe completed three planned sessions of RFA followed by percutaneous needle biopsy, all of which obtained tumor tissue that could be pathologically diagnosed. Two tumors were metastatic from renal clear cell carcinoma and rectal adenocarcinoma, respectively; one tumor was primary lung adenocarcinoma. There was no death or major complication related to the procedures. Although pneumothorax occurred in two patients, these resolved without the need for aspiration or chest tube placement. Tumor seeding was not observed, but 21 months after the procedure, one case developed local tumor progression that was treated by additional RFA.ConclusionPathologic diagnosis was possible by needle biopsy immediately after RFA for lung tumors. This technique may reduce the risks and efforts of performing biopsy and RFA on separate occasions.

  17. Comparison of quality of life between men and women who underwent Transforaminal Percutaneous Endoscopic Discectomy for lumbar disc herniation.

    Science.gov (United States)

    Kapetanakis, Stylianos; Gkasdaris, Grigorios; Thomaidis, Tryfon; Charitoudis, Georgios; Kazakos, Konstantinos

    2017-01-01

    Studies describing the efficacy of TPED on shortness of recovery and improvement of postoperative quality of life are limited, especially regarding gender something that has never been reported before in the literature. The purpose of this study is to evaluate possible differences of the health-related quality of life in patients who underwent TPED for LDH in accordance with sex. Seventy-six patients diagnosed and treated with TPED for LDH with 1 year follow-up were selected and divided into two groups of equal number depending on sex. Their quality of life was evaluated by using the SF-36 before the operation, six weeks, three, six and twelve months postoperatively. A statistical analysis was conducted, in order to compare the 8 scaled scores of the SF-36 combining each time two chronological phases in the total of patients, in each group and between groups. Fifty-two (68.4%) patients were ≤63 years old, while the rest 24 (31,4%) were >63 years old (mean ±SD = 56,5 ±12,1 years). Apart from the PF domain, the scores were higher in every visit for the two groups, but the change between groups was not significant. Women had a significantly higher increase of PF score in 3 months after TPED and in the interval 6 weeks-3 months comparing with men. However, in the intervals 3 months-6 months and 3 months-12 months men presented significantly higher increase compared to women. Statistically significant improvement of the quality of life for both men and women was observed. Generally, there was no significant difference between the two groups. As regards to the physical functioning, it appears to be a significant difference which is counterpoised over time. 2. TPED for LDH does not present major differences in the improvement of quality of life regarding gender.

  18. Percutaneous Renal Tumor Ablation: Radiation Exposure During Cryoablation and Radiofrequency Ablation

    Energy Technology Data Exchange (ETDEWEB)

    McEachen, James C., E-mail: james.mceachen2@gmail.com [Mayo Clinic, Division of Preventive, Occupational, and Aerospace Medicine (United States); Leng, Shuai; Atwell, Thomas D. [Mayo Clinic, Department of Radiology (United States); Tollefson, Matthew K. [Mayo Clinic, Department of Urology (United States); Friese, Jeremy L. [Mayo Clinic, Department of Radiology (United States); Wang, Zhen; Murad, M. Hassan [Mayo Clinic, Division of Preventive, Occupational, and Aerospace Medicine (United States); Schmit, Grant D. [Mayo Clinic, Department of Radiology (United States)

    2016-02-15

    IntroductionOnce reserved solely for non-surgical cases, percutaneous ablation is becoming an increasingly popular treatment option for a wider array of patients with small renal masses and the radiation risk needs to be better defined as this transition continues.Materials and MethodsRetrospective review of our renal tumor ablation database revealed 425 patients who underwent percutaneous ablation for treatment of 455 renal tumors over a 5-year time period. Imparted radiation dose information was reviewed for each procedure and converted to effective patient dose and skin dose using established techniques. Statistical analysis was performed with each ablative technique.ResultsFor the 331 cryoablation procedures, the mean DLP was 6987 mGycm (SD = 2861) resulting in a mean effective dose of 104.7 mSv (SD = 43.5) and the mean CTDI{sub vol} was 558 mGy (SD = 439) resulting in a mean skin dose of 563.2 mGy (SD = 344.1). For the 124 RFA procedures, the mean DLP was 3485 mGycm (SD = 1630) resulting in a mean effective dose of 50.3 mSv (SD = 24.0) and the mean CTDI{sub vol} was 232 mGy (SD = 149) resulting in a mean skin dose of 233.2 mGy (SD = 117.4). The difference in patient radiation exposure between the two renal ablation techniques was statistically significant (p < 0.001).ConclusionBoth cryoablation and RFA imparted an average skin dose that was well below the 2 Gy deterministic threshold for appreciable sequela. Renal tumor cryoablation resulted in a mean skin and effective radiation dose more than twice that for RFA. The radiation exposure for both renal tumor ablation techniques was at the high end of the medical imaging radiation dose spectrum.

  19. Pretreatment Evaluation with Contrast-Enhanced Ultrasonography for Percutaneous Radiofrequency Ablation of Hepatocellular Carcinomas with Poor Conspicuity on Conventional Ultrasonography

    International Nuclear Information System (INIS)

    Kim, Ah Yeong; Lee, Min Woo; Rhim, Hyunchul; Cha, Dong Ik; Choi, Dongil; Kim, Young-sun; Lim, Hyo Keun; Cho, Seong Whi

    2013-01-01

    To determine whether pretreatment evaluation with contrast-enhanced ultrasonography (CEUS) is effective for percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) with poor conspicuity on conventional ultrasonography (US). This retrospective study was approved by the institutional review board and informed consent was waived. From June 2008 to July 2011, 82 patients having HCCs (1.2 ± 0.4 cm) with poor conspicuity on planning US for RFA were evaluated with CEUS prior to percutaneous RFA. We analyzed our database, radiologic reports, and US images in order to determine whether the location of HCC candidates on planning US coincide with that on CEUS. To avoid incomplete ablation, percutaneous RFA was performed only when HCC nodules were identified on CEUS. The rate of technical success was assessed. The cumulative rate of local tumor progression was estimated with the use of the Kaplan-Meier method (mean follow-up: 24.0 ± 13.0 months). Among 82 patients, 73 (89%) HCCs were identified on CEUS, whereas 9 (11%) were not. Of 73 identifiable HCCs on CEUS, the location of HCC on planning US corresponded with that on CEUS in 64 (87.7%), whereas the location did not correspond in 9 (12.3%) HCCs. Technical success was achieved for all 73 identifiable HCCs on CEUS in a single (n = 72) or two (n = 1) RFA sessions. Cumulative rates of local tumor progression were estimated as 1.9% and 15.4% at 1 and 3 years, respectively. Pretreatment evaluation with CEUS is effective for percutaneous RFA of HCCs with poor conspicuity on conventional US

  20. A New Risk Factor Profile for Contrast-Induced Acute Kidney Injury in Patients Who Underwent an Emergency Percutaneous Coronary Intervention.

    Science.gov (United States)

    Yuan, Ying; Qiu, Hong; Song, Lei; Hu, Xiaoying; Luo, Tong; Zhao, Xueyan; Zhang, Jun; Wu, Yuan; Qiao, Shubin; Yang, Yuejin; Gao, Runlin

    2017-01-01

    We developed a new risk factor profile for contrast-induced acute kidney injury (CI-AKI) under a new definition in patients who underwent an emergency percutaneous coronary intervention (PCI). Consecutive patients (n = 1061) who underwent an emergency PCI were divided into a derivation group (n = 761) and a validation group (n = 300). The rates of CI-AKI were 23.5% (definition 1: serum creatinine [SCr] increase ≥25% in 72 hours), 4.3% (definition 2: SCr increase ≥44.2 μmol/L in 72 hours), and 7.0% (definition 3: SCr increase ≥44.2 μmol/L in 7 days). Due to the high sensitivity of definition 1 and the high rate of missed cases for late diagnosis of CI-AKI under definition 2, definition 3 was used in the study. The risk factor profile included body surface area 15.00 × 10 9 /L ( P = .047), estimated glomerular filtration rate 133 μmol/L ( P = .007), intra-aortic balloon pump application ( P = .006), and diuretics administration ( P < .001), showing a significant predictive power in the derivation group and validation group. The new risk factor profile of CI-AKI under a new CI-AKI definition in emergency PCI patients is easily applicable with a useful predictive value.

  1. Impact of high-density lipoprotein 3 cholesterol subfraction on periprocedural myocardial injury in patients who underwent elective percutaneous coronary intervention.

    Science.gov (United States)

    Harada, Kazuhiro; Kikuchi, Ryosuke; Suzuki, Susumu; Tanaka, Akihito; Aoki, Toshijiro; Iwakawa, Naoki; Kojima, Hiroki; Hirayama, Kenshi; Mitsuda, Takayuki; Sumi, Takuya; Negishi, Yosuke; Ishii, Hideki; Murohara, Toyoaki

    2018-02-02

    Periprocedural myocardial injury (PMI) is a major complication of percutaneous coronary intervention (PCI) and is associated with atherosclerotic coronary plaque and worse clinical outcomes. High-density lipoprotein cholesterol (HDL-C) is a protective factor for cardiovascular disease. However, the role of HDL-C subfractions, such as HDL2 cholesterol (HDL2-C) or HDL3 cholesterol (HDL3-C), in cardiovascular disease remains unclear. The purpose of the study was to investigate the relationship between HDL2-C and HDL3-C subfractions and the incidence of PMI in patients who underwent elective PCI. We enrolled 129 patients who underwent elective PCI for stable angina pectoris. PMI was defined as an increase in high-sensitivity troponin T levels > 5 times the upper normal limit (> 0.070 ng/mL) at 24 h after PCI. Serum HDL-C subfractions (HDL2-C and HDL3-C) were assessed using ultracentrifugation in patients with and those without PMI. HDL3-C levels were significantly lower in patients with PMI than in those without (15.1 ± 3.0 mg/dL vs. 16.4 ± 2.9 mg/dL, p = 0.016) and had an independent and inverse association with PMI (odds ratio, 0.86; 95% confidence interval, 0.74-0.99; p = 0.038). When divided by the cut-off value of HDL3-C for PMI (14.3 mg/dL), the incidence of PMI was significantly higher in low HDL3-C patients than in high HDL3-C patients (51.2% vs. 30.2%, p = 0.020). HDL3-C was an independent inverse predictor of PMI in patients who underwent elective PCI.

  2. Percutaneous bipolar radiofrequency thermocoagulation for the treatment of lumbar disc herniation.

    Science.gov (United States)

    Zeng, Zhenhua; Yan, Min; Dai, Yi; Qiu, Weidong; Deng, Shuo; Gu, Xinzhu

    2016-08-01

    Lumbar disc herniation is usually managed with conservative treatment or surgery. However, conservative therapy seldom yields good results, and surgery is associated with multiple complications. This study aimed to assess bipolar radiofrequency thermocoagulation for the treatment of lumbar disc herniation. A total of 168 patients with lumbar disc herniation suitable for radiofrequency thermocoagulation were enrolled and randomized to monopolar radiofrequency thermocoagulation (control group, n=84) or bipolar radiofrequency thermocoagulation (experimental group, n=84) treatment groups. Ablation sites were targeted under CT scan guidance, and consecutive radiofrequency therapy was used. One and two probes were used for monopolar and bipolar thermocoagulation, respectively. Thermocoagulation was achieved at 50°C, 60°C, and 70°C for 60s each, 80°C for 90s, and 92°C for 100s. Symptoms and complications were evaluated using the modified Macnab criteria and Visual Analog Scale at 7, 30, and 180days postoperatively. At 180days, a significantly higher efficacy rate was obtained in the experimental group compared with control patients (91.6% versus 79.7%, Pdisc herniation treatment, and should be further explored for broad clinical application. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Percutaneous dual-switching monopolar radiofrequency ablation using a separable clustered electrode: A preliminary study

    International Nuclear Information System (INIS)

    Choi, Tae Won; Lee, Jeong Min; Lee, Dong Ho; Lee, Jeong Hoon; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung Hwan; Han, Joon Koo

    2017-01-01

    To prospectively evaluate the safety and therapeutic effectiveness of dual-switching monopolar (DSM) radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC), and to retrospectively compare the results with those of single-switching monopolar (SSM) RFA in a historical control group. This study was approved by the Institutional Review Board, with informed consent obtained from all patients. Fifty-two HCC patients who underwent DSM-RFA using a separable clustered electrode and dual-generators were prospectively enrolled. Technical parameters, complications, technical success, technical effectiveness, and local tumor progression (LTP) rates were evaluated by means of post-procedural and follow-up imaging. Thereafter, the outcome of DSM-RFA was compared with those of 249 retrospectively included HCC patients treated with SSM-RFA.There were two major complications (3.8%, 2/52) including pleural and pericardial effusion in the DSM-RFA group. The DSM-RFA yielded a 100% technical success rate, a 98.1% technical effectiveness rate, and a 4.3% 2-year LTP rate. In a retrospective comparison between the two groups, DSM-RFA created significantly larger ablation volume (4.20 ± 2.07 cm 3 /min vs. 3.03 ± 1.99 cm 3 /min, p < 0.01), and delivered higher energy (1.43 ± 0.37 kcal/min vs. 1.25 ± 0.50 kcal/min, p < 0.01) per given time, than SSM-RFA. There was no significant difference in major procedure-related complications (3.8% vs. 4.4%) and technical effectiveness rate (98.1% vs. 96.4%) between the two groups (p = 1.00). In addition, the 2-year LTP rate of DSM-RFA and SSM-RFA were 4.3% and 10.1%, respectively (p = 0.15). DSM-RFA using a separable clustered electrode is safe and provides high local tumor control and good preliminary clinical outcome for small HCCs, which are at least comparable to those of SSM-RFA

  4. Percutaneous dual-switching monopolar radiofrequency ablation using a separable clustered electrode: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Tae Won; Lee, Jeong Min; Lee, Dong Ho; Lee, Jeong Hoon; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung Hwan; Han, Joon Koo [Seoul National University Hospital, Seoul (Korea, Republic of)

    2017-09-15

    To prospectively evaluate the safety and therapeutic effectiveness of dual-switching monopolar (DSM) radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC), and to retrospectively compare the results with those of single-switching monopolar (SSM) RFA in a historical control group. This study was approved by the Institutional Review Board, with informed consent obtained from all patients. Fifty-two HCC patients who underwent DSM-RFA using a separable clustered electrode and dual-generators were prospectively enrolled. Technical parameters, complications, technical success, technical effectiveness, and local tumor progression (LTP) rates were evaluated by means of post-procedural and follow-up imaging. Thereafter, the outcome of DSM-RFA was compared with those of 249 retrospectively included HCC patients treated with SSM-RFA.There were two major complications (3.8%, 2/52) including pleural and pericardial effusion in the DSM-RFA group. The DSM-RFA yielded a 100% technical success rate, a 98.1% technical effectiveness rate, and a 4.3% 2-year LTP rate. In a retrospective comparison between the two groups, DSM-RFA created significantly larger ablation volume (4.20 ± 2.07 cm{sup 3}/min vs. 3.03 ± 1.99 cm{sup 3}/min, p < 0.01), and delivered higher energy (1.43 ± 0.37 kcal/min vs. 1.25 ± 0.50 kcal/min, p < 0.01) per given time, than SSM-RFA. There was no significant difference in major procedure-related complications (3.8% vs. 4.4%) and technical effectiveness rate (98.1% vs. 96.4%) between the two groups (p = 1.00). In addition, the 2-year LTP rate of DSM-RFA and SSM-RFA were 4.3% and 10.1%, respectively (p = 0.15). DSM-RFA using a separable clustered electrode is safe and provides high local tumor control and good preliminary clinical outcome for small HCCs, which are at least comparable to those of SSM-RFA.

  5. Renal cell carcinoma metastasis involving vertebral hemangioma: dual percutaneous treatment by navigational bipolar radiofrequency ablation and high viscosity cement vertebroplasty.

    Science.gov (United States)

    Zerlauth, Jean-Baptiste; Meuli, Reto; Dunet, Vincent

    2017-09-01

    The case of a 70-year-old woman with progressive renal cell carcinoma (RCC) metastatic invasion of a L3 vertebral hemangioma treated by dual percutaneous radiofrequency ablation (RFA) and vertebroplasty is reported. The patient was surgically treated for RCC in 2001. Chemotherapy and immunotherapy were introduced in 2013 for ovarian, bladder and cerebral metastatic disease. An asymptomatic L3 benign hemangioma was noticed at this time. One-year CT and MRI follow-up studies demonstrated a nodular isolated soft tissue lesion involving the anterior edge of the hemangioma. Percutaneous treatment consisted of a L3 vertebral body unipedicular approach to perform a biopsy, RFA with a navigational bipolar RFA device and vertebroplasty using high viscosity cement. Histopathological examination confirmed metastasis of RCC. The 5-month spinal MRI and CT examinations demonstrated complete disappearance of the tumor. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Acute myocardial infarction in progressively elderly patients. A comparative analysis of immediate results in patients who underwent primary percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Mattos

    2001-01-01

    Full Text Available OBJECTIVE: Analysis of the in-hospital results, in progressively elderly patients who undergo primary percutaneous coronary intervention (PCI in the first 24 hours of AMI. METHODS: The patients were divided into three different age groups (60/69, 70/79, and > or = 80 years and were treated from 7/95 until 12/99. The primary success rate and the occurrence of major clinical events were analyzed at the end of the in-hospital phase. Coronary stent implantation and abciximab use were employed at the intervencionist discretion. RESULTS: We analyzed 201 patients with age ranging from 60 to 93 years, who underwent primary PCI. Patients with ages above 70 were more often female (p=.015. Those with ages above 80 were treated later with PCI (p=.054, and all of them presented with total occlusion of the infarct-related artery. Coronary stents were implanted in 30% of the patients. Procedural success was lower in > or = 80 year old patients (p=.022, and the death rate was higher in > or = 70 years olds (p=.019. Reinfarction and coronary bypass surgery were uncommon events. A trend occurred toward a higher combined incidence of major in-hospital events according to increased age (p=.064. CONCLUSION: Elderly patients ( > or = 70 years presented with adverse clinical and angiographic profiles and patients > or = 80 years of age obtained reduced TIMI 3 flow success rates after primary PTCA, and those > or = 70 years had a higher death rate.

  7. Acute myocardial infarction in progressively elderly patients. A comparative analysis of immediate results in patients who underwent primary percutaneous coronary intervention.

    Science.gov (United States)

    Mattos, L A; Zago, A; Chaves, A; Pinto, I; Tanajura, L; Staico, R; Centemero, M; Feres, F; Maldonado, G; Cano, M; Abizaid, A; Abizaid, A; Sousa, A G; Sousa, J E

    2001-01-01

    Analysis of the in-hospital results, in progressively elderly patients who undergo primary percutaneous coronary intervention (PCI) in the first 24 hours of AMI. The patients were divided into three different age groups (60/69, 70/79, and > or =80 years) and were treated from 7/95 until 12/99. The primary success rate and the occurrence of major clinical events were analyzed at the end of the in-hospital phase. Coronary stent implantation and abciximab use were employed at the interventionist discretion. We analyzed 201 patients with age ranging from 60 to 93 years, who underwent primary PCI. Patients with ages above 70 were more often female (p=.015). Those with ages above 80 were treated later with PCI (p=.054), and all of them presented with total occlusion of the infarct-related artery. Coronary stents were implanted in 30% of the patients. Procedural success was lower in > or =80 year old patients (p=.022), and the death rate was higher in > or =70 years olds (p=.019). Reinfarction and coronary bypass surgery were uncommon events. A trend occurred toward a higher combined incidence of major in-hospital events according to increased age (p=.064). Elderly patients (> or =70 years) presented with adverse clinical and angiographic profiles and patients > or =80 years of age obtained reduced TIMI 3 flow success rates after primary PTCA, and those > or =70 years had a higher death rate.

  8. Clinical impacts of inhibition of renin-angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention.

    Science.gov (United States)

    Park, Hyukjin; Kim, Hyun Kuk; Jeong, Myung Ho; Cho, Jae Yeong; Lee, Ki Hong; Sim, Doo Sun; Yoon, Nam Sik; Yoon, Hyun Ju; Hong, Young Joon; Kim, Kye Hun; Park, Hyung Wook; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun; Kim, Young Jo; Cho, Myeong Chan; Kim, Chong Jim

    2017-01-01

    Successful percutaneous coronary intervention (PCI) of the occluded infarct-related artery (IRA) in latecomers may improve long-term survival mainly by reducing left ventricular remodeling. It is not clear whether inhibition of renin-angiotensin system (RAS) brings additional better clinical outcomes in this specific population subset. Between January 2008 and June 2013, 669 latecomer patients with acute ST-segment elevation myocardial infarction (STEMI) (66.2±12.1 years, 71.0% males) in Korea Acute Myocardial Infarction Registry (KAMIR) who underwent a successful PCI were enrolled. The study population underwent a successful PCI for a totally occluded IRA. They were divided into two groups according to whether they were prescribed RAS inhibitors at the time of discharge: group I (RAS inhibition, n=556), and group II (no RAS inhibition, n=113). During the one-year follow-up, major adverse cardiac events (MACE), which consist of cardiac death and myocardial infarction, occurred in 71 patients (10.6%). There were significantly reduced incidences of MACE in the group I (hazard ratio=0.34, 95% confidence interval 0.199-0.588, p=0.001). In subgroup analyses, RAS inhibition was beneficial in patients with male gender, history of hypertension or diabetes mellitus, and even in patients with left ventricular ejection fraction (LVEF) ≥40%. In the baseline and follow-up echocardiographic data, benefit in changes of LVEF and left ventricular end-systolic volume was noted in group I. In latecomers with STEMI, RAS inhibition improved long-term clinical outcomes after a successful PCI, even in patients with low risk who had relatively preserved LVEF. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  9. Radiofrequency Ablation for 110 Malignant Liver Tumours: Preliminary Results on Percutaneous and Surgical Approaches

    Directory of Open Access Journals (Sweden)

    J. Wong

    2009-01-01

    Conclusion: RFA is a safe and effective procedure for treating patients with malignant liver tumours. No difference in short term outcomes was observed between percutaneous and surgical approaches. A more prolonged follow-up study is required to assess longer-term outcomes.

  10. Percutaneous ultrasonographically guided radiofrequency heat ablation for treatment of primary hyperparathyroidism in dogs.

    Science.gov (United States)

    Pollard, R E; Long, C D; Nelson, R W; Hornof, W J; Feldman, E C

    2001-04-01

    To evaluate the efficacy and safety of ultrasonographically guided radiofrequency heat ablation of parathyroid masses in dogs with primary hyperparathyroidism. Clinical trial. 11 dogs. In all dogs, either 1 or 2 parathyroid masses were evident ultrasonographically. Dogs were anesthetized, and a 20-gauge over-the-needle catheter was directed into the parathyroid mass via ultrasonographic guidance. Radiofrequency heat was applied to the stylet of the catheter until there was sonographically apparent change to the entire parenchyma of the mass. Serum total and ionized calcium and parathyroid hormone concentrations were monitored daily for 5 days after the ablation procedure and again at 1, 2, and 3-month intervals, if possible. Dogs were monitored for adverse effects. One treatment was required in 6 dogs, 2 treatments were required in 2 dogs, and treatment was unsuccessful in 3 dogs. Serum total and ionized calcium concentrations were within reference ranges within 2 days of the last procedure in all 8 successfully treated dogs. Serum parathyroid hormone concentration was decreased 24 hours after treatment in all 8 dogs. Hypocalcemia developed in 5 of the 8 successfully treated dogs, all of which required treatment. One dog had a transient voice change. Other adverse effects were not reported. Ultrasonographically guided radiofrequency heat ablation of parathyroid masses is a safe and effective alternative to surgery in dogs with primary hyperparathyroidism.

  11. Percutaneous radiofrequency lesioning of the suprascapular nerve for the management of chronic shoulder pain: a case series

    Directory of Open Access Journals (Sweden)

    Simopoulos TT

    2012-04-01

    Full Text Available Thomas T Simopoulos, Jyotsna Nagda, Musa M AnerArnold Pain Management Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USAPurpose: The objective of this study was to retrospectively evaluate the analgesic effects of continuous radiofrequency lesioning of the suprascapular nerve (SSN for chronic shoulder pain. The authors sought to obtain insight into the time-sensitive analgesic success and complications of this therapy.Patients and methods: This study was a retrospective case series involving patients with unremitting shoulder pain that had lasted for at least 12 months. Patients were selected if they showed a reduction of at least 50% in pain intensity during the anesthetic phase after SSN block, no additional motor weakness of the shoulder, and pain relief lasting for less than 2 months after separate treatments of the SSN with depot corticosteroids and pulsed radiofrequency. Nine patients were referred to the Arnold Pain Management Center. Of these nine patients, six patients who had significant chronic shoulder pain unresponsive to oral medications and intra-articular injections and who were not considered surgical candidates were selected. These patients were treated with a single radiofrequency lesion of the SSN at 80°C for 60 seconds. The primary outcome was a reduction in pain intensity by 50%, as determined by the numeric rating scale, and duration of this effect. The secondary outcome was improvement in either the passive or the active range of motion (ROM. Patients were also monitored for adverse effects such as weakness or increased pain.Results: The pooled mean numeric rating scale score before the procedure was 7.2 ± 1.2; this fell to 3.0 ± 0.9 at 5–7 weeks post procedure. The duration of pain relief ranged from 3 to 18 months, and all patients underwent at least one additional treatment. The change in baseline ROM improved from an average of 60° ± 28° (flexion and 58° ± 28° (abduction

  12. Outcome of Triple Antiplatelet Therapy Including Cilostazol in Elderly Patients with ST-Elevation Myocardial Infarction who Underwent Primary Percutaneous Coronary Intervention: Results from the INTERSTELLAR Registry.

    Science.gov (United States)

    Jang, Ho-Jun; Park, Sang-Don; Park, Hyun Woo; Suh, Jon; Oh, Pyung Chun; Moon, Jeonggeun; Lee, Kyounghoon; Kang, Woong Chol; Kwon, Sung Woo; Kim, Tae-Hoon

    2017-06-01

    Compared with dual antiplatelet therapy including aspirin and clopidogrel, triple antiplatelet therapy including cilostazol has a mortality benefit in patients with ST-segment elevation myocardial infarction. However, whether the mortality benefit persists in elderly patients is not clear. From 2007 to 2014, 1278 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were retrospectively analyzed. The patients were divided into four groups by age (elderly, respectively) and antiplatelet strategy (triple or dual antiplatelet therapy). We compared the mortality rates between the triple and dual antiplatelet therapy groups. There were 1052 (male, 85%; mean age, 56.3 ± 10.4 years) patients in the young group and 241 (male, 52.7%; mean age, 80.3 ± 4.5 years) patients in the elderly group. In the young and elderly groups, 220 (20.9%) and 28 (12.3%) patients were treated with triple antiplatelet therapy. During a 1-year follow-up period, 80 patients died (4.2% in the young group vs. 15.5% in the elderly group). Kaplan-Meier survival analysis revealed that triple antiplatelet therapy was associated with a lower mortality rate in the young group (log-rank, p = 0.005). Although there were more angiographic high-risk patients in the elderly group, similar mortality rates were reported (log-rank, p = 0.803) without increased bleeding rates (1 vs. 3.6% in the elderly group, p = 0.217). Triple antiplatelet therapy might be a better antiplatelet regimen than dual antiplatelet therapy for patients with ST-segment elevation myocardial infarction. Although this benefit was strong in patients aged elderly patients (aged ≥75 years).

  13. Percutaneous radiofrequency thermal ablation of lung VX2 tumors in a rabbit model: evaluation with helical CT findings for the complete and partal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Gong Yong; Han, Young Min; Lim, Yeong Su; Jang, Kyu Yun; Lee, Sang Yong; Chung, Gyung Ho [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2004-05-01

    To evaluate the radiologic findings for complete and partial ablation after percutaneous CT-guided transthoracic radiofrequency ablation (RFA) of lung VX2 tumor implanted in rabbits. Thirteen rabbits with successfully implanted lung VX2 were used. Three rabbits as controls did not receive RFA while the other ten rabbits underwent RFA; 5 complete and 5 partial. RFA was performed using an internally cooled, 17-gauge electrode (Radionics, Burlington, MA) with a 1-cm active tip under CT guidance. Postprocedural CT was performed within 3 days, and we analyzed the ablated size, enhancement pattern, shape, margin, and complications of the complete and partial ablation groups. Rabbits were sacrificed after postprocedural CT with an overdose of ketamine, and pathologic findings of the ablated groups were compared with those of the control group. The size of the ablated lesions and the enhancement pattern differed between the completely and partially ablated groups on chest CT. The size of the ablated lesions was increased by 47.1% in the completely ablated group and by 2.1% in the partially ablated group. In the completely ablated group, VX2 tumor showed absolutely no enhancement, whereas only ablated pulmonary parenchyma outside VX2 showed mild enhancement on enhanced CT. In the partial ablated group, a part of VX2 became strongly enhanced on enhanced CT. On microscopic examination, the completely ablated group demonstrated that a viable tumor cell was not visible. In the partially ablated group, however, a viable tumor cell within the surrounding fibrous capsule on the peripheral area of the VX2 was observed. The important CT findings for evaluation of complete and partial RFA are the ablated size and enhancement pattern of the ablated lesion.

  14. Percutaneous Radiofrequency Ablation of Colorectal Cancer Liver Metastases: Factors Affecting Outcomes—A 10-year Experience at a Single Center

    Science.gov (United States)

    Shady, Waleed; Petre, Elena N.; Gonen, Mithat; Erinjeri, Joseph P.; Brown, Karen T.; Covey, Anne M.; Alago, William; Durack, Jeremy C.; Maybody, Majid; Brody, Lynn A.; Siegelbaum, Robert H.; D’Angelica, Michael I.; Jarnagin, William R.; Solomon, Stephen B.; Kemeny, Nancy E.

    2016-01-01

    Purpose To identify predictors of oncologic outcomes after percutaneous radiofrequency ablation (RFA) of colorectal cancer liver metastases (CLMs) and to describe and evaluate a modified clinical risk score (CRS) adapted for ablation as a patient stratification and prognostic tool. Materials and Methods This study consisted of a HIPAA-compliant institutional review board–approved retrospective review of data in 162 patients with 233 CLMs treated with percutaneous RFA between December 2002 and December 2012. Contrast material–enhanced CT was used to assess technique effectiveness 4–8 weeks after RFA. Patients were followed up with contrast-enhanced CT every 2–4 months. Overall survival (OS) and local tumor progression–free survival (LTPFS) were calculated from the time of RFA by using the Kaplan-Meier method. Log-rank tests and Cox regression models were used for univariate and multivariate analysis to identify predictors of outcomes. Results Technique effectiveness was 94% (218 of 233). Median LTPFS was 26 months. At univariate analysis, predictors of shorter LTPFS were tumor size greater than 3 cm (P < .001), ablation margin size of 5 mm or less (P < .001), high modified CRS (P = .009), male sex (P = .03), and no history of prior hepatectomy (P = .04) or hepatic arterial infusion chemotherapy (P = .01). At multivariate analysis, only tumor size greater than 3 cm (P = .01) and margin size of 5 mm or less (P < .001) were independent predictors of shorter LTPFS. Median and 5-year OS were 36 months and 31%. At univariate analysis, predictors of shorter OS were tumor size larger than 3 cm (P = .005), carcinoembryonic antigen level greater than 30 ng/mL (P = .003), high modified CRS (P = .02), and extrahepatic disease (EHD) (P < .001). At multivariate analysis, tumor size greater than 3 cm (P = .006) and more than one site of EHD (P < .001) were independent predictors of shorter OS. Conclusion Tumor size of less than 3 cm and ablation margins greater than 5 mm

  15. The efficacy of intraperitoneal saline infusion for percutaneous radiofrequency ablation for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Park, Soo Young; Tak, Won Young; Jeon, Seong Woo; Cho, Chang Min; Kweon, Young Oh; Kim, Sung Kook; Choi, Yong Hwan

    2010-01-01

    Objective: To evaluated the efficacy and safety of radiofrequency ablation (RFA) with intraperitoneal saline infusion. Background: Ultrasound-guided RFA is not always feasible due to the tumor location, possible adjacent tissue damage or poor sonographic identification. Patients and methods: Ultrasound-guided RFA with intraperitoneal saline infusion was performed in 116 patients between June 2001 and March 2008. Results: The overall technical feasibility of the intraperitoneal saline infusions was 90.5% (105 patients). The purposes of the intraperitoneal saline infusion were achieved in 100 patients (86.2%) by visualizing the tumor located in hepatic dome (47 patients), prevent adjacent organ damage (42 patients) and withdrawing overlying omentum (10 patients). Complete ablation of tumor was accomplished in 102 patients (87.9%). Complications associated with the treatment occurred in seven patients (6.0%). There was no case of adverse event directly related to intraperitoneal saline infusion. Conclusions: Intraperitoneal saline infusion is an effective and safe procedure that can be used to overcome the current limitations of ultrasound-guided RFA.

  16. Predictive value of inflammatory factors on contrast-induced acute kidney injury in patients who underwent an emergency percutaneous coronary intervention.

    Science.gov (United States)

    Yuan, Ying; Qiu, Hong; Hu, Xiaoying; Luo, Tong; Gao, Xiaojin; Zhao, Xueyan; Zhang, Jun; Wu, Yuan; Qiao, Shubin; Yang, Yuejin; Gao, Runlin

    2017-09-01

    Contrast-induced acute kidney injury (CI-AKI) is one of the most serious complications in patients who undergo percutaneous coronary intervention (PCI), especially in those with acute coronary syndrome. It has been shown that inflammation may play an important role in the pathophysiology of CI-AKI. Inflammatory factors may play a predominant role in the prediction of CI-AKI in patients who undergo emergency PCI. Patients who underwent emergency PCI from 2013 to 2015 were consecutively enrolled and were divided into CI-AKI and non-CI-AKI groups. Logistic analysis was used to identify the risk factors of CI-AKI. Receiver operator characteristic curve analysis was performed to evaluate the area under the curve (AUC) and to establish the optimal cutoff. A total of 1061 patients were included, and the CI-AKI rate was 5.47% (58/1061). Logistic analysis showed that the white blood cell (WBC) count (odds ratio [OR]: 1.103, 95% confidence interval [CI]: 1.018-1.195, P = 0.016), neutrophil (N) count (OR: 1.134, 95% CI: 1.045-1.232, P = 0.003), neutrophil to lymphocyte ratio (NLR) (OR: 1.105, 95% CI: 1.044-1.169, P = 0.001), C-reactive protein (CRP) level (OR: 1.006, 95% CI: 1.001-1.011, P = 0.020), high-sensitivity C-reactive protein (hs-CRP) level (OR: 1.099, 95% CI: 1.020-1.184, P = 0.013), and big endothelin-1 (ET-1) level (OR: 4.030, 95% CI: 1.989-8.165, P < 0.001) were all significant predictors for CI-AKI, as was the left ventricular ejection fraction and diuretic administration. The AUC of the big ET-1 level was the highest (0.793, 95% CI: 0.733-0.853), followed by the NLR (0.708, 95% CI: 0.641-0.774), hs-CRP level (0.705, 95% CI: 0.627-0.782), CRP level (0.684, 95% CI: 0.607-0.761), N count (0.655, 95% CI: 0.584-0.726), WBC count (0.620, 95% CI: 0.544-0.695), and erythrocyte sedimentation rate (0.611, 95% CI: 0.527-0.695). The WBC count, N count, NLR, CRP level, hs-CRP level, and big ET-1 level are all associated with an increased risk of CI-AKI, and among which, the

  17. Phase I/II Multi-Institutional Study of Percutaneous Radiofrequency Ablation for Painful Osteoid Osteoma (JIVROSG-0704)

    Energy Technology Data Exchange (ETDEWEB)

    Miyazaki, Masaya, E-mail: mmiyazak@gunma-u.ac.jp [Gunma University Hospital, Department of Interventional Radiology and Clinical Ultrasound Center (Japan); Arai, Yasuaki [National Center Hospital, Division of Diagnostic Radiology (Japan); Myoui, Akira [Osaka University Hospital, Medical Center for Translational Research (Japan); Gobara, Hideo [Okayama University Medical School, Department of Radiology (Japan); Sone, Miyuki [National Center Hospital, Division of Diagnostic Radiology (Japan); Rosenthal, Daniel I. [Harvard Medical School, Department of Radiology, Massachusetts General Hospital (United States); Tsushima, Yoshito [Gunma University Hospital, Department of Interventional Radiology and Clinical Ultrasound Center (Japan); Kanazawa, Susumu [Okayama University Medical School, Department of Radiology (Japan); Ehara, Shigeru [Iwate Medical University School of Medicine, Department of Radiology (Japan); Endo, Keigo [Gunma University Hospital, Department of Interventional Radiology and Clinical Ultrasound Center (Japan)

    2016-10-15

    PurposeThis multicenter prospective study was conducted to evaluate the safety and efficacy of percutaneous radiofrequency ablation (RFA) for painful osteoid osteoma (OO).Materials and MethodsPatients with OO (femur: n = 17, tibia: n = 2, humerus: n = 1, rib: n = 1) were enrolled and treated with RFA. In phase I, nine patients were evaluated for safety. In phase II, 12 patients were accrued, and an intent-to-treat analysis was performed on all patients. The primary endpoint was to evaluate the treatment safety. The secondary endpoint was to evaluate the efficacy for pain relief by the visual analogue scale (VAS) at 4 weeks after RFA. Treatment efficacy was classified as significantly effective (SE) when VAS score decreased by ≥5 or score was <2, moderately effective when VAS score decreased by <5–≥2 and score was ≥2, and not effective (NE) when VAS score decreased by <2 or score was increased. Cases where the need for analgesics increased after treatment were also NE.ResultsRFA procedures were completed in all patients. Minor adverse effects (AEs) were observed as 4.8–14.3 % in 12 patients, and no major AEs were observed. Mean VAS score was 7.1 before treatment, 1.6 at 1 week, 0.3 at 4 weeks, and 0.2 at 3 months. All procedures were classified as SE. Pain recurrence was not noted in any patient during follow-up (mean: 15.1 months).ConclusionRFA is a safe, highly effective, and fast-acting treatment for painful extraspinal OO. Future studies with a greater number of patients are needed.

  18. Phase I/II Multi-Institutional Study of Percutaneous Radiofrequency Ablation for Painful Osteoid Osteoma (JIVROSG-0704)

    International Nuclear Information System (INIS)

    Miyazaki, Masaya; Arai, Yasuaki; Myoui, Akira; Gobara, Hideo; Sone, Miyuki; Rosenthal, Daniel I.; Tsushima, Yoshito; Kanazawa, Susumu; Ehara, Shigeru; Endo, Keigo

    2016-01-01

    PurposeThis multicenter prospective study was conducted to evaluate the safety and efficacy of percutaneous radiofrequency ablation (RFA) for painful osteoid osteoma (OO).Materials and MethodsPatients with OO (femur: n = 17, tibia: n = 2, humerus: n = 1, rib: n = 1) were enrolled and treated with RFA. In phase I, nine patients were evaluated for safety. In phase II, 12 patients were accrued, and an intent-to-treat analysis was performed on all patients. The primary endpoint was to evaluate the treatment safety. The secondary endpoint was to evaluate the efficacy for pain relief by the visual analogue scale (VAS) at 4 weeks after RFA. Treatment efficacy was classified as significantly effective (SE) when VAS score decreased by ≥5 or score was <2, moderately effective when VAS score decreased by <5–≥2 and score was ≥2, and not effective (NE) when VAS score decreased by <2 or score was increased. Cases where the need for analgesics increased after treatment were also NE.ResultsRFA procedures were completed in all patients. Minor adverse effects (AEs) were observed as 4.8–14.3 % in 12 patients, and no major AEs were observed. Mean VAS score was 7.1 before treatment, 1.6 at 1 week, 0.3 at 4 weeks, and 0.2 at 3 months. All procedures were classified as SE. Pain recurrence was not noted in any patient during follow-up (mean: 15.1 months).ConclusionRFA is a safe, highly effective, and fast-acting treatment for painful extraspinal OO. Future studies with a greater number of patients are needed.

  19. Percutaneous radiofrequency ablation of lung tumors: evaluation of the literature using evidence-based techniques.

    LENUS (Irish Health Repository)

    Chan, Victoria O

    2012-02-01

    PURPOSE: The aim of this study was to evaluate the literature for articles assessing radiofrequency ablation (RFA) for pulmonary malignancy. MATERIALS AND METHODS: The "bottom-up" approach to evidence-based practice was applied by 2 reviewers to the retrieval and appraisal of original research articles published on pulmonary RFA between 2002 and 2009. Primary lung cancer and pulmonary metastases data were analyzed separately. The relationship between the percentage of local recurrence rate and lesion size, patient age, follow-up duration, and time to local recurrence was assessed using Spearman\\'s rank correlation. Discrete time series were used to evaluate time trends. RESULTS: Secondary evidence yielded 1 review of 26 observational studies. Primary evidence yielded 46 studies that seemed suitable for detailed appraisal. A total of 2905 ablations were performed in 1584 patients. Eight studies evaluated primary lung cancers alone, 11 evaluated pulmonary metastases alone, 25 evaluated both, and 2 did not specify the histology. Results revealed trends toward increasing use of conscious sedation over general anesthesia, increasing use of multitined probes, decreasing size of nodule selection, and use of positron emission tomography\\/computed tomography as the optimal follow-up tool. Mean morbidity was 24.6%. The most prevalent side effects included pneumothorax (28.3%), pleural effusions (14.8%), and pain (14.1%). Procedure-related mortality ranged from 0 to 5.6, with an overall procedure-related mortality rate of 0.21%. There were 282 (12.2%) local recurrences occurring at a mean of 13 months. The mean overall survival rate was 59.4%, and the cancer-specific survival rate was 82.6%. CONCLUSIONS: This evidence-based practice review of pulmonary RFA shows it to be a promising treatment for pulmonary malignancy in carefully selected patient populations. Studies with higher levels of evidence, including case-control, prospective nonrandomized and randomized trials

  20. Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Xu, H.-X.; Xie, X.-Y.; Lu, M.-D. E-mail: lumd@21cn.com; Chen, J.-W.; Yin, X.-Y.; Xu, Z.-F.; Liu, G.-J

    2004-01-01

    AIM: To investigate the therapeutic efficacy of thermal ablation for treatment of hepatocellular carcinoma (HCC) using microwave and radiofrequency (RF) energy application. MATERIALS AND METHODS: A total of 190 nodules in 97 patients (84 male, 13 female; mean age 53.4 years, range 24-74 years) with HCC were treated with microwave or RF ablation in the last 4 years. The applicators were introduced into the tumours under conscious analgesic sedation by intravenous administration of fentanyl citrate and droperidol and local anaesthesia in both thermal ablation procedures. The patients were then followed up with contrast-enhanced computed tomography (CT) to evaluate treatment response. Survival was analysed using the Kaplan-Meier method. RESULTS: Complete ablation was obtained in 92.6% (176/190) nodules. The complete ablation rates were 94.6% (106/112) in microwave ablation and 89.7% (70/78) in RF ablation. The complete ablation rates in tumours{<=}2.0, 2.1-3.9 and {>=}4.0 cm were 93.1, 93.8 and 86.4%, respectively. Local recurrence was found in 9.5% nodules and the rates in tumours{<=}2.0, 2.1-3.9 and {>=}4.0 cm in diameter were 3.4, 9.9 and 31.8%, respectively. In the follow-up period, 7.1% nodules ablated by microwave and 12.8% by RF presented local recurrence. The 1, 2 and 3-year distant recurrence-free survivals were 47.2, 34.9 and 31.0%, respectively. Estimated mean survival was 32 months, and 1, 2 and 3-year cumulative survivals were 75.6, 58.5, and 50.0%, respectively. One and 2 years survivals of Child-Pugh class A, B and C patients were 83.8 and 70.4%, 78.2 and 53.2%, 36.3 and 27.3%, respectively. CONCLUSION: Thermal ablation therapy by means of microwave and RF energy application is an effective and safe therapeutic technique for hepatocellular carcinoma. Large tumours can be completely ablated, but have a significantly higher risk of local recurrence at follow-up.

  1. Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation

    International Nuclear Information System (INIS)

    Xu, H.-X.; Xie, X.-Y.; Lu, M.-D.; Chen, J.-W.; Yin, X.-Y.; Xu, Z.-F.; Liu, G.-J.

    2004-01-01

    AIM: To investigate the therapeutic efficacy of thermal ablation for treatment of hepatocellular carcinoma (HCC) using microwave and radiofrequency (RF) energy application. MATERIALS AND METHODS: A total of 190 nodules in 97 patients (84 male, 13 female; mean age 53.4 years, range 24-74 years) with HCC were treated with microwave or RF ablation in the last 4 years. The applicators were introduced into the tumours under conscious analgesic sedation by intravenous administration of fentanyl citrate and droperidol and local anaesthesia in both thermal ablation procedures. The patients were then followed up with contrast-enhanced computed tomography (CT) to evaluate treatment response. Survival was analysed using the Kaplan-Meier method. RESULTS: Complete ablation was obtained in 92.6% (176/190) nodules. The complete ablation rates were 94.6% (106/112) in microwave ablation and 89.7% (70/78) in RF ablation. The complete ablation rates in tumours≤2.0, 2.1-3.9 and ≥4.0 cm were 93.1, 93.8 and 86.4%, respectively. Local recurrence was found in 9.5% nodules and the rates in tumours≤2.0, 2.1-3.9 and ≥4.0 cm in diameter were 3.4, 9.9 and 31.8%, respectively. In the follow-up period, 7.1% nodules ablated by microwave and 12.8% by RF presented local recurrence. The 1, 2 and 3-year distant recurrence-free survivals were 47.2, 34.9 and 31.0%, respectively. Estimated mean survival was 32 months, and 1, 2 and 3-year cumulative survivals were 75.6, 58.5, and 50.0%, respectively. One and 2 years survivals of Child-Pugh class A, B and C patients were 83.8 and 70.4%, 78.2 and 53.2%, 36.3 and 27.3%, respectively. CONCLUSION: Thermal ablation therapy by means of microwave and RF energy application is an effective and safe therapeutic technique for hepatocellular carcinoma. Large tumours can be completely ablated, but have a significantly higher risk of local recurrence at follow-up

  2. Selective Percutaneous Controlled Radiofrequency Thermocoagulation of the Gasserian Ganglion To Control Facial Pain Due to Medication-Related Osteonecrosis of the Jaw.

    Science.gov (United States)

    Taniguchi, Ayano; Fukazawa, Keita; Hosokawa, Toyoshi

    2017-10-01

    Medication-related osteonecrosis of the jaw (MRONJ) is an important complication in patients treated with antiresorptive agents such as bisphosphonates and the receptor activator of nuclear factor κB ligand inhibitor (denosumab). Treatment of MRONJ is extremely difficult, which makes it a distressing long-term complication. We report a case of intractable facial pain due to MRONJ that was successfully controlled with selective percutaneous controlled radiofrequency thermocoagulation of the Gasserian ganglion. A 68-year-old woman with breast cancer was diagnosed as having MRONJ. She was very distressed because of jaw pain and infections secondary to MRONJ. Her quality of life (QOL) was severely decreased. Since alleviation of the MRONJ could not be expected within the patient's life expectancy, it was decided to investigate the usefulness of selective percutaneous controlled radiofrequency thermocoagulation of the Gasserian ganglion to control the pain. After the procedure, the anesthesia was obtained in the distribution of the third branch of the trigeminal nerve, and the pain completely disappeared. Although hypoesthesia was provoked as a complication, it was tolerated by the patient and she was very satisfied. Up to the time of death, there was no recurrence of pain or worsening of the MRONJ. This procedure is a common technique for treating trigeminal neuralgia. Its effect is immediate and long lasting, although it provokes hypoesthesia in treated division, and it is also suited for cancer patients in terminal stage. This case suggests that the procedure was useful for improving the patient's QOL.

  3. Treatment Failure After Image-Guided Percutaneous Radiofrequency Ablation (RFA) of Renal Tumors - A Systematic Review with Description of Type, Frequency, Risk Factors and Management.

    Science.gov (United States)

    Vollherbst, Dominik; Bertheau, Robert; Kauczor, Hans-Ulrich; Radeleff, Boris Alexis; Pereira, Philippe L; Sommer, Christof-Matthias

    2017-03-01

    Background  Radiofrequency ablation (RFA) is an established treatment for small renal tumors. The objective of this review is to systematically assess the type, frequency, risk factors and management of treatment failure after image-guided percutaneous RFA of renal tumors. Method  10 studies (967 patients, 1033 tumors) with a mean/median follow-up of ≥ 30 months were systematically identified and analyzed. Results and Conclusion  Image-guided percutaneous RFA of localized renal tumors is very effective. The most common type of treatment failure is residual unablated tumor (5.9 %), followed by local tumor progression (4.7 %). De novo tumors in the kidneys occur in 1.3 % of cases and extra-renal metastases in 2.0 %. Local tumor progression, de novo tumors in the kidneys and extra-renal metastases occur predominantly later than 12 months after initial RFA. Tumor size > 3 cm and central tumor location are the major risk factors for treatment failure. In the case of treatment failure, repeated RFA shows high success rates (86.3 % for residual unablated tumors and 87.5 % for local tumor progression). Key Points: · Treatment failure can be subdivided into residual unablated tumor and local tumor progression.. · Residual unablated tumor occurs in 5.9 % of cases.. · Local tumor progression occurs in 4.7 % of cases.. · Tumor size and location are the major risk factors for treatment failure.. · Repeated RFA is effective and commonly used for management.. Citation Format · Vollherbst D, Bertheau R, Kauczor H et al. Treatment Failure After Image-Guided Percutaneous Radiofrequency Ablation (RFA) of Renal Tumors - A Systematic Review with Description of Type, Frequency, Risk Factors and Management. Fortschr Röntgenstr 2017; 189: 219 - 227. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Outcomes of patients with hepatocellular carcinoma referred for percutaneous radiofrequency ablation at a tertiary center: Analysis focused on the feasibility with the use of ultrasonography guidance

    International Nuclear Information System (INIS)

    Kim, Ji-Eun; Kim, Young-sun; Rhim, Hyunchul; Lim, Hyo K.; Lee, Min Woo; Choi, Dongil; Shin, Sung Wook; Cho, Sung Ki

    2011-01-01

    Purpose: This study aimed to assess the feasibility of performing ultrasonography (US)-guided percutaneous radiofrequency (RF) ablation on patients with hepatocellular carcinoma (HCC) and identify causes of procedure infeasibility and its predisposing conditions. Materials and methods: A total of 109 consecutive patients (male:female = 86:23; mean 59.9 years) with 136 HCCs (mean 1.8 cm) who had been referred for planning US were analyzed. We evaluated overall procedure feasibility as well as specific factors relating to feasibility, including inability to visualize the tumor with US and factors relating to safety of the procedure. Results: The use of percutaneous RF ablation was concluded as infeasible for 45 tumors (33.1%). Reasons for infeasibility included tumor invisibility (n = 32), a high risk of collateral thermal injury (n = 5), absence of a safe electrode path (n = 5) and a combination of factors (n = 3). Among 136 tumors, 36(26.5%) were invisible due to isoechogenicity (n = 16), indiscrimination from surrounding cirrhotic nodules (n = 10) or an unfavorable location (n = 10). Tumor invisibility was significantly attributed to a small tumor size (P < 0.001, risk ratio = 0.823) and the presence of macronodular cirrhosis (P = 0.006, risk ratio = 4.117). Seven patients with invisible tumors were treated with RF ablation after follow-up (n = 4) or with use of adjacent structures as landmarks (n = 3). Ultimately, 65 of 109 patients were treated with percutaneous RF ablation. Conclusions: US-guided percutaneous RF ablation for HCC was feasible in about two-thirds of candidates. Infeasibility was mostly due to inability to visualize the tumor with US, especially for patients with smaller tumor and macronodular cirrhosis.

  5. Percutaneous Radiofrequency Ablation of Osteoid Osteomas with Use of Real-Time Needle Guidance for Accurate Needle Placement: A Pilot Study

    International Nuclear Information System (INIS)

    Busser, Wendy M. H.; Hoogeveen, Yvonne L.; Veth, Rene P. H.; Schreuder, H. W. Bart; Balguid, Angelique; Renema, W. KlaasJan; SchultzeKool, Leo J.

    2011-01-01

    Purpose: To evaluate the accuracy and technical success of positioning a radiofrequency ablation (RFA) electrode in osteoid osteomas by use of a new real-time needle guidance technology combining cone-beam computed tomography (CT) and fluoroscopy. Materials and Methods: Percutaneous RFA of osteoid osteomas was performed in five patients (median age 18 years), under general anesthesia, with the use of cone-beam CT and fluoroscopic guidance for electrode positioning. The outcome parameters were technical success, meaning correct needle placement in the nidus; accuracy defined as the deviation (in mm) from the center of the nidus; and clinical outcome at follow-up. Results: In all five cases, positioning was possible within 3 mm of the determined target location (median nidus size 6.8 mm; range 5–10.2 mm). All procedures were technically successful. All patients were free of pain at clinical follow-up. No complications were observed. Conclusion: Real-time fluoroscopy needle guidance based on cone-beam CT is a useful tool to accurately position radiofrequency needles for minimally invasive treatment of osteoid osteomas.

  6. Prognostic Impact of Combined Dysglycemia and Hypoxic Liver Injury on Admission in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (from the INTERSTELLAR Cohort).

    Science.gov (United States)

    Jang, Ho-Jun; Oh, Pyung Chun; Moon, Jeonggeun; Suh, Jon; Park, Hyun Woo; Park, Sang-Don; Lee, Kyounghoon; Kim, Je Sang; Lee, Hyun Jong; Choi, Rak Kyeong; Choi, Young-Jin; Kang, Woong Chol; Kwon, Sung Woo; Kim, Tae-Hoon

    2017-04-15

    Dysglycemia on admission is known to predict the prognosis of ST-segment elevation myocardial infarction (STEMI). Recently, hypoxic liver injury (HLI) has been proposed as a novel prognosticator for STEMI. We evaluated the prognostic impact of combined dysglycemia and HLI at the time of presentation in patients with STEMI who underwent primary percutaneous coronary intervention. From 2007 to 2014, 1,525 consecutive patients (79% men, mean age 61 years) who underwent primary percutaneous coronary intervention for STEMI in the INTERSTELLAR (Incheon-Bucheon Cohort of Patients Undergoing Primary PCI for Acute ST-Elevation Myocardial Infarction) cohort were analyzed retrospectively. Dysglycemia was defined as either hypoglycemia (serum glucose 250 mg/dl). HLI was defined as more than twofold increase of any serum aminotransferases above the upper normal limit. Patients were divided into 4 groups according to their dysglycemia and HLI status on admission: group 1, normoglycemia without HLI; group 2, dysglycemia without HLI; group 3, normoglycemia with HLI; and group 4, dysglycemia with HLI. Primary end point was inhospital death and secondary end point was all-cause mortality at 12 months after the index procedure. Of the 1,525 patients, there were 87 inhospital deaths (5.7%) and 113 all-cause deaths (7.4%) at 12 months after the index procedure. Both dysglycemia and HLI on admission were independent predictors of inhospital death. Inhospital mortality rate was the highest in group 4 (32.1%), followed by groups 2 and 3. Kaplan-Meier survival analysis at 12 months showed similar trends among the 4 groups. In conclusion, combined dysglycemia and HLI on admission predicts early prognosis for STEMI. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Percutaneous Biopsy and Radiofrequency Ablation of Osteoid Osteoma with Excess Reactive New Bone Formation and Cortical Thickening Using a Battery-Powered Drill for Access: A Technical Note

    Energy Technology Data Exchange (ETDEWEB)

    Filippiadis, D., E-mail: dfilippiadis@yahoo.gr; Gkizas, C., E-mail: chgkizas@gmail.com; Kostantos, C., E-mail: drkarpen@yahoo.gr; Mazioti, A., E-mail: argyromazioti@yahoo.gr; Reppas, L., E-mail: l.reppas@yahoo.com; Brountzos, E., E-mail: ebrountz@med.uoa.gr; Kelekis, N., E-mail: kelnik@med.uoa.gr; Kelekis, A., E-mail: akelekis@med.uoa.gr [University General Hospital “ATTIKON”, 2nd Radiology Department (Greece)

    2016-10-15

    PurposeTo report our experience with the use of a battery-powered drill in biopsy and radiofrequency ablation of osteoid osteoma with excess reactive new bone formation. The battery-powered drill enables obtaining the sample while drilling.Materials and MethodsDuring the last 18 months, 14 patients suffering from painful osteoid osteoma with excess reactive new bone formation underwent CT-guided biopsy and radiofrequency ablation. In order to assess and sample the nidus of the osteoid osteoma, a battery-powered drill was used. Biopsy was performed in all cases. Then, coaxially, a radiofrequency electrode was inserted and ablation was performed with osteoid osteoma protocol. Procedure time (i.e., drilling including local anesthesia), amount of scans, technical and clinical success, and the results of biopsy are reported.ResultsAccess to the nidus through the excess reactive new bone formation was feasible in all cases. Median procedure time was 50.5 min. Histologic verification of osteoid osteoma was performed in all cases. Radiofrequency electrode was coaxially inserted within the nidus and ablation was successfully performed in all lesions. Median amount CT scans, performed to control correct positioning of the drill and precise electrode placement within the nidus was 11. There were no complications or material failure reported in our study.ConclusionsThe use of battery-powered drill facilitates access to the osteoid osteoma nidus in cases where excess reactive new bone formation is present. Biopsy needle can be used for channel creation during the access offering at the same time the possibility to extract bone samples.

  8. Comparative evaluation of oxygen-ozone therapy and combined use of oxygen-ozone therapy with percutaneous intradiscal radiofrequency thermocoagulation for the treatment of lumbar disc herniation.

    Science.gov (United States)

    Gautam, Sujeet; Rastogi, V; Jain, Ankur; Singh, A P

    2011-01-01

    To compare the efficacy of oxygen-ozone therapy and the combined use of oxygen-ozone therapy with percutaneous intradiscal radiofrequency thermocoagulation (PIRFT) for the treatment of contained lumbar disc herniation. Ninety-one adult patients with low back pain secondary to contained lumbar disc herniation were randomly assigned into two groups. Ozone group received intradiscal oxygen-ozone therapy (4 to 7 mL of oxygen ozone mixture); ozone-PIRFT group received a combination of oxygen-ozone therapy with PIRFT (radiofrequency lesioning at 80°C for 360 s). Primary outcome measures included a visual analog scale (VAS) for pain and the Oswestry disability index (ODI). Secondary outcome measures included pain relief, reduction of analgesic consumption, and patient's satisfaction. Clinical assessment of these outcome measures was performed at 2 weeks, 1 month, 3 months, 6 months, and 1 year after the procedure. VAS scores and ODI were significantly decreased by both ozone and ozone-PIRFT when compared with the baseline values at all points of follow-up; however, ozone-PIRFT produced a significant reduction in the VAS scores and ODI when compared to ozone at 2 weeks, 1 month, 3 months, 6 months, and 1 year follow-up. Ozone-PIRFT also resulted in a significant change in all secondary measures at all points of follow-up, as compared with the ozone group. Ozone-PIRFT is more efficacious than ozone alone in reducing pain scores, analgesic consumption, improving functional outcome, and satisfaction of patients with contained lumbar disc herniation. © 2010 World Institute of Pain.

  9. Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Tian-tian, E-mail: matthewwu1979@hotmail.com; Li, Wei-min, E-mail: weimin-li-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Li, Hu-cheng, E-mail: hucheng-li-surgery@126.com [The 307th Hospital of PLA, General Surgery Department (China); Ao, Guo-kun, E-mail: guokun-ao-radiology@126.com [The 309th Hospital of PLA, Radiology Department (China); Zheng, Fang, E-mail: fang-zheng-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Lin, Hu, E-mail: hu-lin-radiology@126.com [The 309th Hospital of PLA, Radiology Department (China)

    2017-02-15

    PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.

  10. Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

    International Nuclear Information System (INIS)

    Wu, Tian-tian; Li, Wei-min; Li, Hu-cheng; Ao, Guo-kun; Zheng, Fang; Lin, Hu

    2017-01-01

    PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.

  11. Percutaneous upper thoracic radiofrequency sympathectomy in Raynaud phenomenon: a comparison of T2/T3 procedure versus T2 lesion with phenol application.

    Science.gov (United States)

    Gabrhelik, Tomas; Michalek, Pavel; Adamus, Milan; Berta, Emil

    2009-01-01

    Percutaneous radiofrequency (RF) thoracic sympathectomy is an alternative method to surgical procedures for the treatment of acral ischemia in Raynaud phenomenon. The procedure is indicated if conservative therapy fails to provide sufficient relief. The aim of this study was to compare classic T2 and T3 RF thermolesioning with a less invasive procedure at the level of T2 only. Fifty adult patients, American Society of Anesthesiologists (ASA) classification I to III, were randomly assigned to 1 of 2 groups. T2 and T3 thoracic RF thermolesion was performed in 1 group, whereas T2 thermolesion with local application of 0.5 mL of 6% phenol was delivered in the second group. Changes in cold perception, pain, and quality of life were assessed using a questionnaire. Blood circulation in the upper extremity was evaluated using infrared thermography. Patients were observed for a period of 3 months. A significant decrease in pain according to visual analog scale (P Raynaud phenomenon. A single-shot procedure at the level of T2 may be preferable because of the shorter procedure duration of this technique.

  12. Percutaneous treatment of liver tumors with an adapted probe for cooled-tip, impedance-controlled radio-frequency ablation under open-magnet MR guidance: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Kelekis, Alexis D.; Terraz, Sylvain; Roggan, Andre; Terrier, Francois; Majno, Pietro; Mentha, Gilles; Roth, Arnaud; Becker, Christoph D. [Department of Diagnostic and Interventional Radiology, University Hospital, 24 rue Micheli-du-Crest, 1211, Geneva (Switzerland)

    2003-05-01

    Percutaneous radio-frequency (RF) ablation of liver tumors is usually performed under guidance of real-time US, but some tumor nodules in some patients cannot be adequately visualized with this technique. We report our preliminary results with an MR-compatible, internally perfused 17-G RF probe adapted to a standard RF generator for impedance-controlled RF ablation under MR guidance. Following initial testing of the probe for MR compatibility, artifacts and macroscopic effects on an ex vivo pig liver, four patients with eight neoplastic liver nodules (five metastatic and three primary), which could not be properly targeted by US, were treated with the cooled-tip technique under MRI guidance in an open 0.23-T magnet. Metallic artifacts produced by the probe were useful for accurate placement and did not interfere with MRI monitoring at the end of the procedure. Based on imaging findings, the immediate result of RF was considered adequate in all instances. Local recurrence occurred in one instance after 6 months, requiring repeat treatment. No adverse effects were noted. Initial experience suggests that the probe we used allows to perform impedance-controlled cooled-tip RF ablation of liver tumors under open-magnet MR guidance. (orig.)

  13. Outcome of long-axis percutaneous sacroplasty for the treatment of sacral insufficiency fractures with a radiofrequency-induced, high-viscosity bone cement

    Energy Technology Data Exchange (ETDEWEB)

    Eichler, Katrin [University of Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); J. W. Goethe University of Frankfurt, Institute for Diagnostic and Interventional Radiology, Frankfurt (Germany); Zangos, Stephan; Vogl, Thomas J. [University of Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Mack, Martin G. [Radiology Munich, Munich (Germany); Marzi, Ingo [University of Frankfurt, Department of Trauma, Hand and Reconstructive Surgery, Frankfurt (Germany)

    2014-04-15

    Our goal was to assess the technical results in patients who underwent long-axis sacroplasty for the treatment of sacral insufficiency fractures (SIF) by radiofrequency-induced high-viscosity bone cement augmentation. Twelve patients with bilateral sacral fractures were treated by augmentation with radiofrequency-activated, high-viscosity polymethylmethacrylate (PMMA) bone cement under local anesthesia. CT-guided sacroplasty was performed by using a long-axis approach through a single entry point. Thirty-six vertebrae were treated in 12 sessions under a combination of CT and fluoroscopic guidance using a bilateral access and a cavity-creating osteotome prior to remote-controlled, hydraulically driven cement injection. The visual analogue scale (VAS) score before sacroplasty and at 1 and 3 months after the treatment was obtained. PMMA leaks were evaluated retrospectively using the post-interventional CT. The mean amount of high-viscosity PMMA injected per patient was 7.8 ml. No major adverse events were observed. In the first 4 days after the procedure, the mean VAS score decreased from 8.1 ± 1.9 to mean 3.1 ± 1.2 and was followed by a gradual but continuous decrease throughout the rest of the follow-up period at 24 weeks (mean 2.2 ± 1.1) and 48 weeks (mean 2.1 ± 1.4). CT fluoroscopy-guided sacral augmentation was safe and effective in all 12 patients with osteoporotic SIF. (orig.)

  14. Hyaluronic Acid Gel Injection to Prevent Thermal Injury of Adjacent Gastrointestinal Tract during Percutaneous Liver Radiofrequency Ablation

    International Nuclear Information System (INIS)

    Hasegawa, Takaaki; Takaki, Haruyuki; Miyagi, Hideki; Nakatsuka, Atsuhiro; Uraki, Junji; Yamanaka, Takashi; Fujimori, Masashi; Sakuma, Hajime; Yamakado, Koichiro

    2013-01-01

    This study evaluated the safety, feasibility, and clinical utility of hyaluronic acid gel injection to separate the gastrointestinal tract from the tumor during liver radiofrequency ablation (RFA). Eleven patients with liver tumors measuring 0.9–3.5 cm (mean ± standard deviation, 2.1 ± 0.8 cm) that were adjacent to the gastrointestinal tracts received RFA after the mixture of hyaluronic acid gel and contrast material (volume, 26.4 ± 14.5 mL; range, 10–60 mL) was injected between the tumor and the gastrointestinal tract under computed tomographic–fluoroscopic guidance. Each tumor was separated from the gastrointestinal tract by 1.0–1.5 cm (distance, 1.2 ± 0.2 cm) after injection of hyaluronic acid gel, and subsequent RFA was performed without any complications in all patients. Although tumor enhancement disappeared in all patients, local tumor progression was found in a patient (9.1 %, 1 of 11) during the follow-up of 5.5 ± 3.2 months (range, 0.4–9.9 months). In conclusion, hyaluronic acid gel injection is a safe and useful technique to avoid thermal injury of the adjacent gastrointestinal tract during liver RFA

  15. Hyaluronic Acid Gel Injection to Prevent Thermal Injury of Adjacent Gastrointestinal Tract during Percutaneous Liver Radiofrequency Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Takaaki, E-mail: hasegawat@clin.medic.mie-u.ac.jp; Takaki, Haruyuki; Miyagi, Hideki; Nakatsuka, Atsuhiro; Uraki, Junji; Yamanaka, Takashi; Fujimori, Masashi; Sakuma, Hajime; Yamakado, Koichiro [Mie University School of Medicine, Department of Radiology (Japan)

    2013-08-01

    This study evaluated the safety, feasibility, and clinical utility of hyaluronic acid gel injection to separate the gastrointestinal tract from the tumor during liver radiofrequency ablation (RFA). Eleven patients with liver tumors measuring 0.9-3.5 cm (mean {+-} standard deviation, 2.1 {+-} 0.8 cm) that were adjacent to the gastrointestinal tracts received RFA after the mixture of hyaluronic acid gel and contrast material (volume, 26.4 {+-} 14.5 mL; range, 10-60 mL) was injected between the tumor and the gastrointestinal tract under computed tomographic-fluoroscopic guidance. Each tumor was separated from the gastrointestinal tract by 1.0-1.5 cm (distance, 1.2 {+-} 0.2 cm) after injection of hyaluronic acid gel, and subsequent RFA was performed without any complications in all patients. Although tumor enhancement disappeared in all patients, local tumor progression was found in a patient (9.1 %, 1 of 11) during the follow-up of 5.5 {+-} 3.2 months (range, 0.4-9.9 months). In conclusion, hyaluronic acid gel injection is a safe and useful technique to avoid thermal injury of the adjacent gastrointestinal tract during liver RFA.

  16. Radiofrequency Neurotomy

    Science.gov (United States)

    ... drive you home What you can expect During radiofrequency neurotomy Radiofrequency neurotomy is an outpatient procedure, so ... skin before the radiofrequency needles are inserted. After radiofrequency neurotomy You'll be taken to another room ...

  17. Long-term results of CT-guided percutaneous radiofrequency ablation of inoperable patients with stage Ia non-small cell lung cancer: A retrospective cohort study.

    Science.gov (United States)

    Huang, Bing-Yang; Li, Xin-Min; Song, Xiao-Yong; Zhou, Jun-Jun; Shao, Zhuang; Yu, Zhi-Qi; Lin, Yi; Guo, Xin-Yu; Liu, Da-Jiang; Li, Lu

    2018-03-16

    This study was performed to retrospectively evaluate the 10-year overall survival (OS), progression-free survival (PFS), and local control rates of patients with inoperable stage Ia non-small cell lung cancer (NSCLC) who underwent computed tomography (CT)-guided radiofrequency ablation (RFA) in a single center. Fifty patients with inoperable NSCLC underwent RFA between 2004 and 2016. Thoracic surgeons evaluated the patients and performed RFA under CT guidance. Follow-up CT and positron emission tomography/CT scans were obtained. Local control rates and recurrence patterns were analyzed. Seventy-three lesions in 50 patients (M:F = 22:28; median age: 73 years; range: 52-82 years) were treated with CT-guided RFA. The mean lesion size was 2.2 cm (range: 1-3 cm). No procedure-related deaths occurred. Low-grade fever was the most common post-ablation complication, with an incidence rate of 36%. The 1-, 2-, 3-, 5-, and 10-year OS rates of patients with Ia NSCLC were 96.0%, 86.5%, 67.1%, 36.3%, and 1%, respectively, and the 1-, 2-, 3-, and 5-year PFS rates were 94.0%, 77.5%, 43.5%, and 10.8%, respectively. The most common pattern of recurrence was local, and 15 patients with recurrence were treated with repeat RFA. Tumor size Ia NSCLC. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Percutaneous radiofrequency lesions adjacent to the dorsal root ganglion alleviate spasticity and pain in children with cerebral palsy: pilot study in 17 patients

    Directory of Open Access Journals (Sweden)

    van Rhijn Lodewijk W

    2010-06-01

    Full Text Available Abstract Background Cerebral palsy (CP may cause severe spasticity, requiring neurosurgical procedures. The most common neurosurgical procedures are continuous infusion of intrathecal baclofen and selective dorsal rhizotomy. Both are invasive and complex procedures. We hypothesized that a percutaneous radiofrequency lesion of the dorsal root ganglion (RF-DRG could be a simple and safe alternative treatment. We undertook a pilot study to test this hypothesis. Methods We performed an RF-DRG procedure in 17 consecutive CP patients with severe hip flexor/adductor spasms accompanied by pain or care-giving difficulties. Six children were systematically evaluated at baseline, and 1 month and 6 months after treatment by means of the Modified Ashworth Scale (MAS, Gross Motor Function Measure (GMFM and a self-made caregiver's questionnaire. Eleven subsequent children were evaluated using a Visual Analogue Scale (VAS for spasticity, pain and ease of care. Results A total of 19 RF-DRG treatments were performed in 17 patients. We found a small improvement in muscle tone measured by MAS, but no effect on the GMFM scale. Despite this, the caregivers of these six treated children unanimously stated that the quality of life of their children had indeed improved after the RF-DRG. In the subsequent 11 children we found improvements in all VAS scores, in a range comparable to the conventional treatment options. Conclusion RF-DRG is a promising new treatment option for severe spasticity in CP patients, and its definitive effectiveness remains to be defined in a randomised controlled trial.

  19. Percutaneous Radiofrequency Ablation Versus Robotic-Assisted Partial Nephrectomy for the Treatment of Small Renal Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Pantelidou, Maria [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Challacombe, Ben [King’s Health Partners, Department of Urology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); McGrath, Andrew [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Brown, Matthew [King’s Health Partners, Department of Urology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Ilyas, Shahzad; Katsanos, Konstantinos, E-mail: konstantinos.katsanos@gstt.nhs.uk; Adam, Andreas [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom)

    2016-11-15

    IntroductionThe authors compared the oncologic outcomes of radiofrequency ablation (RFA) with robotic-assisted partial nephrectomy (RPN) for the treatment of T1 stage renal cell carcinoma (RCC).Materials and methodsThis was a retrospective data analysis of a high-volume single tertiary centre. Patients were treated with RFA or RPN following multidisciplinary decision making. Only histologically proven RCCs were included. Baseline demographics were collected, and PADUA scores of tumour features were calculated to standardize baseline anatomy. Peri-operative complications, kidney function and oncological outcomes were compared.ResultsSixty-three cases were included in each group. Baseline renal function was poorer in RFA, and 16/63 RFA patients had tumours in single kidneys compared to 1/63 RPN cases (p < 0.001). Length of stay was shorter in RFA (1 vs. 3 days, p < 0.0001). Post-procedure renal function decline at 30 days was significantly less in RFA [(−0.8) ± 9.6 vs. (−16.1) ± 19.5 mls/min/1.73 m{sup 2}; p < 0.0001]. More minor complications were recorded in RPN (10/63 vs. 4/63, p = 0.15), but local recurrence was numerically higher in RFA (6/63 vs. 1/63, p = 0.11). Disease-free survival (DFS) was not significantly different (adjusted HR = 0.6, 95 % Cl 0.1–3.7; p = 0.60). Increasing tumour size was an independent predictor of local recurrence (adjusted HR = 1.7; 95 % Cl 1.1–2.6 per cm; p = 0.02).ConclusionsBoth RPN and RFA offer very good oncological outcomes for the treatment of T1 RCC with low peri-operative morbidity and similar oncologic outcomes. RFA demonstrated fewer peri-operative complications and better preservation of renal function, whereas RPN had an insignificantly lower local recurrence rate. RFA should be offered alongside RPN for selected cases.

  20. Radiofrequency (thermal) ablation versus no intervention or other interventions for hepatocellular carcinoma

    DEFF Research Database (Denmark)

    Weis, Sebastian; Franke, Annegret; Mössner, Joachim

    2013-01-01

    Hepatocellular carcinoma is the fifth most common cancer worldwide. Percutaneous interventional therapies, such as radiofrequency (thermal) ablation (RFA), have been developed for early hepatocellular carcinoma. RFA competes with other interventional techniques such as percutaneous ethanol...

  1. CT-guided percutaneous radiofrequency ablation in osteoid osteoma. Re-assessments of results with optimized technique and possible pain patterns in mid-term follow-up

    International Nuclear Information System (INIS)

    Omlor, G.; Merle, C.; Lehner, B.; Ewerbeck, V.; Rehnitz, C.; Weber, M.A.; Ludwig, K.

    2012-01-01

    To re-assess radiofrequency ablation (RFA) of osteoid osteoma (OO) with an optimized technique and to evaluate patterns of post-interventional pain important for the detection of recurrence. 44 consecutive patients with OO treated with precise inclusion criteria by RFA were examined retrospectively. RFA was performed with an optimized technique. Technical success (TS), primary and secondary clinical success (PCS/SCS) and minor and major complications (MIC/MAC) were evaluated. Pain patterns defined as 'osteoid osteoma-specific pain' (OOSP) and 'unspecific pain' (UP), 'limitations in daily activity' (LDA) and 'patient satisfaction' (PS) were evaluated using a numeric rating scale (0 - 10; 0 = no pain, 0 = no limitation, 10 = fully satisfied). The pain intensity before and after RFA was compared. The mean follow-up time was 35 months (n = 40, range 2 - 60 months). TS was 100 % (n = 44), PCS 98 % (n = 44), and SCS 100 % (n = 40). MIC and MAC were 0 % (n = 44). OOSP was 0 after RFA in all 44 patients. UP was 0 in 24 of 40 patients (60 %), 1 in 11 patients (28 %) for up to 7 days and 1 - 4 in 5 patients (13 %) for 30 - 180 days. LDA was 0 in 39 of 40 patients (98 %), and 1 in 1 patient. PS was 10 in all patients. The pain after RFA was significantly less than before RFA (p < 0.0001). Using an optimized technique primary clinical success rates in the high nineties have to be expected. Unspecific pain of low intensity is not unusual after RFA and has to be distinguished from pain caused by recurrent disease. (orig.)

  2. CT-guided percutaneous radiofrequency ablation in osteoid osteoma. Re-assessments of results with optimized technique and possible pain patterns in mid-term follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Omlor, G.; Merle, C.; Lehner, B.; Ewerbeck, V. [Universitaetsklinik Heidelberg (Germany). Orthopaedische Universitaetsklinik; Rehnitz, C.; Weber, M.A. [Universitaetsklinik Heidelberg (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Ludwig, K. [Klinikum Herford (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie

    2012-04-15

    To re-assess radiofrequency ablation (RFA) of osteoid osteoma (OO) with an optimized technique and to evaluate patterns of post-interventional pain important for the detection of recurrence. 44 consecutive patients with OO treated with precise inclusion criteria by RFA were examined retrospectively. RFA was performed with an optimized technique. Technical success (TS), primary and secondary clinical success (PCS/SCS) and minor and major complications (MIC/MAC) were evaluated. Pain patterns defined as 'osteoid osteoma-specific pain' (OOSP) and 'unspecific pain' (UP), 'limitations in daily activity' (LDA) and 'patient satisfaction' (PS) were evaluated using a numeric rating scale (0 - 10; 0 = no pain, 0 = no limitation, 10 = fully satisfied). The pain intensity before and after RFA was compared. The mean follow-up time was 35 months (n = 40, range 2 - 60 months). TS was 100 % (n = 44), PCS 98 % (n = 44), and SCS 100 % (n = 40). MIC and MAC were 0 % (n = 44). OOSP was 0 after RFA in all 44 patients. UP was 0 in 24 of 40 patients (60 %), 1 in 11 patients (28 %) for up to 7 days and 1 - 4 in 5 patients (13 %) for 30 - 180 days. LDA was 0 in 39 of 40 patients (98 %), and 1 in 1 patient. PS was 10 in all patients. The pain after RFA was significantly less than before RFA (p < 0.0001). Using an optimized technique primary clinical success rates in the high nineties have to be expected. Unspecific pain of low intensity is not unusual after RFA and has to be distinguished from pain caused by recurrent disease. (orig.)

  3. Percutaneous transpedicular management of discitis.

    Science.gov (United States)

    Arya, S; Crow, W N; Hadjipaviou, A G; Nauta, H J; Borowski, A M; Vierra, L A; Walser, E

    1996-01-01

    To present the technique of percutaneous transpedicular biopsy and debridement of discs in diagnosis and management of discitis. Fifteen patients underwent disc biopsy through a transpedicular approach with local anesthesia and fluoroscopic guidance. An attempt was made to debride the disc as much as possible. A surgical vacuum drain was deployed through the transpedicular tract when there was persistent drainage. Fifteen patients underwent percutaneous transpedicular disc biopsy and debridement of disc for suspected discitis. Three patients underwent biopsy only and 12 underwent percutaneous discectomy. Six patients had at least one positive culture. Eight patients who underwent discectomy had immediate improvement of pain or neurologic symptoms, obviating emergency surgical debridement of the disc. Four patients did not improve and underwent surgical debridement and fusion. Transpedicular biopsy of the disc is an effective technique for adequate tissue retrieval and diagnosis of discitis. Adequate debridement in selected patients with antibiotic therapy may be definitive. Epidural extension of discitis and massive vertebral destruction precludes percutaneous treatment.

  4. Radiofrequency Ablation in the Management of Advanced Stage Thymomas: A Case Report on a Novel Multidisciplinary Therapeutic Approach

    Directory of Open Access Journals (Sweden)

    Panagiotis Paliogiannis

    2014-01-01

    Full Text Available We describe in this report a case of successful radiofrequency ablation of an unresectable stage III-type B3 thymoma, and we discuss the role of this novel approach in the management of patients with advanced stage thymoma. The patient, a 59-year-old Caucasian male underwent neoadjuvant chemotherapy with only a slight reduction of the mass. Subsequently, an explorative sternotomy and debulking were performed; before closing the thorax, radiofrequency ablation of the residual tumor was carried out and a partial necrosis of the mass was achieved. A further percutaneous radiofrequency ablation was performed subsequently, obtaining complete necrosis of the lesion. Successively, the patient underwent adjuvant radiotherapy. As a result of this multidisciplinary treatment, complete and stable response was obtained. It is hard to say which of the single treatments had the major impact on cure; nevertheless, the results obtained suggest that radiofrequency ablation must be taken into account for the treatment of advanced stage thymomas, and its effectiveness must be further assessed in future studies.

  5. Malignant hepatic tumors treated with percutaneous radio-frequency ablation: Comparison between contrast-enhanced color Doppler ultrasound and spiral CT in evaluating the therapeutic efficacy

    International Nuclear Information System (INIS)

    Yoon, Jung Hee; Han, Sang Suk; Cha, Sung Sook

    2002-01-01

    To compare contrast-enhanced color Doppler ultrasound (CECDUS) with spiral CT in the evaluation of the therapeutic efficacy of malignant hepatic tumors after radio-frequency ablation (RFA). During a recent 2 year period (April 1999 to March 2001). One hundred fifteen hepatic tumors (95 hepatocellular carcinomas and 20 metastases; mean diameter, 2.7 cm) from 83 consecutive patients (60 men and 23 women; mean age, 57 years) that were treated with RFA were included in this study. Both CECDUS and two-or three phase spiral CT were performed a day after RFA as the immediate follow-up study in most cases. Afterward, both imaging studies were alternatively performed on monthly basis, but when incomplete ablation was suspected on one follow-up imaging study, the other imaging study was performed within a week for comparison. For ultrasound contrast agent, a suspension of 2.5 g or 4.0 g Levovist (Schering AG, Berlin, Germany) with a concentration of 300 mg/mL was used. For evaluating the therapeutic efficacy, the presence of viable portion, either residual or recurrent, within the ablated tumor was determined on each imaging study. The criteria for viable portion were defined as focal or irregular enhancement at the periphery of the ablated tumor on the arterial or portal phase spiral CT images and intratumoral vascularities on CECDUS. The correspondence rate between both imaging studies was assessed to compare the diagnostic accuracy of both studies in evaluating a residual or recurrent tumor. In addition, their imaging findings were analyzed. Analyzing both imaging findings of 116 malignant hepatic tumors, the correspondence rate between CECDUS and CT obtained after 116 times of imaging studies was 91.4% (106/116). For the diagnosis of residual or recurrent tumors, the sensitivity, specificity and diagnostic accuracy of spiral CT were 71%, 99%, and 94%, respectively, while those of CECDUS were 87%, 99%, and 97%, respectively. As the immediate follow-up study, CECDUS seemed

  6. Radiofrequency: Thermage.

    Science.gov (United States)

    Polder, Kristel D; Bruce, Suzanne

    2011-05-01

    Nonablative procedures for facial rejuvenation have become increasingly popular. One such method to improve laxity and diminish rhytids is monopolar capacitively coupled radiofrequency (MRF). The authors discuss clinical studies using MRF. The authors also discuss their clinical experiences as well as recommendations for optimal results. MRF using the Thermage CPT system (Solta Medical, Hayward, California) offers minimal downtime with a favorable side-effect profile. Although there are many radiofrequency devices on the market for aesthetic use, MRF has the most clinical trials to date to support its use as an effective, evidence-based modality to improve rhytids and tighten the skin. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Biliary obstruction caused by intra-biliary tumor growth from recurred hepatocellular carcinoma after radiofrequency ablation: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Ji Hyun; Kim, Jae Won [Dept. of Radiology, Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2014-04-15

    A 59-year-old man with a known central hepatocellular carcinoma (HCC) underwent a trans-arterial-chemo-embolization (TACE) and a post-TACE percutaneous radiofrequency ablation (PRFA). Two months after the PRFA, the patient presented jaundice and an abdominal computed tomography was obtained. An arterial enhancing mass adjacent to the ablated necrotic lesion with a continuously coexisting mass inside the right hepatic duct, suggestive of a HCC recurrence with a direct extension to the biliary tract was found. Finally a biliary tumor obstruction has been developed and a percutaneous transhepatic biliary drainage was performed. This case of biliary obstruction caused by directly invaded recurred HCC after PRFA will be reported because of its rare occurrence.

  8. Percutaneous bone tumor management.

    Science.gov (United States)

    Gangi, Afshin; Buy, Xavier

    2010-06-01

    Interventional radiology plays a major role in the management of bone tumors. Many different percutaneous techniques are available. Some aim to treat pain and consolidate a pathological bone (cementoplasty); others aim to ablate tumor or reduce its volume (sclerotherapy, thermal ablation). In this article, image-guided techniques of primary and secondary bone tumors with vertebroplasty, ethanol injection, radiofrequency ablation, laser photocoagulation, cryoablation, and radiofrequency ionization (coblation) will be reviewed. For each modality, the principles, the indications, and the results will be presented. The technical choice depends on the therapeutic intent-curative or palliative-and the need for consolidation, but also on the general status of the patient and the other therapeutic options. For the most complex cases, combined treatments can be required. However, the less disabling technique should always be considered first.

  9. Combination acetabular radiofrequency ablation and cementoplasty using a navigational radiofrequency ablation device and ultrahigh viscosity cement: technical note.

    Science.gov (United States)

    Wallace, Adam N; Huang, Ambrose J; Vaswani, Devin; Chang, Randy O; Jennings, Jack W

    2016-03-01

    Percutaneous radiofrequency ablation and cementoplasty is an alternative palliative therapy for painful metastases involving axial load-bearing bones. This technical report describes the use of a navigational radiofrequency probe to ablate acetabular metastases from an anterior approach followed by instillation of ultrahigh viscosity cement under CT-fluoroscopic guidance. The tumor ablation databases of two institutions were retrospectively reviewed to identify patients who underwent combination acetabular radiofrequency ablation and cementoplasty using the STAR Tumor Ablation and StabiliT Vertebral Augmentation Systems (DFINE; San Jose, CA). Pre-procedure acetabular tumor volume was measured on cross-sectional imaging. Pre- and post-procedure pain scores were measured using the Numeric Rating Scale (10-point scale) and compared. Partial pain improvement was categorically defined as ≥ 2-point pain score reduction. Patients were evaluated for evidence of immediate complications. Electronic medical records were reviewed for evidence of delayed complications. During the study period, 12 patients with acetabular metastases were treated. The median tumor volume was 54.3 mL (range, 28.3-109.8 mL). Pre- and post-procedure pain scores were obtained from 92% (11/12) of the cohort. The median pre-procedure pain score was 8 (range, 3-10). Post-procedure pain scores were obtained 7 days (82%; 9/11), 11 days (9.1%; 1/11) or 21 days (9.1%; 1/11) after treatment. The median post-treatment pain score was 3 (range, 1-8), a statistically significant difference compared with pre-treatment (P = 0.002). Categorically, 73% (8/11) of patients reported partial pain relief after treatment. No immediate symptomatic complications occurred. Three patients (25%; 3/12) were discharged to hospice within 1 week of treatment. No delayed complications occurred in the remaining 75% (9/12) of patients during median clinical follow-up of 62 days (range, 14-178 days). Palliative percutaneous

  10. TREATMENT OF LUMBAR HERNIAS BY ENDOSCOPIC NUCLEOPLASTY WITH RADIOFREQUENCY

    Directory of Open Access Journals (Sweden)

    Heber Humberto Alfaro Pachicano

    2016-03-01

    Full Text Available ABSTRACT Objective: To evaluate the postoperative outcomes of minimally invasive technique for treating lumbar disc herniation in patients undergoing percutaneous endoscopic nucleoplasty with radiofrequency in the center of minimally invasive procedures Veracruz (CEMIVER of the HRAEV.. Methods: A descriptive, comparative, ambispective and longitudinal study. The clinical records of patients who underwent herniated disc surgery were reviewed from March 2010 to March 2015. Inclusion criteria were individuals of both sexes, aged 18-65 years, with disc herniation diagnosis by MRI, evocative discography (pain and clinical evaluation. The variables were analyzed by VAS, Oswestry disability index for functional assessment and Macnab criteria for modified retrospective cross clinical classification. Results: 161 patients were included, 81 female and 80 male, aged between 18 and 65 years with severe (83.8% and moderate (16.2% disability according to the Oswestry disability index; the total of excellent results was 83.8%, 9.5% were good, 4.8% were median and 1.9% were poor results, according to the Macnab criteria; the average time of surgery was 84 minutes per procedure, and the postoperative average bleeding was 65 ml. Of the total, 87.4% of the patients were on an outpatient basis and 7.6% had a short hospital stay.. Conclusion: It was found that percutaneous endoscopic nucleoplasty with radiofrequency technique is a procedure that offers great benefits for patients with lumbar disc herniation, including performing it under local anesthesia, with clear visualization of the surgical field, minimal pain, little bleeding, shorter operative time, does not cause instability of anatomical structures and has minimal rate of complications.

  11. Hemobilia, intrahepatic hematoma and acute thrombosis with cavernomatous transformation of the portal vein after percutaneous thermoablation of a liver metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Francica, G.; Marone, G.; D' Angelo, V. [Divisione di Gastroenterologia, Ospedale ' ' Cardinale Ascalesi' ' , Naples (Italy); Solbiati, L. [Divisione di Ecografia e Radiologia Interventistica, Ospedale Generale Busto Arsizio (Italy); Siani, A. [Servizio di Radiologia, Ospedale Civile ' ' S. Maria Delle Grazie' ' , Pozzuoli (Italy)

    2000-06-01

    A 53-year-old-man underwent US-guided percutaneous thermal ablation with a cooled-tip needle of three liver metastases from gastric cancer. Six days later, the patient was re-admitted for melena, scleral jaundice, and anemia. Abdominal US disclosed echogenic material in the gallbladder lumen (hemobilia) and a focal lesion with mixed echotexture in segment III (hepatic hematoma). On day 5 portal cavernomatosis was diagnosed at US and confirmed by color Doppler and a helical CT exam. The case described emphasizes that radio-frequency interstitial hyperthermia may cause not only traumatic injury of the liver parenchyma but also thermally mediated damage of vascular structures. (orig.)

  12. Transarterial embolization (TAE) as add-on to percutaneous radiofrequency ablation (RFA) for the treatment of renal tumors: Review of the literature, overview of state-of-the-art embolization materials and further perspective of advanced image-guided tumor ablation

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, C.M., E-mail: christof.sommer@med.uni-heidelberg.de [Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg (Germany); Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Katharinenhospital, Stuttgart (Germany); Pallwein-Prettner, L., E-mail: leo.pallwein-prettner@bhs.at [Department of Diagnostic and Interventional Radiology, Krankenhaus der Barmherzigen Schwestern Linz, Linz (Austria); Vollherbst, D.F., E-mail: dominik@vollherbst.de [Clinic for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn (Germany); Seidel, R., E-mail: roland.seidel@uks.eu [Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg/Saar (Germany); Rieder, C., E-mail: christian.rieder@mevis.fraunhofer.de [Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen (Germany); Radeleff, B.A., E-mail: boris.radeleff@med.uni-heidelberg.de [Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg (Germany); Kauczor, H.U., E-mail: hu.kauczor@med.uni-heidelberg.de [Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg (Germany); Wacker, F., E-mail: wacker.frank@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover (Germany); Richter, G.M., E-mail: g.richter@klinikum-stuttgart.de [Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Katharinenhospital, Stuttgart (Germany); Bücker, A., E-mail: arno.buecker@uks.eu [Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg/Saar (Germany); Rodt, T., E-mail: rodt.thomas@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover (Germany); and others

    2017-01-15

    Highlights: • TAE as add-on to percutaneous RFA is feasible, safe, and very effective. • State-of-the-art embolization materials include tightly-size-calibrated microspheres. • MWA, cryoablation and IRE are TA systems beyond RFA. • Visible beads rank among the most promising innovative embolization materials. • Software-based solutions will be increasingly important for treatment guidance. - Abstract: Percutaneous radiofrequency ablation (RFA) for the treatment of stage I renal cell carcinoma has recently gained significant attention as the now available long-term and controlled data demonstrate that RFA can result in disease-free and cancer-specific survival comparable with partial and/or radical nephrectomy. In the non-controlled single center trials, however, the rates of treatment failure vary. Operator experience and ablation technique may explain some of the different outcomes. In the controlled trials, a major limitation is the lack of adequate randomization. In case reports, original series and overview articles, transarterial embolization (TAE) before percutaneous RFA was promising to increase tumor control and to reduce complications. The purpose of this study was to systematically review the literature on TAE as add-on to percutaneous RFA for renal tumors. Specific data regarding technique, tumor and patient characteristics as well as technical, clinical and oncologic outcomes have been analyzed. Additionally, an overview of state-of-the-art embolization materials and the radiological perspective of advanced image-guided tumor ablation (TA) will be discussed. In conclusion, TAE as add-on to percutaneous RFA is feasible and very effective and safe for the treatment of T1a tumors in difficult locations and T1b tumors. Advanced radiological techniques and technologies such as microwave ablation, innovative embolization materials and software-based solutions are now available, or will be available in the near future, to reduce the limitations of

  13. Radiofrequency radiation

    International Nuclear Information System (INIS)

    Elder, J.A.; Czerski, P.A.; Stuchly, M.A.; Mild, K.H.; Sheppard, A.R.

    1989-01-01

    High-level radiofrequency radiation is a source of thermal energy that carries all of the known implications of heating for biological systems, including burns, temporary and permanent changes in reproduction, cataracts, and death. In general, no changes in chromosomes, DNA or the reproductive potential of animals exposed to RF radiation have been reported in the absence of significant rises in temperature, though there are limited data on DNA and chromosomal changes at non-thermal levels. Human data are currently limited and do not provide adequate information about the relationship between prolonged low-level RF radiation exposure and increased mortality or morbidity, including cancer incidence. In epidemiological studies and clinical reports of RF effects in man, the problems of quantification are numerous and include uncertainties about ''dose'', health effects, latent periods, dose-response relationships, and interactions with other physical or chemical agents. 228 refs, 6 figs, 2 tabs

  14. Treatment of Osteoid Osteomas Using a Navigational Bipolar Radiofrequency Ablation System

    Energy Technology Data Exchange (ETDEWEB)

    Wallace, Adam N., E-mail: wallacea@mir.wustl.edu; Tomasian, Anderanik, E-mail: tomasiana@mir.wustl.edu [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States); Chang, Randy O., E-mail: changr@wusm.wustl.edu [Washington University School of Medicine (United States); Jennings, Jack W., E-mail: jenningsj@mir.wustl.edu [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States)

    2016-05-15

    BackgroundPercutaneous CT-guided radiofrequency ablation is a safe and effective minimally invasive treatment for osteoid osteomas. This technical case series describes the use of a recently introduced ablation system with a probe that can be curved in multiple directions, embedded thermocouples for real-time monitoring of the ablation volume, and a bipolar design that obviates the need for a grounding pad.MethodsMedical records of all patients who underwent radiofrequency ablation of an osteoid osteoma with the STAR Tumor Ablation System (DFINE; San Jose, CA) were reviewed. The location of each osteoid osteoma, nidus volume, and procedural details were recorded. Treatment efficacy and long-term complications were assessed at clinical follow-up.ResultsDuring the study period, 18 osteoid osteomas were radiofrequency ablated with the multidirectional bipolar system. Lesion locations included the femur (50 %; 9/18), tibia (22 %; 4/18), cervical spine (11 %; 2/18), calcaneus (5.5 %; 1/18), iliac bone (5.5 %; 1/18), and fibula (5.5 %; 1/18). The median nidus volume of these cases was 0.33 mL (range 0.12–2.0 mL). All tumors were accessed via a single osseous channel. Median cumulative ablation time was 5 min and 0 s (range 1 min and 32 s–8 min and 50 s). All patients with clinical follow-up reported complete symptom resolution. No complications occurred.ConclusionSafe and effective CT-guided radiofrequency ablation of osteoid osteomas can be performed in a variety of locations using a multidirectional bipolar system.

  15. Intraductal Cooling via a Nasobiliary Tube During Radiofrequency Ablation of Central Liver Tumors Reduces Biliary Injuries.

    Science.gov (United States)

    Felker, Ely R; Lee-Felker, Stephanie A; Ajwichai, Khobkhoon; Tan, Nelly; Lu, David S; Durazo, Francisco A; Raman, Steven S

    2015-06-01

    The objective of our study was to determine the safety and efficacy of intraductal perfusion of chilled 5% dextrose in water (D5W) via an endoscopic nasobiliary tube (NBT) for the prevention of thermal bile duct injury in patients undergoing percutaneous radiofrequency ablation (RFA) of central liver tumors. We performed a retrospective study comparing outcomes of 32 consecutive patients who underwent percutaneous RFA of central liver tumors without intraductal perfusion of chilled D5W (control cohort) and 14 consecutive patients who underwent temporary intraductal perfusion of chilled D5W at 2 mL/s via endoscopic NBT placement before RFA (endoscopic NBT cohort). The primary and secondary outcomes were the rate of biliary complications and local tumor progression, respectively. All patients tolerated the procedures well. There was a significantly lower rate of biliary complications in the endoscopic NBT cohort (0/14 patients, 0%) than in the control cohort (10/32 patients, 31%) (p NBT cohort (12/14 patients, 86%) compared with the control cohort (20/32 patients, 62%) (p = 0.05). There was no difference in the rate of local tumor progression between the endoscopic NBT cohort (4/19 tumors, 21%) and the control cohort (9/39 tumors, 23%) (p = 1.0). Perfusion of chilled water through an endoscopic NBT helps prevent thermal biliary injury during RFA of central liver tumors without increasing rates of local tumor progression.

  16. WORKSHOPS: Radiofrequency superconductivity

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    In the continual push towards higher energy particle beams, superconducting radiofrequency techniques now play a vital role, highlighted in the fifth workshop on radiofrequency superconductivity, held at DESY from 19 - 24 August 1991

  17. Nephron-sparing percutaneous ablation of a 5 cm renal cell carcinoma by superselective embolization and percutaneous RF-ablation

    International Nuclear Information System (INIS)

    Tacke, J.; Mahnken, A.; Buecker, A.; Guenther, R.W.; Rohde, D.

    2001-01-01

    Purpose: To report on the nephron-sparing, percutaneous ablation of a large renal cell carcinoma by combined superselective embolization and percutaneous radiofrequency ablation. Materials and Methods: A 5 cm renal cell carcinoma of a 43-year-old drug abusing male with serologically proven HIV, hepatitis B and C infection, who refused surgery, was superselectively embolized using microspheres (size: 500 - 700 μm) and a platinum coil under local anesthesia. Percutaneous radiofrequency ablation using a 7F LeVeen probe (size of expanded probe tip: 40 mm) and a 200 Watt generator was performed one day after transcatheter embolization under general anesthesia. Results: The combined treatment resulted in complete destruction of the tumor without relevant damage of the surrounding healthy renal tissue. The patient was discharged 24 hours after RF ablation. No complications like urinary leaks or fistulas were observed and follow up CT one day and 4 weeks after the radiofrequency intervention revealed no signs of residual tumor growth. Conclusion: The combined transcatheter embolization and percutaneous radiofrequency ablation of renal cell carcinoma has proved technically feasible, effective, and safe in this patient. It may be offered as an alternative treatment to partial or radical nephrectomy under certain circumstances. Abbreviations: RF = radiofrequency ablation; CT = computed tomography; HIV = human immunodeficiency virus. (orig.) [de

  18. Percutaneous cryoablation for hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Kyoung Doo Song

    2016-12-01

    Full Text Available Local ablation therapy is considered as a conventional treatment option for patients with early stage hepatocellular carcinoma (HCC. Although radiofrequency (RF ablation is widely used for HCC, the use of cryoablation has been increasing as newer and safer cryoablation systems have developed. The thermodynamic mechanism of freezing and thawing used in cryoablation is the Joule-Thomson effect. Cryoablation destroys tissue via direct tissue destruction and vascular-related injury. A few recent comparative studies have shown that percutaneous cryoablation for HCCs is comparable to percutaneous RF ablation in terms of long term therapeutic outcomes and complications. Cryoablation has several advantages over RF ablation such as well visualization of iceball, no causation of severe pain, and lack of severe damage to great vessels and gallbladder. It is important to know the advantages and disadvantages of cryoablation compared with RF ablation for improvement of therapeutic efficacy and safety.

  19. Radiofrequency Ablation Treatment for Renal Cell Carcinoma: Early Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seong Hoon; Yoon, Seong Kuk; Cho, Jin Han; Oh, Jong Young; Nam, Kyung Jin; Kwon, Hee Jin; Kim, Su Yeon; Kang, Myong Jin; Choi, Sun Seob; Sung, Gyung Tak [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2008-08-15

    To evaluate the early clinical experience associated with radiofrequency (RF) ablation in patients with renal cell carcinoma (RCC). The RF ablation treatment was performed on 17 tumors from 16 patients (mean age, 60.5 years; range, 43 73 years) with RCC. The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery. All tumors were treated by a percutaneous CT (n = 10), followed by an US-guided (n = 2), laparoscopy-assisted US (n = 2), and an open (n = 2) RF ablation. Furthermore, patients underwent a follow- up CT at one day, one week, one month, three and six months, and then every six months from the onset of treatment. We evaluated the technical success, technical effectiveness, ablation zone, benign periablation enhancement, irregular peripheral enhancement, and complications. All 17 exophytic tumors (mean size, 2.2 cm; range, 1.1 5.0 cm) were completely ablated. Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17 33 months). A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1). The RF ablation is an alternative treatment for exophytic RCCs and represents a promising treatment for some patients with small RCCs.

  20. Radiofrequency Ablation Treatment for Renal Cell Carcinoma: Early Clinical Experience

    International Nuclear Information System (INIS)

    Park, Seong Hoon; Yoon, Seong Kuk; Cho, Jin Han; Oh, Jong Young; Nam, Kyung Jin; Kwon, Hee Jin; Kim, Su Yeon; Kang, Myong Jin; Choi, Sun Seob; Sung, Gyung Tak

    2008-01-01

    To evaluate the early clinical experience associated with radiofrequency (RF) ablation in patients with renal cell carcinoma (RCC). The RF ablation treatment was performed on 17 tumors from 16 patients (mean age, 60.5 years; range, 43 73 years) with RCC. The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery. All tumors were treated by a percutaneous CT (n = 10), followed by an US-guided (n = 2), laparoscopy-assisted US (n = 2), and an open (n = 2) RF ablation. Furthermore, patients underwent a follow- up CT at one day, one week, one month, three and six months, and then every six months from the onset of treatment. We evaluated the technical success, technical effectiveness, ablation zone, benign periablation enhancement, irregular peripheral enhancement, and complications. All 17 exophytic tumors (mean size, 2.2 cm; range, 1.1 5.0 cm) were completely ablated. Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17 33 months). A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1). The RF ablation is an alternative treatment for exophytic RCCs and represents a promising treatment for some patients with small RCCs

  1. Radiofrequency ablation of liver metastases

    International Nuclear Information System (INIS)

    Pereira, P.L.; Clasen, S.; Schmidt, D.; Wiskirchen, J.; Tepe, G.; Claussen, C.D.; Boss, A.; Gouttefangeas, C.; Burkart, C.

    2004-01-01

    The liver is the second only to lymph nodes as the most common site of metastatic disease irrespective of the primary tumor. Up to 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improvement of the survival time, only approximately 20% of the patients are eligible for surgical intervention. Radiofrequency (RF) ablation represents one of the most important alternatives as well as complementary methods for the therapy of liver metastases. RF ablation can lead in a selected patient group to a palliation or to an increased life expectancy. RF ablation appears either safer (vs. cryotherapy) or easier (vs. laser) or more effective (percutaneous ethanol instillation [PEI]), transarterial chemoembolisation [TACE] in comparison with other minimal invasive procedures. RF ablation can be performed percutaneously, laparoscopically or intraoperatively and may be combined with chemotherapy as well as with surgical resection. Permanent technical improvements of RF systems, a better understanding of the underlying electrophysiological principles and an interdisciplinary approach will lead to a prognosis improvement in patients with liver metastases. (orig.) [de

  2. [Radiofrequency ablation of liver metastases].

    Science.gov (United States)

    Pereira, P L; Clasen, S; Boss, A; Schmidt, D; Gouttefangeas, C; Burkart, C; Wiskirchen, J; Tepe, G; Claussen, C D

    2004-04-01

    The liver is the second only to lymph nodes as the most common site of metastatic disease irrespective of the primary tumor. Up to 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improvement of the survival time, only approximately 20% of the patients are eligible for surgical intervention. Radiofrequency (RF) ablation represents one of the most important alternatives as well as complementary methods for the therapy of liver metastases. RF ablation can lead in a selected patient group to a palliation or to an increased life expectancy. RF ablation appears either safer (vs. cryotherapy) or easier (vs. laser) or more effective (percutaneous ethanol instillation [PEI], transarterial chemoembolisation [TACE]) in comparison with other minimal invasive procedures. RF ablation can be performed percutaneously, laparoscopically or intraoperatively and may be combined with chemotherapy as well as with surgical resection. Permanent technical improvements of RF systems, a better understanding of the underlying electrophysiological principles and an interdisciplinary approach will lead to a prognosis improvement in patients with liver metastases.

  3. Renal Tumors: Technical Success and Early Clinical Experience with Radiofrequency Ablation of 18 Tumors

    International Nuclear Information System (INIS)

    Sabharwal, Rohan; Vladica, Philip

    2006-01-01

    Purpose. To evaluate the feasibility, safety, and technical efficacy of image-guided radiofrequency ablation (RFA) for the treatment of small peripheral renal tumors and to report our early results with this treatment modality. Methods. Twenty-two RFA sessions for 18 tumors were performed in 11 patients with renal tumors. Indications included coexistent morbidity, high surgical or anesthetic risk, solitary kidney, and hereditary predisposition to renal cell carcinoma. Ten patients had CT-guided percutaneous RFA performed on an outpatient basis. One patient had open intraoperative ultrasound-guided RFA. Technical success was defined as elimination of areas that enhanced at imaging within the entire tumor. With the exception of one patient with renal insufficiency who required gadolinium-enhanced MRI, the remaining patients underwent contrast-enhanced CT for post-treatment follow-up assessment. Follow-up was performed after 2-4 weeks and then at 3, 6, 12 months, and every 12 months thereafter. Results. Fourteen (78%) of 18 tumors were successfully ablated with one session. Three of the remaining four tumors required two sessions for successful ablation. One tumor will require a third session for areas of persistent enhancement. Mean patient age was 72.82 ± 10.43 years. Mean tumor size was 1.95 ± 0.79 cm. Mean follow-up time was 10.91 months. All procedures were performed without any major complications. Conclusions. Our early experience with percutaneous image-guided radiofrequency ablation demonstrates it to be a feasible, safe, noninvasive, and effective treatment of small peripheral renal tumors

  4. Case Study of Hepatic Radiofrequency Ablation Causing a Systemic Inflammatory Response Under Total Intravenous Anesthesia

    International Nuclear Information System (INIS)

    Schalte, Gereon; Waning, Christian; Rossaint, Rolf; Mahnken, Andreas H.; Henzler, Dietrich; Tacke, Josef

    2010-01-01

    To investigate the effects of hepatic radiofrequency ablation (RFA) in patients with malignant liver disease with respect to inflammation activation and stress response. In an observational trial, we investigated the physiologic parameters of 17 patients (20 interventions) who underwent percutaneous RFA under general anesthesia after applying total intravenous anesthesia. TNFα, IL-6, IL-8, IL-10, adrenaline and noradrenaline, liver enzymes, lactate and creatine kinase were determined pre-interventionally after induction of anesthesia (T1), 90 minutes after initiation of RFA (T2), immediately after the conclusion of the procedure (T3), and 24 hours after the procedure (T4). A significant increase in body temperature (p < 0.001), and mean arterial pressure (p = 0.001) were measured intraoperatively (T2) and the day after the procedure (T4). Increased levels of IL-6 were measured at T3 and T4 (p = 0.001). IL-10 increased immediately after the procedure (T3; p = 0.007). IL-6 levels correlated well with the total energy applied (γ = 0.837). Significant increases in the levels of adrenaline and noradrenaline were present at T3 and T4 (p < 0.001). The RFA-induced destruction of hepatic tissue was associated with increased levels of AST, ALT, GLDH and LDH. Percutaneous RFA of hepatic malignancies causes an inflammatory and endocrine activation, similar to the systemic inflammatory response syndrome. These effects have to be taken in account when dealing with patients susceptible to sepsis or multi-organ failure

  5. Radiofrequency Ablation of Functioning Adrenal Adenomas: Preliminary Clinical and Laboratory Findings.

    Science.gov (United States)

    Szejnfeld, Denis; Nunes, Thiago Franchi; Giordano, Endrigo Emanuel; Freire, Fabio; Ajzen, Sergio Aron; Kater, Claudio Elias; Goldman, Suzan Menasce

    2015-10-01

    To evaluate clinical and laboratory findings in patients undergoing radiofrequency (RF) ablation for functioning adrenal adenomas. Eleven adult patients, nine with Conn syndrome and two with Cushing syndrome, underwent percutaneous computed tomography-guided RF ablation for benign adrenal neoplasms. Systolic, diastolic, and mean blood pressure and the number of classes of antihypertensive drugs used by each patient were analyzed before and 1, 4, and 12 weeks after the procedure. Serum hormone levels were analyzed within 30 days before and 12 weeks after the procedure. Of the nine patients with Conn syndrome, eight showed normal serum aldosterone levels after the procedure and one patient had a nodule located very close to the inferior vena cava, resulting in incomplete ablation. The two patients with Cushing syndrome had normal serum and salivary cortisol levels after the procedure. Mean aldosterone concentration at baseline was 63.3 ng/dL ± 28.0 and decreased to 13.3 ng/dL ± 13.5 at 12 weeks postoperatively (P = .008). Systolic, diastolic, and mean blood pressures decreased significantly in the first week after the procedure (P < .001) and remained stable during further follow-up. In patients with Conn syndrome or Cushing syndrome, percutaneous RF ablation of functioning adrenal adenomas may result in normalization of hormone secretion, improvement in blood pressure, and reduced need for antihypertensive drugs. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

  6. Case Study of Hepatic Radiofrequency Ablation Causing a Systemic Inflammatory Response Under Total Intravenous Anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Schalte, Gereon; Waning, Christian; Rossaint, Rolf; Mahnken, Andreas H. [University Hospital, RWTH Aachen, Aachen, (Germany); Henzler, Dietrich [Dalhousie University, Queen Elisabeth II Health Sciences Center, Halifax (Canada); Tacke, Josef [Interventional Radiology, Klinikum Passau, Passau (Germany)

    2010-12-15

    To investigate the effects of hepatic radiofrequency ablation (RFA) in patients with malignant liver disease with respect to inflammation activation and stress response. In an observational trial, we investigated the physiologic parameters of 17 patients (20 interventions) who underwent percutaneous RFA under general anesthesia after applying total intravenous anesthesia. TNF{alpha}, IL-6, IL-8, IL-10, adrenaline and noradrenaline, liver enzymes, lactate and creatine kinase were determined pre-interventionally after induction of anesthesia (T1), 90 minutes after initiation of RFA (T2), immediately after the conclusion of the procedure (T3), and 24 hours after the procedure (T4). A significant increase in body temperature (p < 0.001), and mean arterial pressure (p = 0.001) were measured intraoperatively (T2) and the day after the procedure (T4). Increased levels of IL-6 were measured at T3 and T4 (p = 0.001). IL-10 increased immediately after the procedure (T3; p = 0.007). IL-6 levels correlated well with the total energy applied ({gamma} = 0.837). Significant increases in the levels of adrenaline and noradrenaline were present at T3 and T4 (p < 0.001). The RFA-induced destruction of hepatic tissue was associated with increased levels of AST, ALT, GLDH and LDH. Percutaneous RFA of hepatic malignancies causes an inflammatory and endocrine activation, similar to the systemic inflammatory response syndrome. These effects have to be taken in account when dealing with patients susceptible to sepsis or multi-organ failure

  7. Fluoroscopy-guided radiofrequency ablation for small hepatocellular carcinoma: a retrospective comparison with ultrasound-guided ablation

    International Nuclear Information System (INIS)

    Kim, J.; Yoon, C.J.; Seong, N.J.; Jeong, S.-H.; Kim, J.W.

    2015-01-01

    Aim: To compare the therapeutic efficacy of fluoroscopy-guided radiofrequency ablation (F-RFA) and ultrasound-guided RFA (US-RFA) in treatment of small hepatocellular carcinoma (HCC). Materials and methods: Between January 2006 and January 2012, 93 patients with small HCCs underwent percutaneous RFA. In 42 patients with 46 HCCs invisible on US, F-RFA was performed following intra-arterial iodised oil injection (group A). The remaining 51 patients with 58 HCCs received US-RFA (group B). Technical effectiveness, complications, local tumour progression, and patient survival were retrospectively compared between the two groups. Results: Technical effectiveness was achieved in 45 HCCs of group A (97.8%) and 64 HCCs of group B (96.6%; p=0.65). There was no major complication in either group. The 1-, 3-, and 5-year local tumour progression rates were lower in group A than those of group B with marginal significance (0%, 3.7% and 3.7% in group A, and 13%, 13%, and 13% in group B; p=0.05). The 1-, 3-, and 5-year patient survival rates were 100%, 58.3%, and 51.2% (group A), and 82.4%, 54.9%, and 46.1% (group B; p=0.26). Conclusions: F-RFA is a feasible and safe treatment for small HCC invisible on US. Its therapeutic efficacy was comparable with that of US-RFA. -- Highlights: •Fluoroscopy-guided radiofrequency ablation can treat small hepatocellular carcinoma invisible on ultrasonography. •Fluoroscopy-guided radiofrequency ablation can treat small hepatocellular carcinoma with unfavorable location. •Therapeutic efficacy of fluoroscopy-guided radiofrequency ablation is comparable with ultrasound-guided procedure

  8. Pulse-dose radiofrequency treatment in pain management-initial experience.

    Science.gov (United States)

    Ojango, Christine; Raguso, Mario; Fiori, Roberto; Masala, Salvatore

    2017-12-23

    Radiofrequency procedures have been used for treating various chronic pain conditions for decades. These minimally invasive percutaneous treatments employ an alternating electrical current with oscillating radiofrequency wavelengths to eliminate or alter pain signals from the targeted site. The aim of the continuous radiofrequency procedure is to increase the temperature sufficiently to create an irreversible thermal lesion on nerve fibres and thus permanently interrupt pain signals. The pulsed radiofrequency procedure utilises short pulses of radiofrequency current with intervals of longer pauses to avert a temperature increase to the level of permanent tissue damage. The goal of these pulses is to alter the processing of pain signals, but to avoid relevant structural damage to nerve fibres, as seen in the continuous radiofrequency procedure. The pulse-dose radiofrequency procedure is a technical improvement of the pulsed radiofrequency technique in which the delivery mode of the current is adapted. During the pulse-dose radiofrequency procedure thermal damage is avoided. In addition, the amplitude and width of the consecutive pulses are kept the same. The method ensures that each delivered pulse keeps the same characteristics and therefore the dose is similar between patients. The current review outlines the pulse-dose radiofrequency procedure and presents our institution's chronic pain management studies.

  9. Percutaneous cholecystostomy for patients with acute cholecystitis and an increased surgical risk

    NARCIS (Netherlands)

    H. van Overhagen (H.); H. Meyers (Hjalmar); H.W. Tilanus (Hugo); J. Jeekel (Hans); J.S. Laméris (Johan )

    1996-01-01

    textabstractPurpose: To evaluate percutaneous cholecystostomy in patients with acute cholecystitis and an increased surgical risk. Methods: Thirty-three patients with acute cholecystitis (calculous, n = 22; acalculous, n = 11) underwent percutaneous cholecystostomy by means of a transhepatic (n =

  10. [Ultrasound guided percutaneous nephrolithotripsy].

    Science.gov (United States)

    Guliev, B G

    2014-01-01

    The study was aimed to the evaluation of the effectiveness and results of ultrasound guided percutaneous nephrolithotripsy (PNL) for the treatment of patients with large stones in renal pelvis. The results of PNL in 138 patients who underwent surgery for kidney stones from 2011 to 2013 were analyzed. Seventy patients (Group 1) underwent surgery with combined ultrasound and radiological guidance, and 68 patients (Group 2)--only with ultrasound guidance. The study included patients with large renal pelvic stones larger than 2.2 cm, requiring the formation of a single laparoscopic approach. Using the comparative analysis, the timing of surgery, the number of intra- and postoperative complications, blood loss and length of stay were evaluated. Percutaneous access was successfully performed in all patients. Postoperative complications (exacerbation of chronic pyelonephritis, gross hematuria) were observed in 14.3% of patients in Group 1 and in 14.7% of patients in Group 2. Bleeding requiring blood transfusion, and injuries of adjacent organs were not registered. Efficacy of PNL in the Group 1 was 95.7%; 3 (4.3%) patients required additional interventions. In Group 2, the effectiveness of PNL was 94.1%, 4 (5.9%) patients additionally underwent extracorporeal lithotripsy. There were no significant differences in the effectiveness of PNL, the volume of blood loss and duration of hospitalization. Ultrasound guided PNL can be performed in large pelvic stones and sufficient expansion of renal cavities, thus reducing radiation exposure of patients and medical staff.

  11. Percutaneous vertebroplasty

    International Nuclear Information System (INIS)

    Hierholzer, J.; Fuchs, H.; Depriester, C.; Venz, S.; Maier-Hauff, K.; Schulz, R.; Koch, K.

    2002-01-01

    Purpose: To describe the procedure of percutaneous vertebroplasty and to present our first clinical results of patients treated for benign or malignant painful vertebral body disease. Material and Methods: We performed percutaneous vertebroplasty in 31 painful lesions of the spine. Liquid bone cement was injected into the affected vertebral body using fluoroscopic guidance through a bilateral transpedicular approach. Etiology of the bone disease was assessed by biopsy. Pain intensity was assessed before and 1 week after the procedure by standardized catalogue. Results: Percutaneous vertebroplasty was performed in 17 thoracic and in 14 lumbar spine bodies of benign (n = 23) or malignant (n = 8) disease; no clinically relevant complications occurred. All patients reported significant pain relief 1 week after the intervention. One week after treatment, patients were pain-free in 15/31 vertebral bodies, and reported mild residual pain not necessitating narcotic medication in 16/31 cases. Conclusion: In accordance with the literature, percutaneous vertebroplasty proved to be a highly effective, minimal invasive interventional procedure to treat severely painful bone lesions of benign and malignant origin. (orig.) [de

  12. CT-guided radiofrequency tumor ablation in children.

    Science.gov (United States)

    Botsa, Evanthia; Poulou, Loukia S; Koutsogiannis, Ioannis; Ziakas, Panayiotis D; Koundouraki, Antonia; Alexopoulou, Efthimia; Thanos, Loukas

    2014-11-01

    Image-guided radiofrequency ablation is a well-accepted technique of interventional oncology in adults. To evaluate the efficacy and safety of CT-guided radiofrequency ablation as a minimally invasive treatment for metastatic neoplasms in children. A total of 15 radiofrequency ablation sessions were performed in 12 children and young adults (median age 9.5; range 5-18 years) with metastatic malignancies. Seven children and young adults had secondary hepatic lesions, three had pulmonary and two had bone lesions. Radiofrequency ablation was performed under conscious sedation. The median lesion size was 1.7 cm (range 1.3-2.8 cm). The median time for ablation was 8 min (range 7-10 min). Radiofrequency procedures were technically successful in all tumors. Postablation imaging immediately after, and 1 month and 3 months after radiofrequency ablation showed total necrosis in all patients. At 6-month follow-up, three patients (all with lesion size >2 cm) had local recurrence and underwent a second radiofrequency ablation session. At 2-year follow-up no patient had recurrence of the treated tumor. Post-ablation syndrome occurred in four children. No major complication occurred. CT-guided radiofrequency tumor ablation was safe and efficient for palliative treatment in our cohort of patients.

  13. CT-guided radiofrequency tumor ablation in children

    Energy Technology Data Exchange (ETDEWEB)

    Botsa, Evanthia [National and Kapodistrian University of Athens, First Pediatric Clinic, Agia Sofia Children' s Hospital, Athens (Greece); Poulou, Loukia S.; Koundouraki, Antonia; Thanos, Loukas [Sotiria General Hospital for Chest Diseases, Department of Medical Imaging and Interventional Radiology, Athens (Greece); Koutsogiannis, Ioannis [General Military Hospital NIMTS, Department of Medical Imaging, Athens (Greece); Ziakas, Panayiotis D. [Warren Alpert Medical School of Brown University Rhode Island Hospital, Division of Infectious Diseases, Providence, RI (United States); Alexopoulou, Efthimia [Attikon University Hospital, Second Department of Radiology, Athens University School of Medicine, Athens (Greece)

    2014-11-15

    Image-guided radiofrequency ablation is a well-accepted technique of interventional oncology in adults. To evaluate the efficacy and safety of CT-guided radiofrequency ablation as a minimally invasive treatment for metastatic neoplasms in children. A total of 15 radiofrequency ablation sessions were performed in 12 children and young adults (median age 9.5; range 5-18 years) with metastatic malignancies. Seven children and young adults had secondary hepatic lesions, three had pulmonary and two had bone lesions. Radiofrequency ablation was performed under conscious sedation. The median lesion size was 1.7 cm (range 1.3-2.8 cm). The median time for ablation was 8 min (range 7-10 min). Radiofrequency procedures were technically successful in all tumors. Postablation imaging immediately after, and 1 month and 3 months after radiofrequency ablation showed total necrosis in all patients. At 6-month follow-up, three patients (all with lesion size >2 cm) had local recurrence and underwent a second radiofrequency ablation session. At 2-year follow-up no patient had recurrence of the treated tumor. Post-ablation syndrome occurred in four children. No major complication occurred. CT-guided radiofrequency tumor ablation was safe and efficient for palliative treatment in our cohort of patients. (orig.)

  14. Radiofrequency ablation in dermatology

    Directory of Open Access Journals (Sweden)

    Sachdeva Silonie

    2007-01-01

    Full Text Available Radiofreqeuency ablation is a versatile dermatosurgical procedure used for surgical management of skin lesions by using various forms of alternating current at an ultra high frequency. The major modalities in radiofrequency are electrosection, electrocoagulation, electrodessication and fulguration. The use of radiofrequency ablation in dermatosurgical practice has gained importance in recent years as it can be used to treat most of the skin lesions with ease in less time with clean surgical field due to adequate hemostasis and with minimal side effects and complications. This article focuses on the major tissue effects and factors influencing radiofrequency ablation and its application for various dermatological conditions.

  15. Radiofrequency ablation for renal tumors. Our experience

    International Nuclear Information System (INIS)

    Hiraoka, Kenji; Kawauchi, Akihiro; Nakamura, Terukazu; Soh, Jintetsu; Mikami, Kazuya; Miki, Tsuneharu

    2009-01-01

    The objective of this study was to report our results of percutaneous radiofrequency ablation (RFA) for renal tumors and to assess predictors of therapeutic efficacy. Forty patients (median age 73 years) with renal tumors were treated with RFA under local or epidural anesthesia. All of them had high surgical risk or refused radical surgery. Tumors were punctured percutaneously using the Radionics Cool-tip RF System under computed tomography or ultrasonographic guidance. Median tumor diameter was 24 mm. After RFA, contrast-enhanced computed tomography or magnetic resonance imaging was performed within 1 month. Complete response (CR) was defined as no enhancement inside the tumor. Factors related to the outcome and to renal function were assessed. Median follow up was 16 months. CR was observed in 34 cases (85.0%). A significant difference in CR rate was observed between tumors ≤30 mm and those >30 mm. Outcomes tended to be better for tumors in the mid to lower kidney, and those away from the renal hilum. Recurrence was observed in one case (2.9%), but a CR was obtained again by additional RFA. Out of a total of 77 RFA procedures, complications occurred in only three cases (3.9%), and conservative treatment was possible in all cases. Serum creatinine levels 3 months after RFA did not differ from those before RFA. Percutaneous RFA is a safe and effective treatment for small renal tumors in patients with high surgical risk or who refuse radical surgery. (author)

  16. Reconstruction of Vertebral Body After Radiofrequency Ablation and Augmentation in Dorsolumbar Metastatic Vertebral Fracture: Analysis of Clinical and Radiological Outcome in a Clinical Series of 18 Patients.

    Science.gov (United States)

    Maugeri, Rosario; Graziano, Francesca; Basile, Luigi; Gulì, Carlo; Giugno, Antonella; Giammalva, Giuseppe Roberto; Visocchi, Massimiliano; Iacopino, Domenico Gerardo

    2017-01-01

    Painful spinal metastases usually occur in malignant neoplastic disease. Treatment for bone metastases has been largely conservative, and it includes the use of high doses of analgesics, radiotherapy, chemotherapy, hormone therapy, and bisphosphonates; however, results are sometimes transient and ineffective. In the presence of neurological involvement a surgical strategy should be considered. Recently, percutaneous procedures such as radiofrequency ablation, vertebroplasty, and kyphoplasty have been introduced as palliative techniques to treat painful vertebral metastases [3, 11, 25]. In our study we combined the use of radiofrequency ablation with vertebroplasty in the treatment of dorsolumbar metastatic vertebral fractures in order to examine the relationship between restoration of the vertebral structure and decrease in pain. From January 2014 to March 2015 we retrospectively analyzed 18 patients with malignant vertebral lesions who underwent radiofrequency ablation with vertebroplasty followed by cementoplasty, with posterior transpedicle fixation on levels near the lesions. The parameters examined were: demographics, pain relief, and the distribution of polymethylmethacrylate (PMMA) determined by the mean Saliou filling score; all complications were recorded. The mean age of the patients was 55.72 years (range 34-69); average operative time was 60.4 min (range, 51-72). The average pain index score (visual analog score; VAS) decreased significantly from 8.05 at baseline to 3.0 (p < 0.05) after 6 months. The Saliou filling score revealed a distribution of PMMA in the vertebral body that was satisfactory (12-18) in eight patients, mediocre (6-12) in seven patients, and inadequate (0-6) in the remaining three patients. In two vertebrae, minimal asymptomatic cement leakage occurred in the lateral recess without neurological damage. No pulmonary embolism and no visceral or neural damage was recorded. Radiofrequency ablation combined with vertebroplasty seems to

  17. Multiphasic helical Computed Tomography of hepatocellular carcinoma. Evaluation after various percutaneous ablation procedures

    International Nuclear Information System (INIS)

    Catalano, O.; Esposito, M.; Lobianco, R.; Cusati, B.; Altei, F.; Siani, A.

    1999-01-01

    The purpose of this paper is to report the personal experience with helical CT evaluation of hepatocellular carcinoma treated with various percutaneous interventional procedures. From December 1996 to September 1998 it were examined with helical CT 41 patients (73 nodules in all) with hepatocellular carcinoma treated with percutaneous ablation therapies: conventional ethanol injection in 18 subjects (31 nodules), one-shot ethanol injection 3 (8 nodules), radiofrequency thermal ablation in 16 (25 nodules), and combined chemo embolization and ethanol injection in 4 (9 nodules). CT performed was 4-27 days after the last session, acquiring biphasic volumetric images in 14 patients and triphasic volumetric images in 27. A second treatment with subsequent CT study was performed for 28 lesions; 15 underwent 3 serial studies and 6 underwent 4 studies. Compared with pretreatment findings, the diameter was unchanged in 62% of the nodules and increased in 38%. Morphology was unchanged in 63% of the lesions while in 37% a mild deformation toward the needle path or a more regular and round shape was evident. Borders were unchanged in 37% of the cases and modified in 63%, appearing well-defined in 73% and ill-defined in 27%. The necrotic portion had a low attenuation with a nodule-to-parenchyma gradient more evident on delayed than on venous and finally arterial acquisitions; 8% of the lesions were not recognizable on unenhanced scans. During the arterial phase the residual tumor appeared hyperdense in 97% of the nodules and isodense in 3%, while during the portal phase it was hyperdense in 22%, isodense in 28% and hypodense in 50%, and during the delayed phase hypodense in 100%. Residual viable tissue was identified in 44% of the nodules and quantified as 100% in 1% of all lesions, > 75% in 3%, > 50% in 4%, > 25% in 23%. In conclusion, multiple-phase helical CT allows optimal depiction of primitive liver nodules treated with percutaneous interventional procedures and has a

  18. Percutaneous ablation of pancreatic cancer

    Science.gov (United States)

    D’Onofrio, Mirko; Ciaravino, Valentina; De Robertis, Riccardo; Barbi, Emilio; Salvia, Roberto; Girelli, Roberto; Paiella, Salvatore; Gasparini, Camilla; Cardobi, Nicolò; Bassi, Claudio

    2016-01-01

    Pancreatic ductal adenocarcinoma is a highly aggressive tumor with an overall 5-year survival rate of less than 5%. Prognosis and treatment depend on whether the tumor is resectable or not, which mostly depends on how quickly the diagnosis is made. Chemotherapy and radiotherapy can be both used in cases of non-resectable pancreatic cancer. In cases of pancreatic neoplasm that is locally advanced, non-resectable, but non-metastatic, it is possible to apply percutaneous treatments that are able to induce tumor cytoreduction. The aim of this article will be to describe the multiple currently available treatment techniques (radiofrequency ablation, microwave ablation, cryoablation, and irreversible electroporation), their results, and their possible complications, with the aid of a literature review. PMID:27956791

  19. Percutaneous cholecystostomy

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan E-mail: akhano@tr.net; Akinci, Devrim; Oezmen, Mustafa N

    2002-09-01

    Percutaneous cholecystostomy (PC), a technique that consists of percutaneous catheter placement in the gallbladder lumen under imaging guidance, has become an alternative to surgical cholecystostomy in recent years. Indications of PC include calculous or acalculous cholecystitis, cholangitis, biliary obstruction and opacification of biliary ducts. It also provides a potential route for stone dissolution therapy and stone extraction. Under aseptic conditions and ultrasound guidance, using local anesthesia, the procedure is carried out by using either modified Seldinger technique or trocar technique. Transhepatic or transperitoneal puncture can be performed as an access route. Several days after the procedure transcatheter cholangiography is performed to assess the patency of cystic duct, presence of gallstones and catheter position. The tract is considered mature in the absence of leakage to the peritoneal cavity, subhepatic, subcapsular, or subdiaphragmatic spaces. Response rates to PC in the literature are between the range of 56-100% as the variation of different patient population. Complications associated with PC usually occur immediately or within days and include haemorrhage, vagal reactions, sepsis, bile peritonitis, pneumothorax, perforation of the intestinal loop, secondary infection or colonisation of the gallbladder and catheter dislodgment. Late complications have been reported as catheter dislodgment and recurrent cholecystitis. PC under ultrasonographic guidance is a cost-effective, easy to perform and reliable procedure with low complication and high success rates for critically ill patients with acute cholecystitis. It is generally followed by elective cholecystectomy, if possible. However, it may be definitive treatment, especially in acalculous cholecystitis.

  20. Palliative Radiofrequency Ablation for Recurrent Prostate Cancer

    International Nuclear Information System (INIS)

    Jindal, Gaurav; Friedman, Marc; Locklin, Julia; Wood, Bradford J.

    2006-01-01

    Percutaneous radiofrequency ablation (RFA) is a minimally invasive local therapy for cancer. Its efficacy is now becoming well documented in many different organs, including liver, kidney, and lung. The goal of RFA is typically complete eradication of a tumor in lieu of an invasive surgical procedure. However, RFA can also play an important role in the palliative care of cancer patients. Tumors which are surgically unresectable and incompatible for complete ablation present the opportunity for RFA to be used in a new paradigm. Cancer pain runs the gamut from minor discomfort relieved with mild pain medication to unrelenting suffering for the patient, poorly controlled by conventional means. RFA is a tool which can potentially palliate intractable cancer pain. We present here a case in which RFA provided pain relief in a patient with metastatic prostate cancer with pain uncontrolled by conventional methods

  1. Radiofrequency ablation of osteoid osteoma

    NARCIS (Netherlands)

    Vanderschueren, Geert Maria Joris Michael

    2009-01-01

    The main purpose of this thesis was to evaluate the effectiveness and safety of CT-guided radiofrequency ablation for the treatment of spinal and non-spinal osteoid osteomas. Furthermore, the technical requirements needed for safe radiofrequency ablation and the clinical outcome after radiofrequency

  2. Influence of radiofrequency surgery on architecture of the palatine tonsils.

    Science.gov (United States)

    Plzak, Jan; Macokova, Pavla; Zabrodsky, Michal; Kastner, Jan; Lastuvka, Petr; Astl, Jaromir

    2014-01-01

    Radiofrequency surgery is a widely used modern technique for submucosal volume reduction of the tonsils. So far there is very limited information on morphologic changes in the human tonsils after radiofrequency surgery. We performed histopathological study of tonsillectomy specimens after previous bipolar radiofrequency induced thermotherapy (RFITT). A total of 83 patients underwent bipolar RFITT for hypertrophy of palatine tonsils. Tonsil volume reduction was measured by 3D ultrasonography. Five patients subsequently underwent tonsillectomy. Profound histopathological examination was performed to determine the effect of RFITT on tonsillar architecture. All tonsillectomy specimens showed the intact epithelium, intact germinal centers, normal vascularization, and no evidence of increased fibrosis. No microscopic morphological changes in tonsillectomy specimens after bipolar RFITT were observed. RFITT is an effective submucosal volume reduction procedure for treatment of hypertrophic palatine tonsils with no destructive effect on microscopic tonsillar architecture and hence most probably no functional adverse effect.

  3. Percutaneous Tracheostomy

    Science.gov (United States)

    Mehta, Chitra; Mehta, Yatin

    2017-01-01

    Percutaneous dilatational tracheostomy (PDT) is a commonly performed procedure in critically sick patients. It can be safely performed bedside by intensivists. This has resulted in decline in the use of surgical tracheostomy in intensive care unit (ICU) except in few selected cases. Most common indication of tracheostomy in ICU is need for prolonged ventilation. About 10% of patients requiring at least 3 days of mechanical ventilator support get tracheostomised during ICU stay. The ideal timing of PDT remains undecided at present. Contraindications and complications become fewer with increase in experience. Various methods of performing PDT have been discovered in last two decades. Preoperative work up, patient selection and post tracheostomy care form key components of a successful PDT. Bronchoscopy and ultrasound have been found to be useful procedural adjuncts, especially in presence of unfavorable anatomy. This article gives a brief overview about the use of PDT in ICU. PMID:28074819

  4. Percutaneous gastroenterostomy

    Energy Technology Data Exchange (ETDEWEB)

    Wittich, G.R.; Van Sonnenberg, E.; Casola, G.; Jantsch, H.; Walter, R.; Lechner, G.

    1987-05-01

    Percutaneous gastrostomies or gastroenterostomies serve for temporary or permanent enteric feeding in patients with obstruction or functional derangement of the esophagus or hypopharynx. In addition, this radiological procedure may be indicated for small bowel decompression. The authors present their experience in 71 patients. Insufflation of air through a nasogastric tube or catheter is the preferred method for gastric distension. The inferior margin of the left lobe of the liver and the transverse colon are localized sonographically and fluoroscopically prior to puncture. Either Seldinger or Trocartechniques have proven effective in establishing access to the stomach. The feeding tube is advanced into the proximal jejunum to reduce the likelyhood of gastroesophageal reflux and possible aspiration. Complications were encountered in four patients and included catheter dislocation in three and respiratory distress in one patient.

  5. Percutaneous angioscopy

    International Nuclear Information System (INIS)

    Beck, A.

    1987-01-01

    In dogs and 11 patients a new endoscopic method for arteries has been developed. The approach is transfemoral, and endoscopy is combined with angiography, percutaneous transluminal angioplasty (PTA), and local lysis. An ultrathin endoscope with a diameter of 2.4 mm is used, which also provides a working channel with a diameter of 0.4 mm. Guide wires, contrast media, and drugs for local lysis can be inserted through this channel. Under fluoroscopic control, the endoscope is placed in the region of interest, followed by a special method for decreasing blood flow. Endoscopy is documented by video or by a high-speed camera. No complications have occurred. In all patients, it was possible to demonstrate the results of dilatation, recanalization, or local lysis before and after the interventional procedure. (orig.) [de

  6. Pneumonia and mortality after percutaneous endoscopic gastrostomy insertion.

    Science.gov (United States)

    Azzopardi, Neville; Ellul, Pierre

    2013-01-01

    Percutaneous endoscopic gastrostomy feeding provides enteral nutrition to patients with neurological dysphagia. Thirty-day mortality rates of 4-26% have been reported, with pneumonia being the common cause post-percutaneous endoscopic gastrostomy insertion. This retrospective analysis of percutaneous endoscopic gastrostomy tube insertions in Malta (January 2008 - June 2010) compares the incidence of pneumonia in patients fed through a nasogastric tube versus in those fed via a percutaneous endoscopic gastrostomy tube. We analyzed the indications, poor prognostic factors and mortality for percutaneous endoscopic gastrostomy insertion. Ninety-seven patients underwent percutaneous endoscopic gastrostomy insertion. Fifty-four patients received nasogastric feeds before percutaneous endoscopic gastrostomy feeds. Patients on nasogastric feeds developed 32 episodes of pneumonia over a total of 7884 days of feeds (1 every 246 days). Patients with percutaneous endoscopic gastrostomy feeds after a period of nasogastric feeds developed 48 pneumonia episodes over 36,238 days (1 every 755 days). Patients with percutaneous endoscopic gastrostomy feeds without previous nasogastric feeds developed 28 pneumonia episodes over 23,983 days (1 every 856 days), and this was statistically significant (χ 2 test p value nasogastric feeds. However, pneumonia is still the major cause of death among percutaneous endoscopic gastrostomy patients.

  7. Radiofrequency and microwave tumor ablation in patients with implanted cardiac devices: Is it safe?

    Energy Technology Data Exchange (ETDEWEB)

    Skonieczki, Brendan D., E-mail: bskonieczki@lifespan.org [Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University/Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States); Wells, Catherine, E-mail: cwells1@bidmc.harvard.edu [Department of Radiology, Harvard Medical School/Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215 (United States); Wasser, Elliot J., E-mail: ewasser@lifespan.org [Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University/Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States); Dupuy, Damian E., E-mail: ddupuy@lifespan.org [Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University/Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States)

    2011-09-15

    Purpose: To identify malfunction of implanted cardiac devices during or after thermal ablation of tumors in lung, kidney, liver or bone, using radiofrequency (RF) or microwave (MW) energy. Materials and methods: After providing written consent, 19 patients (15 men and 4 women; mean age 78 years) with pacemakers or pacemaker/defibrillators underwent 22 CT image-guided percutaneous RF or MW ablation of a variety of tumors. Before and after each procedure, cardiac devices were interrogated and reprogrammed by a trained cardiac electrophysiology fellow. Possible pacer malfunctions included abnormalities on electrocardiographic (EKG) monitoring and alterations in device settings. Our institutional review board approved this Health Insurance Portability and Accountability Act-compliant study. Informed consent for participation in this retrospective study was deemed unnecessary by our review board. Results: During 20 of 22 sessions, no abnormalities were identified in continuous, EKG tracings or pacemaker functions. However, in two sessions significant changes, occurred in pacemaker parameters: inhibition of pacing during RF application in one, session and resetting of mode by RF energy in another session. These changes did not, result in hemodynamic instability of either patient. MW ablation was not associated with, any malfunction. In all 22 sessions, pacemakers were undamaged and successfully reset to original parameters. Conclusion: RF or MW ablation of tumors in liver, kidney, bone and lung can be performed safely in patients with permanent intra-cardiac devices, but careful planning between radiology and cardiology is essential to avoid adverse outcomes.

  8. Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Dong; Yoon, Seong Guk; Sung, Gyung Tak [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2012-09-15

    To retrospectively evaluate the intermediate results of radiofrequency ablation (RFA) of small renal masses (SRMs). Percutaneous or laparoscopic RFA was performed on 48 renal tumors in 47 patients. The follow-up studies included a physical examination, chest radiography, creatinine level, and contrast-enhanced CT or MRI. To confirm the pathologic criteria of complete ablation, 35 patients underwent a follow-up biopsy. Recurrence was defined as contrast enhancement on imaging studies after 3 months, lesion growth at subsequent imaging, or viable cancer cells on follow-up biopsy. Technical success was achieved in 43 (89.6%) of 48 renal tumors. The mean tumor size was 2.3 cm and the mean follow-up period was 49.6 months. Repeated RFA was necessary in 5 tumors due to incomplete ablation. The overall complication rate was 35.8%, of which 96.2% were mild complications. Serum creatinine levels at 12 months after RFA did not differ from those before RFA (1.28 vs. 1.36 mg/dL). Four patients were found to have recurrence at various follow-up intervals, and distant metastasis was not found in any cases. RFA appears to be a useful treatment for selected patients with SRMs. Our 4-year follow-up results disclose an excellent therapeutic outcome with RFA, while achieving effective local tumor control.

  9. Percutaneous Achilles Tendon Lengthening

    Science.gov (United States)

    ... All Site Content AOFAS / FootCareMD / Treatments Percutaneous Achilles Tendon Lengthening Page Content ​ Pre-operative incision markings along ... What is the goal of a percutaneous Achilles tendon lengthening? The goal of this procedure is to ...

  10. Radiofrequency Ablation Effectively Treated Focal Recurrence of Mesothelioma.

    Science.gov (United States)

    Nakamura, Akifumi; Takuwa, Teruhisa; Hashimoto, Masaki; Kondo, Nobuyuki; Takaki, Haruyuki; Fujiwara, Masayuki; Yamakado, Koichiro; Hasegawa, Seiki

    2018-02-01

    A 55-year-old man with malignant pleural mesothelioma underwent multimodality treatment comprising induction chemotherapy followed by extrapleural pneumonectomy and radiation therapy. After 2.5 years, focal recurrence occurred, with computed tomography revealing a tumor in the left cardiophrenic angle. Surgery was considered a problem for the patient because of the previous extrapleural pneumonectomy and difficult tumor location. Radiofrequency ablation was thus performed; the course was uneventful, and there was no recurrence. Radiofrequency ablation should be considered an option to treat recurrence of malignant pleural mesothelioma. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. PERCUTANEOUS ELECTROHEMOSTASIS AFTER PERCUTANEOUS NEPHROLITHOTOMY

    Directory of Open Access Journals (Sweden)

    R. N. Trushkin

    2017-01-01

    Full Text Available The article describes the clinical case in a patient with bilateral nephrolithiasis, chronic kidney disease of the 4th stage, after which bleeding from the left kidney developed after simultaneous bilateral percutaneous nephrolithotomy (PNL, leading to severe hemic hypoxia. Conservative therapy, blood transfusion did not lead to a persistent effect, the bleeding continued to recur. Given the presence of chronic renal failure (CRF from the embolization of the branches of the renal artery, it was decided to abstain, given the extremely high risk of aggravation of nephropathy after the administration of the contrast drug. Left-sided nephrectomy would inevitably lead to the development of terminal chronic renal failure. Patients performed an electrocoagulation of the fistula wall with a Karl Storz 26C resectoscope in 60W mode. The bleeding was completely stopped. The patient is discharged from the hospital in a satisfactory condition. At the time of discharge in the conduct of replacement renal therapy did not need. When analyzing publications in The Cochrane Library, PubMed, Medline and Web of Science, we did not find a description of such a method of hemostasis.

  12. Percutaneous thermal ablation of renal neoplasms

    International Nuclear Information System (INIS)

    Tacke, J.; Mahnken, A.H.; Guenther, R.W.

    2005-01-01

    Due to modern examination techniques such as multidetector computed tomography and high-field magnetic resonance imaging, the detection rate of renal neoplasms is continually increasing. Even though tumors exceeding 4 cm in diameter rarely metastasize, all renal lesions that are possible neoplasms should be treated. Traditional treatment techniques include radical nephrectomy or nephron-sparing resection, which are increasingly performed laparoscopically. Modern thermal ablation techniques such as hyperthermal techniques like radiofrequency ablation RFA, laser induced thermal ablation LITT, focused ultrasound FUS and microwave therapy MW, as well as hypothermal techniques (cryotherapy) may be a useful treatment option for patients who are unfit for or refuse surgical resection. Cryotherapy is the oldest and best known thermal ablation technique and can be performed laparoscopically or percutaneously. Since subzero temperatures have no antistyptic effect, additional maneuvers must be performed to control bleeding. Percutaneous cryotherapy of renal tumors is a new and interesting method, but experience with it is still limited. Radiofrequency ablation is the most frequently used method. Modern probe design allows volumes between 2 and 5 cm in diameter to be ablated. Due to hyperthermal tract ablation, the procedure is deemed to be safe and has a low complication rate. Although there are no randomized comparative studies to open resection, the preliminary results for renal RFA are promising and show RFA to be superior to other thermal ablation techniques. Clinical success rates are over 90% for both, cryo- and radiofrequency ablation. Whereas laser induced thermal therapy is established in hepatic ablation, experience is minimal with respect to renal application. For lesions of more than 2 cm in diameter, additional cooling catheters are required. MR thermometry offers temperature control during ablation. Microwave ablation is characterized by small ablation volumes

  13. Percutaneous tension band wiring for patellar fractures.

    Science.gov (United States)

    Rathi, Akhilesh; Swamy, M K S; Prasantha, I; Consul, Ashu; Bansal, Abhishek; Bahl, Vibhu

    2012-08-01

    To evaluate outcome of percutaneous tension band wiring for transverse fractures of the patella. 16 men and 7 women aged 27 to 65 (mean, 40) years underwent percutaneous tension band wiring for transverse fractures of the patella with a displacement of >3 mm. Pain, operating time, mobility, functional score, and complications were evaluated. 20 patients underwent successful percutaneous tension band wiring. The remaining 3 patients in whom closed reduction failed underwent open reduction and tension band wiring. The mean operating time was 46 (range, 28-62) minutes. The mean follow-up period was 20 (range, 15-30) months. At the latest follow-up, all patients had regained full extension. The objective score was excellent in 20 patients and good in 3, whereas the subjective score was excellent in 17, good in 5, and fair in one. All patients had radiological union at week 8. One patient had patellofemoral arthritis (secondary to a postoperative articular step). Two patients developed superficial infections, which resolved after antibiotic therapy. Mean thigh muscle wasting was 0.7 (range, 0.4-1) cm. Three patients encountered hardware problems (impingement/irritation of the skin over the knee) necessitating implant removal. Percutaneous tension band wiring is a viable option for transverse fractures of the patella.

  14. Renal effects of percutaneous stone removal

    Energy Technology Data Exchange (ETDEWEB)

    Eshghi, M.; Schiff, R.G.; Smith, A.D.

    1989-02-01

    Preoperative and postoperative renography with 99mTechnetium-diethylene-triamine pentaacetic acid was performed on 33 patients who were free of renal scarring, infection, and obstruction and who underwent percutaneous renal stone removal. Although there was a transient decrease in renal function postoperatively in some patients, statistically significant reductions in renal function occurred only in 1 patient with an arteriovenous malformation that was embolized and in 1 patient who had a postoperative ureteropelvic junction stricture. The creation of more than one nephrostomy tract did not affect the results. In the absence of serious complications, percutaneous nephrostomy does not have a significant effect on renal function.

  15. Exit strategies following percutaneous nephrolithotomy (PCNL)

    DEFF Research Database (Denmark)

    Cormio, Luigi; Gonzalez, Gaspar Ibarlucea; Tolley, David

    2013-01-01

    PURPOSE: To compare the characteristics and outcomes of exit strategies following percutaneous nephrolithotomy (PCNL) using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database. MATERIALS AND METHODS: Two matched data sets were prepared in order to compare...... stent only versus NT only and TTL versus NT only. Patients were matched on the exit strategy using the following variables: case volume of the center where they underwent PCNL, stone burden, the presence of staghorn stone, size of sheath used at percutaneous access, the presence of bleeding during...

  16. Temperature Controlled Radiofrequency Ablation

    Directory of Open Access Journals (Sweden)

    Olaf J. Eick

    2002-07-01

    Full Text Available Since its introduction in 1987, radiofrequency (RF ablation has developed to become the treatment of choice for symptoms caused by atrio ventricular (AV reentrant tachycardia, isthmus related atrial flutter, AV-nodal reentrant tachycardia and to some extent also for certain types of ventricular tachycardias. The introduction of new cardiac activation mapping systems has further contributed to the successful and safe application of RF ablation for various tachyarrhythmias.

  17. Laser and Radiofrequency Air Plasma Sources

    National Research Council Canada - National Science Library

    Scharer, J

    2003-01-01

    .... We have measured plasma density decay rates and been successful in radiofrequency sustainment of the laser-produced plasmas with reduced power levels compared to radiofrequency ionization alone...

  18. Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Garnon, Julien, E-mail: juliengarnon@gmail.com; Koch, Guillaume, E-mail: Guillaume.koch@gmail.com [University Hospital of Strasbourg, Department of Interventional Radiology (France); Ramamurthy, Nitin, E-mail: Nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Caudrelier, Jean, E-mail: caudjean@yahoo.fr [University Hospital of Strasbourg, Department of Interventional Radiology (France); Rao, Pramod, E-mail: pramodrao@me.com [University of Strasbourg, ICube (France); Tsoumakidou, Georgia, E-mail: Georgia.tsoumakidou@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Gangi, Afshin, E-mail: Afshin.gangi@chru-strasbourg.fr [University Hospital of Strasbourg, Department of Interventional Radiology (France)

    2016-09-15

    ObjectiveTo review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures.Materials and MethodsBetween May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57–75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up was undertaken every few weeks until mortality or most recent appointment.ResultsFour pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1–4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2–3 months; one case could not be followed due to early post-procedural oncologic mortality.ConclusionPercutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.

  19. Clinical application of radiofrequency ablation combined with bronchial artery infusion of docetaxel in treating non-small cell lung cancer

    International Nuclear Information System (INIS)

    Lu Xiong; Chen Fang; Lin Yun; Tan Taikang; Wei Wei

    2010-01-01

    Objective: To discuss the clinical application of radiofrequency ablation combined with bronchial artery infusion of docetaxel in treating non-small cell lung cancer and to summarize the experience of using this therapy in clinical practice. Methods: Radiofrequency ablation was performed in twenty-one patients with lung cancer. The diagnosis was confirmed by CT-guided percutaneous needle biopsy or bronchoscopic biopsy in all patients. One week after radiofrequency ablation treatment, bronchial artery infusion of docetaxel was conducted. The therapeutic results were observed and evaluated. Results: After the treatment, the lesion's size was markedly reduced and the clinical symptoms were dramatically improved in all patients. Conclusion: Radiofrequency ablation combined with bronchial artery infusion of docetaxel is a safe, effective and simple technique with excellent therapeutic results for the treatment of non-small cell lung cancer. It is really worth popularizing this technique in clinical practice. (authors)

  20. Percutaneous balloon valvuloplasty of a stenosed mitral bioprosthesis.

    Science.gov (United States)

    Fernandez, J J; DeSando, C J; Leff, R A; Ord, M; Sabbagh, A H

    1990-01-01

    A 62-year-old woman with disabling mitral prosthetic stenosis underwent percutaneous balloon valvuloplasty. The transvalvular gradient preoperatively was 22 mm Hg and was reduced to 6 mm Hg after the valvuloplasty. the valve area was increased from an initial value of 0.77 cm2 to 1.53 cm2. No complications occurred related to the Further studies are necessary to ascertain the indications and long-term results of percutaneous valvuloplasty on bioprosthesis in the mitral position.

  1. Radiofrequency in cosmetic dermatology.

    Science.gov (United States)

    Beasley, Karen L; Weiss, Robert A

    2014-01-01

    The demand for noninvasive methods of facial and body rejuvenation has experienced exponential growth over the last decade. There is a particular interest in safe and effective ways to decrease skin laxity and smooth irregular body contours and texture without downtime. These noninvasive treatments are being sought after because less time for recovery means less time lost from work and social endeavors. Radiofrequency (RF) treatments are traditionally titrated to be nonablative and are optimal for those wishing to avoid recovery time. Not only is there minimal recovery but also a high level of safety with aesthetic RF treatments. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Percutaneous management of tumoral biliary obstruction in children

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Gumus, Burcak; Ozkan, Orhan S.; Ozmen, Mustafa N.; Akhan, Okan [Hacettepe School of Medicine, Department of Radiology, Sihhiye, Ankara (Turkey); Ekinci, Saniye [Hacettepe School of Medicine, Department of Paediatric Surgery, Sihhiye, Ankara (Turkey); Akcoren, Zuhal [Hacettepe School of Medicine, Department of Paediatric Pathology, Sihhiye, Ankara (Turkey); Kutluk, Tezer [Hacettepe School of Medicine, Department of Paediatric Oncology, Sihhiye, Ankara (Turkey)

    2007-10-15

    There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures. To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children. Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis. All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death. Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children. (orig.)

  3. Percutaneous management of tumoral biliary obstruction in children

    International Nuclear Information System (INIS)

    Akinci, Devrim; Gumus, Burcak; Ozkan, Orhan S.; Ozmen, Mustafa N.; Akhan, Okan; Ekinci, Saniye; Akcoren, Zuhal; Kutluk, Tezer

    2007-01-01

    There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures. To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children. Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis. All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death. Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children. (orig.)

  4. CT-guided radiofrequency ablation of spinal osteoid osteomas with concomitant perineural and epidural irrigation for neuroprotection

    International Nuclear Information System (INIS)

    Klass, Darren; Marshall, Tom; Toms, Andoni

    2009-01-01

    Here we report our experience of a neuroprotective adaptation of the technique of CT-guided radiofrequency (RF) ablation of spinal osteoid osteomas. Over 9 years seven patients underwent eight CT-guided RF treatments for osteoid osteoma. CT-guided RF ablation was performed with general anaesthesia. The lesion was heated to 90 C for 2 min for two cycles by using a Cosman SMK TC-10 RF electrode. This was preceded by a bolus of room temperature sterile water (10 ml) injected through a 26G curved spinal needle into the exit foramen and adjacent epidural space for neuroprotection. The age of the patient, sex, lesion location, biopsy results and complications were recorded. All the biopsies (n = 7) demonstrated histological features of osteoid osteoma. All the procedures were technically successful. Clinical success was assessed up to 3 years post procedure. There was an 85% clinical success rate (6 of the 7 patients), with recurrence of a lesion at 6 months, necessitating a repeat procedure (successful). CT-guided percutaneous RF ablation of spinal osteoid osteoma preceded by bolus of sterile water, injected through a spinal needle into the exit foramen and adjacent epidural space for neuroprotection, is a safe and effective procedure. (orig.)

  5. Current oncologic applications of radiofrequency ablation therapies

    Science.gov (United States)

    Shah, Dhruvil R; Green, Sari; Elliot, Angelina; McGahan, John P; Khatri, Vijay P

    2013-01-01

    Radiofrequency ablation (RFA) uses high frequency alternating current to heat a volume of tissue around a needle electrode to induce focal coagulative necrosis with minimal injury to surrounding tissues. RFA can be performed via an open, laparoscopic, or image guided percutaneous approach and be performed under general or local anesthesia. Advances in delivery mechanisms, electrode designs, and higher power generators have increased the maximum volume that can be ablated, while maximizing oncological outcomes. In general, RFA is used to control local tumor growth, prevent recurrence, palliate symptoms, and improve survival in a subset of patients that are not candidates for surgical resection. It’s equivalence to surgical resection has yet to be proven in large randomized control trials. Currently, the use of RFA has been well described as a primary or adjuvant treatment modality of limited but unresectable hepatocellular carcinoma, liver metastasis, especially colorectal cancer metastases, primary lung tumors, renal cell carcinoma, boney metastasis and osteoid osteomas. The role of RFA in the primary treatment of early stage breast cancer is still evolving. This review will discuss the general features of RFA and outline its role in commonly encountered solid tumors. PMID:23671734

  6. Pulse-Dose Radiofrequency in Athletic Pubalgia: Preliminary Results.

    Science.gov (United States)

    Masala, Salvatore; Fiori, Roberto; Raguso, Mario; Ojango, Christine; Morini, Marco; Cuzzolino, Alessandro; Calabria, Eros; Simonetti, Giovanni

    2017-05-01

    Chronic pubalgia affects around 10% of athletes. To determine the role of pulse-dose radiofrequency (PDRF) in athletes with chronic pubalgia and investigate the causes with imaging. Prospective nonrandomized single-group study. PDRF was performed on 32 patients with a chronic pain that had been refractory to conservative therapies during the last 3 mo. The genital branches of the genitofemoral, ilioinguinal, and iliohypogastric nerves and the obturator nerve were the goals of treatment. A 10-cm, 20-gauge cannula was inserted with a percutaneous access on the upper and lower edges of the iliopubic branch. After the spindle was removed, a radiofrequency needle with a 10-mm "active tip" was inserted. The radiofrequency technique was performed with 1200 pulses at 45 V and 20-ms duration, followed by a 480-ms silent phase. The follow-up with a clinical examination was performed at 1, 3, 6, and 9 mo after the procedure. During the follow-up visits, the patients were asked to rate their pain on a 0-10 VAS scale. All of the enrolled patients completed the study. Mean VAS score before the treatment was 8.4 ± 0.6. Twenty-four patients had a reduction of pain VAS scores more than 50% during all follow-up visits and started training and physiotherapy in the days after the radiofrequency procedure. Six patients, each treated 2 times, had a reduction more than 50% of VAS scores and could start training and physiotherapy only after the 2nd procedure. One patient had no pain relief with 2 treatments. Pain intensity decreased up to 9 mo in 31 patients (mean VAS scores 3.4 ± 0.5 at 6 mo and 3.8 ± 0.9 at 9 mo). No complications were observed. PDRF is an effective and safe technique in management of chronic pubalgia in athletes.

  7. Radiofrequency attenuator and method

    Science.gov (United States)

    Warner, Benjamin P [Los Alamos, NM; McCleskey, T Mark [Los Alamos, NM; Burrell, Anthony K [Los Alamos, NM; Agrawal, Anoop [Tucson, AZ; Hall, Simon B [Palmerston North, NZ

    2009-01-20

    Radiofrequency attenuator and method. The attenuator includes a pair of transparent windows. A chamber between the windows is filled with molten salt. Preferred molten salts include quarternary ammonium cations and fluorine-containing anions such as tetrafluoroborate (BF.sub.4.sup.-), hexafluorophosphate (PF.sub.6.sup.-), hexafluoroarsenate (AsF.sub.6.sup.-), trifluoromethylsulfonate (CF.sub.3SO.sub.3.sup.-), bis(trifluoromethylsulfonyl)imide ((CF.sub.3SO.sub.2).sub.2N.sup.-), bis(perfluoroethylsulfonyl)imide ((CF.sub.3CF.sub.2SO.sub.2).sub.2N.sup.-) and tris(trifluoromethylsulfonyl)methide ((CF.sub.3SO.sub.2).sub.3C.sup.-). Radicals or radical cations may be added to or electrochemically generated in the molten salt to enhance the RF attenuation.

  8. Neurohumoral indicators of efficacy radiofrequency cardiac denervation

    Energy Technology Data Exchange (ETDEWEB)

    Evtushenko, A. V., E-mail: ave@cardio-tomsk.ru; Evtushenko, V. V. [National Research Tomsk State University, Tomsk (Russian Federation); Federal State Budgetary Scientific Institution “Research Institute for Cardiology”, Tomsk (Russian Federation); Saushkina, Yu. V.; Gusakova, A. M.; Suslova, T. E.; Dymbrylova, O. N.; Smyshlyaev, K. A.; Kurlov, I. O. [Federal State Budgetary Scientific Institution “Research Institute for Cardiology”, Tomsk (Russian Federation); Lishmanov, Yu. B.; Anfinogenova, Ya. D. [National Research Tomsk Polytechnic University, Tomsk (Russian Federation); Federal State Budgetary Scientific Institution “Research Institute for Cardiology”, Tomsk (Russian Federation); Sergeevichev, D. S. [Academician E.N. Meshalkin State Research Institute of Circulation Pathology, Novosibirsk (Russian Federation); Bykov, A. N.; Syryamkin, V. I.; Kistenev, Yu. V. [National Research Tomsk State University, Tomsk (Russian Federation); Lotkov, A. I. [Institute of Strength Physics and Materials Science of the Siberian Branch of the RAS, Tomsk (Russian Federation); Pokushalov, E. A.

    2015-11-17

    In this study, we compared pre- and postoperative parameters of the cardiac sympathetic innervation. The aim of the study was to examine the approaches to evaluating the quality of radiofrequency (RF)-induced cardiac denervation by using non-invasive and laboratory methods. The study included 32 people with long-lasting persistent atrial fibrillation (AF). The patients were divided into 2 groups according to the objectives of the study: group 1 (main) - 21 patients with mitral valve diseases, which simultaneously with radiofrequency ablation (RFA) AF carried out on the effects of the paraganglionic nervous plexuses by C. Pappone (2004) and N. Doll (2008) schemes. The second group (control) contained 11 patients with heart diseases in sinus rhythm (the RF denervation not been performed). All patients, who underwent surgical treatment, were received examination of cardiac sympathetic tone by using {sup 123}I-MIBG. All of them made blood analysis from ascending aorta and coronary sinus to determine the level of norepinephrine and its metabolites before and after cardiac denervation. Data of radionuclide examination are correlating with laboratory data.

  9. Comparison of microbubble presence in the right heart during mechanochemical and radiofrequency ablation for varicose veins.

    Science.gov (United States)

    Moon, K H; Dharmarajah, B; Bootun, R; Lim, C S; Lane, Tra; Moore, H M; Sritharan, K; Davies, A H

    2017-07-01

    Objective Mechanochemical ablation is a novel technique for ablation of varicose veins utilising a rotating catheter and liquid sclerosant. Mechanochemical ablation and radiofrequency ablation have no reported neurological side-effect but the rotating mechanism of mechanochemical ablation may produce microbubbles. Air emboli have been implicated as a cause of cerebrovascular events during ultrasound-guided foam sclerotherapy and microbubbles in the heart during ultrasound-guided foam sclerotherapy have been demonstrated. This study investigated the presence of microbubbles in the right heart during varicose vein ablation by mechanochemical abaltion and radiofrequency abaltion. Methods Patients undergoing great saphenous vein ablation by mechanochemical abaltion or radiofrequency ablation were recruited. During the ablative procedure, the presence of microbubbles was assessed using transthoracic echocardiogram. Offline blinded image quantification was performed using International Consensus Criteria grading guidelines. Results From 32 recruited patients, 28 data sets were analysed. Eleven underwent mechanochemical abaltion and 17 underwent radiofrequency abaltion. There were no neurological complications. In total, 39% (11/28) of patients had grade 1 or 2 microbubbles detected. Thirty-six percent (4/11) of mechanochemical abaltion patients and 29% (5/17) of radiofrequency ablation patients had microbubbles with no significant difference between the groups ( p=0.8065). Conclusion A comparable prevalence of microbubbles between mechanochemical abaltion and radiofrequency ablation both of which are lower than that previously reported for ultrasound-guided foam sclerotherapy suggests that mechanochemical abaltion may not confer the same risk of neurological events as ultrasound-guided foam sclerotherapy for treatment of varicose veins.

  10. Learning curve in circular multipolar phased radiofrequency ablation of atrial fibrillation.

    Science.gov (United States)

    Martirosyan, Mihran; Kiss, Alexandra; Nagy-Baló, Edina; Sándorfi, Gábor; Tint, Diana; Édes, István; Csanádi, Zoltán

    2015-01-01

    Although atrial fibrillation (AF) ablation is considered a technically challenging procedure, studies on the learning curve of different pulmonary vein isolation (PVI) techniques are limited. We investigated the time-dependent changes in procedural parameters, complication rates, and in the 1-year clinical outcome during our initial experience with circular multipolar phased radiofrequency (RF) ablation. The first 132 consecutive patients (40 female; age: 56.6 ± 10.4 years) who underwent PVI with phased RF ablation for paroxysmal or persistent AF at our center were included in the study. Procedural parameters and atrial arrhythmia-free survival were compared in the first, second and third group of 44 successive patients. All pulmonary veins were successfully isolated in 44 (100%), 41 (93.8%) and 42 (95.5%) patients in Tierce 1, 2 and 3, respectively (p = 0.233). The number of RF applications (per vein) required for isolation and fluoroscopy times demonstrated a significant decrease with experience, and a trend towards lower procedure times in Tierces 2 and 3 was also observed. Atrial arrhythmia-free survival rates at 12 months postablation were 68.18%, 75%, and 70.75% in Tierce 1, Tierce 2 and Tierce 3, respectively (p = 0.772). Pericardial tamponade requiring percutaneous subxiphoid drainage occurred in 1 patient (Tierce 3) as the only significant procedural complication. A learning curve effect was demonstrated in fluoroscopy times and in the number of RF applications but not in the acute success and in the long-term arrhythmia-free survival with circular multipolar RF ablations.

  11. Multicenter Prospective Clinical Series Evaluating Radiofrequency Ablation in the Treatment of Painful Spine Metastases

    International Nuclear Information System (INIS)

    Bagla, Sandeep; Sayed, Dawood; Smirniotopoulos, John; Brower, Jayson; Neal Rutledge, J.; Dick, Bradley; Carlisle, James; Lekht, Ilya; Georgy, Bassem

    2016-01-01

    BackgroundRadiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM.MethodsFifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval.ResultsTwenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported.ConclusionRFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.

  12. Multicenter Prospective Clinical Series Evaluating Radiofrequency Ablation in the Treatment of Painful Spine Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Bagla, Sandeep, E-mail: sandeep.bagla@gmail.com [Vascular Institute of Virginia, LLC (United States); Sayed, Dawood [University of Kansas Medical Center (United States); Smirniotopoulos, John [New York Presbyterian Hospital/Weill Cornell Medical Center (United States); Brower, Jayson [Providence Sacred Heart Medical Center and Children’s Hospital (United States); Neal Rutledge, J. [Seton Medical Center (United States); Dick, Bradley [Suburban Hospital (United States); Carlisle, James [St. Mark’s Hospital (United States); Lekht, Ilya [University of Southern California (United States); Georgy, Bassem [San Diego Imaging (United States)

    2016-09-15

    BackgroundRadiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM.MethodsFifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval.ResultsTwenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported.ConclusionRFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.

  13. Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juleiengarnon@gmail.com [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Tsoumakidou, Georgia, E-mail: georgia.tsoumakidou@chru-strasbourg.fr; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Thénint, Marie-Aude, E-mail: marie-aude.thenint@chru-strasbourg.fr; Rao, Pramod, E-mail: pramodrao@me.com; Koch, Guillaume, E-mail: guillaume.koch@chru-strasbourg.fr; Gangi, Afshin, E-mail: gangi@unistra.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France)

    2016-07-15

    ObjectiveTo describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures.Materials and MethodsBetween May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioning a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications.ResultsMean FB size was 23 mm (range 8–74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications.ConclusionPercutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.

  14. Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System

    International Nuclear Information System (INIS)

    Cazzato, Roberto Luigi; Garnon, Julien; Ramamurthy, Nitin; Tsoumakidou, Georgia; Caudrelier, Jean; Thénint, Marie-Aude; Rao, Pramod; Koch, Guillaume; Gangi, Afshin

    2016-01-01

    ObjectiveTo describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures.Materials and MethodsBetween May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioning a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications.ResultsMean FB size was 23 mm (range 8–74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications.ConclusionPercutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.

  15. Understanding of percutaneous puncture under guidance of ultrasound in treating peritoneal and perinephritic abscess

    International Nuclear Information System (INIS)

    Huang Liying; Wang Jiagang

    2010-01-01

    Objective: To explore the clinical value of percutaneous puncture under guidance of ultrasound in treating peritoneal abscess. Methods: To summarize 68 patients with peritoneal abscess underwent percutaneous puncture under guidance of ultrasound to analyse the method of operation and therapeutic effect. Results: effective power of percutaneous puncture under guidance of ultrasound in treating peritoneal abscess was 96.8%. Conclusion: Percutaneous puncture under guidance of ultrasound in treating peritoneal abscess may avoid injury induced by blinded puncture, with characteristic of easier operation, slighter trauma. higher safety, significant therapeutic effect, and can be spreaded to the clinical application. (authors)

  16. Percutaneous rendezvous technique for the management of a bile duct injury.

    Science.gov (United States)

    Meek, James; Fletcher, Savannah; Crumley, Kristen; Culp, W C; Meek, Mary

    2018-02-01

    The rendezvous technique typically involves combined efforts of interventional radiology, endoscopy, and surgery. It can be done solely percutaneously, whereby the interventionalist gains desired access to one point in the body by approaching it from two different access sites. We present the case of a woman who underwent cholecystectomy complicated by a bile duct injury. A percutaneous rendezvous procedure enabled placement of an internal-external drain from the intrahepatic ducts through the biloma and distal common bile duct and into the duodenum. Thus, a percutaneous rendezvous technique is feasible for managing a bile duct injury when endoscopic retrograde cholangio-pancreatography or percutaneous transhepatic cholangiogram alone has been unsuccessful.

  17. Percutaneous rendezvous technique for the management of a bile duct injury

    Directory of Open Access Journals (Sweden)

    James Meek, DO

    2018-02-01

    Full Text Available The rendezvous technique typically involves combined efforts of interventional radiology, endoscopy, and surgery. It can be done solely percutaneously, whereby the interventionalist gains desired access to one point in the body by approaching it from two different access sites. We present the case of a woman who underwent cholecystectomy complicated by a bile duct injury. A percutaneous rendezvous procedure enabled placement of an internal-external drain from the intrahepatic ducts through the biloma and distal common bile duct and into the duodenum. Thus, a percutaneous rendezvous technique is feasible for managing a bile duct injury when endoscopic retrograde cholangio-pancreatography or percutaneous transhepatic cholangiogram alone has been unsuccessful.

  18. Percutaneous transhepatic biliary drainage

    International Nuclear Information System (INIS)

    Park, Jae Hyung; Hong, Seong Mo; Han, Man Chung

    1982-01-01

    Percutaneous transhepatic biliary drainage was successfully made 20 times on 17 patients of obstructive jaundice for recent 1 year since June 1981 at Department of Radiology in Seoul National University Hospital. The causes of obstructive jaundice was CBD Ca in 13 cases, metastasis in 2 cases, pancreatic cancer in 1 case and CBD stone in 1 case. Percutaneous transhepatic biliary drainage is a relatively ease, safe and effective method which can be done after PTC by radiologist. It is expected that percutaneous transhepatic biliary drainage should be done as an essential procedure for transient permanent palliation of obstructive jaundice

  19. Peritonitis following percutaneous gastrostomy tube insertions in children

    Energy Technology Data Exchange (ETDEWEB)

    Dookhoo, Leema [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); University of Toronto, Faculty of Medicine, Toronto, ON (Canada); Mahant, Sanjay [The Hospital for Sick Children, Department of Pediatrics, Toronto, ON (Canada); Parra, Dimitri A.; John, Philip R.; Amaral, Joao G.; Connolly, Bairbre L. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2016-09-15

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  20. Peritonitis following percutaneous gastrostomy tube insertions in children

    International Nuclear Information System (INIS)

    Dookhoo, Leema; Mahant, Sanjay; Parra, Dimitri A.; John, Philip R.; Amaral, Joao G.; Connolly, Bairbre L.

    2016-01-01

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  1. Peritonitis following percutaneous gastrostomy tube insertions in children.

    Science.gov (United States)

    Dookhoo, Leema; Mahant, Sanjay; Parra, Dimitri A; John, Philip R; Amaral, Joao G; Connolly, Bairbre L

    2016-09-01

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  2. Percutaneous high-frequency selective rhizotomy in the trigeminal neuralgia therapy in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    V. M. Tyurnikov

    2012-01-01

    Full Text Available Trigeminal neuralgia is a rare symptom of multiple sclerosis affecting the disability. Multiple sclerosis related trigeminal neuralgia has been attributed to a demyelinating lesion in the pons. When the adequate pain drug-relieve therapy is not possible or when the patient becomes refractory to the treatment or can not continue pharmacological treatment because of the side effects, surgical intervention, including percutaneous radiofrequency rhizotomy is being discussed. Literature review and the data upon the efficiency and safety of this neurosurgical treatment in 16 patients with multiple sclerosis have been analyzed. Percutaneous radiofrequency rhizotomy has been proved to be a safe, reproducible and effective method of the symptomatic surgical treatment of trigeminal neuralgia in patients with multiple sclerosis in cases of the intolerance/inefficiency of the pharmacological therapy.

  3. Measurement of radiofrequency fields

    International Nuclear Information System (INIS)

    Leonowich, J.A.

    1992-05-01

    We are literally surrounded by radiofrequency (RFR) and microwave radiation, from both natural and man-made sources. The identification and control of man-made sources of RFR has become a high priority of radiation safety professionals in recent years. For the purposes of this paper, we will consider RFR to cover the frequencies from 3 kHz to 300 MHz, and microwaves from 300 MHz to 300 GHz, and will use the term RFR interchangeably to describe both. Electromagnetic radiation and field below 3 kHz is considered Extremely Low Frequency (ELF) and will not be discussed in this paper. Unlike x- and gamma radiation, RFR is non-ionizing. The energy of any RFR photon is insufficient to produce ionizations in matter. The measurement and control of RFR hazards is therefore fundamentally different from ionizing radiation. The purpose of this paper is to acquaint the reader with the fundamental issues involved in measuring and safely using RFR fields. 23 refs

  4. Percutaneous dilatational tracheostomy

    DEFF Research Database (Denmark)

    Johnsen, R.

    2015-01-01

    Introduction Since the introduction and development of percutaneous dilatational tracheostomy (PDT), this procedure is accepted and incorporated in ICUs worldwide. In spite of obvious benefits for the patients, who obtain more comfort and mobility and less use of sedatives, the procedure also...... providers' notes are entered. When searching for -percutaneous dilatation tracheostomy' in the electronic system, we found all patients who had undergone this specific procedure. Afterwards we analyzed each of these patients' hospital records, looking for any periprocedure or postprocedure complications...

  5. Treatment of Benign Thyroid Nodules: Comparison of Surgery with Radiofrequency Ablation.

    Science.gov (United States)

    Che, Y; Jin, S; Shi, C; Wang, L; Zhang, X; Li, Y; Baek, J H

    2015-07-01

    Nodular goiter is one of the most common benign lesions in thyroid nodule. The main treatment of the disease is still the traditional surgical resection, however there are many problems such as general anesthesia, surgical scar, postoperative thyroid or parathyroid function abnormalities, and high nodules recurrence rate in residual gland. The purpose of this study was to compare the efficacy, safety, and cost-effectiveness of 2 treatment methods, surgery and radiofrequency ablation, for the treatment of benign thyroid nodules. From May 2012 to September 2013, 200 patients with nodular goiters who underwent surgery (group A) and 200 patients treated by radiofrequency ablation (group B) were enrolled in this study. Inclusion criteria were the following: 1) cosmetic problem, 2) nodule-related symptoms, 3) hyperfunctioning nodules related to thyrotoxicosis, and 4) refusal of surgery (for group B). An internally cooled radiofrequency ablation system and an 18-ga internally cooled electrode were used. We compared the 2 groups in terms of efficacy, safety, and cost-effectiveness during a 1-year follow-up. After radiofrequency ablation, the nodule volume decreased significantly from 5.4 to 0.4 mL (P = .002) at the 12-month follow-up. The incidence of complications was significantly higher from surgery than from radiofrequency ablation (6.0% versus 1.0%, P = .002). Hypothyroidism was detected in 71.5% of patients after surgery but in none following radiofrequency ablation. The rate of residual nodules (11.9% versus 2.9%, P = .004) and hospitalization days was significantly greater after surgery (6.6 versus 2.1 days, P radiofrequency ablation are both effective treatments of nodular goiter. Compared with surgery, the advantages of radiofrequency ablation include fewer complications, preservation of thyroid function, and fewer hospitalization days. Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules. © 2015 by American

  6. New-generation radiofrequency technology.

    Science.gov (United States)

    Krueger, Nils; Sadick, Neil S

    2013-01-01

    Radiofrequency (RF) technology has become a standard treatment in aesthetic medicine with many indications due to its versatility, efficacy, and safety. It is used worldwide for cellulite reduction; acne scar revision; and treatment of hypertrophic scars and keloids, rosacea, and inflammatory acne in all skin types. However, the most common indication for RF technology is the nonablative tightening of tissue to improve skin laxity and reduce wrinkles. Radiofrequency devices are classified as unipolar, bipolar, or multipolar depending on the number of electrodes used. Additional modalities include fractional RF; sublative RF; phase-controlled RF; and combination RF therapies that apply light, massage, or pulsed electromagnetic fields (PEMFs). This article reviews studies and case series on these devices. Radiofrequency technology for aesthetic medicine has seen rapid advancements since it was used for skin tightening in 2003. Future developments will continue to keep RF technology at the forefront of the dermatologist's armamentarium for skin tightening and rejuvenation.

  7. Percutaneous Cementoplasty for Kienbock’s Disease

    Energy Technology Data Exchange (ETDEWEB)

    Vallejo, Eduardo Crespo, E-mail: dreduardocrespo@gmail.com [Hospital Príncipe de Asturias, Vascular and Interventional Radiology Unit (Spain); Martinez-Galdámez, Mario [Fundación Jimenez Diaz, Neurointerventional Radiology Unit (Spain); Martin, Ernesto Santos [Memorial Sloan-Kettering Center, Vascular and Interventional Radiology Unit (United States); Gregorio, Arturo Perera de [Hospital Príncipe de Asturias, Department of Orthopedic Surgery (Spain); Gallego, Miriam Gamo [Hospital Príncipe de Asturias, Vascular and Interventional Radiology Unit (Spain); Escobar, Angeles Ramirez [Hospital Príncipe de Asturias, Radiology Unit (Spain)

    2017-05-15

    Kienböck disease typically presents with wrist pain, swelling, restricted range of motion, and difficulty in performing activities of daily living. Because the etiology and evolution of disease remain unclear, broad ranges of treatments have been designed. Percutaneous cementoplasty is expanding its role for managing painful bone metastases outside the spine. We can draw a parallel between lytic tumoral lesions and Kienbock’s disease. Increasing the strength and rigidity of lunate with cementoplasty can prevent it from collapse, relieve the symptoms associated with the process of avascular necrosis, and increase the wrist range of motion. We report the case of 30-year-old man with a painful stage IIIA Kienböck disease who underwent percutaneous cementoplasty and experienced immediate effective pain relief and recovery of wrist mobility.

  8. Percutaneous Cementoplasty for Kienbock’s Disease

    International Nuclear Information System (INIS)

    Vallejo, Eduardo Crespo; Martinez-Galdámez, Mario; Martin, Ernesto Santos; Gregorio, Arturo Perera de; Gallego, Miriam Gamo; Escobar, Angeles Ramirez

    2017-01-01

    Kienböck disease typically presents with wrist pain, swelling, restricted range of motion, and difficulty in performing activities of daily living. Because the etiology and evolution of disease remain unclear, broad ranges of treatments have been designed. Percutaneous cementoplasty is expanding its role for managing painful bone metastases outside the spine. We can draw a parallel between lytic tumoral lesions and Kienbock’s disease. Increasing the strength and rigidity of lunate with cementoplasty can prevent it from collapse, relieve the symptoms associated with the process of avascular necrosis, and increase the wrist range of motion. We report the case of 30-year-old man with a painful stage IIIA Kienböck disease who underwent percutaneous cementoplasty and experienced immediate effective pain relief and recovery of wrist mobility.

  9. Saline Infusion Markedly Reduces Impedance and Improves Efficacy of Pulmonary Radiofrequency Ablation

    International Nuclear Information System (INIS)

    Gananadha, Sivakumar; Morris, David Lawson

    2004-01-01

    Radiofrequency ablation (RFA) is a relatively new technique that has been investigated for the treatment of lung tumors. We evaluated for the first time the in vivo use of saline infusion during radiofrequency ablation of sheep lung. We performed RFA on 5 sheep using open and closed chest RFA and the RITA starburst XL and Xli probes using saline infusion with the Xli probe. The impedance and volume of ablation were compared. A total of 16 ablations were produced, 5 percutaneously and 11 open. The impedance during percutaneous and open RFA without saline infusion was 110 ± 16.2 and 183.3 ± 105.8 O, respectively. With the saline infusion the impedance was 71.3 ± 22O and 103.6 ± 37.5O. The effect of this was a significantly larger volume of ablation using the saline infusion during percutaneous RFA (90.6 ± 23 cm 3 vs 10.47 ± 2.9 cm 3 , p = 0.01) and open RFA (107.8 ± 25.8 cm 3 vs 24.9 ± 19.3 cm 3 , p = 0.0002). Saline infusion during RFA is associated with lower impedance, higher power delivery and larger lesion size.

  10. Saline Infusion Markedly Reduces Impedance and Improves Efficacy of Pulmonary Radiofrequency Ablation

    International Nuclear Information System (INIS)

    Gananadha, Sivakumar; Morris, David Lawson

    2004-01-01

    Radiofrequency ablation (RFA) is a relatively new technique that has been investigated for the treatment of lung tumors. We evaluated for the first time the in vivo use of saline infusion during radiofrequency ablation of sheep lung. We performed RFA on 5 sheep using open and closed chest RFA and the RITA starburst XL and Xli probes using saline infusion with the Xli probe. The impedance and volume of ablation were compared. A total of 16 ablations were produced, 5 percutaneously and 11 open. The impedance during percutaneous and open RFA without saline infusion was 110 ± 16.2 and 183.3 ± 105.8 O, respectively. With the saline infusion the impedance was 71.3 ± 22O and 103.6 ± 37.5O. The effect of this was a significantly larger volume of ablation using the saline infusion during percutaneous RFA (90.6 ± 23 cm 3 vs 10.47 ± 2.9 cm 3 , p = 0.01) and open RFA (107.8 ± 25.8 cm 3 vs 24.9 ± 19.3 cm 3 , p = 0.0002). Saline infusion during RFA is associated with lower impedance, higher power delivery and larger lesion size

  11. Intracardiac echo-guided radiofrequency catheter ablation of atrial fibrillation in patients with atrial septal defect or patent foramen ovale repair: a feasibility, safety, and efficacy study.

    Science.gov (United States)

    Lakkireddy, Dhanunjaya; Rangisetty, Umamahesh; Prasad, Subramanya; Verma, Atul; Biria, Mazda; Berenbom, Loren; Pimentel, Rhea; Emert, Martin; Rosamond, Thomas; Fahmy, Tamer; Patel, Dimpi; Di Biase, Luigi; Schweikert, Robert; Burkhardt, David; Natale, Andrea

    2008-11-01

    Intracardiac Echo-Guided Radiofrequency Catheter. Patients with atrial septal defect (ASD) are at higher risk for atrial fibrillation (AF) even after repair. Transseptal access in these patients is perceived to be difficult. We describe the feasibility, safety, and efficacy of pulmonary vein antral isolation (PVAI) in these patients. We prospectively compared post-ASD/patent foramen ovale (PFO) repair patients (group I, n = 45) with age-gender-AF type matched controls (group II, n = 45). All the patients underwent PVAI through a double transseptal puncture with a roving circular mapping catheter technique guided by intracardiac echocardiography (ICE). The short-term (3 months) and long-term (12 month) failure rates were assessed. In group I, 23 (51%) had percutaneous closure devices and 22 (49%) had a surgical closure. There was no significant difference between group I and II in the baseline characteristics. Intracardiac echo-guided double transseptal access was obtained in 98% of patients in group I and in 100% of patients in group II. PVAI was performed in all patients, with right atrial flutter ablation in 7 patients in group I and in 4 patients in group II. Over a mean follow-up of 15 +/- 4 months, group I had higher short-term (18% vs 13%, P = 0.77) and long-term recurrence (24% vs 18%, P = 0.6) than group II. There was no significant difference in the perioperative complications between the two groups. Echocardiography at 3 months showed interatrial communication in 2 patients in group I and 1 patient in group II, which resolved at 12 months. Percutaneous AF ablation using double transseptal access is feasible, safe, and efficacious in patients with ASD and PFO repairs.

  12. Pre-treatment double- or triple-positive tumor markers are predictive of a poor outcome for patients undergoing radiofrequency ablation for hepatocellular carcinoma.

    Science.gov (United States)

    Nitta, Hidetoshi; Nakagawa, Shigeki; Kaida, Takayoshi; Arima, Kota; Higashi, Takaaki; Taki, Katsunobu; Okabe, Hirohisa; Hayashi, Hiromitsu; Hashimoto, Daisuke; Chikamoto, Akira; Ishiko, Takatoshi; Beppu, Toru; Baba, Hideo

    2017-03-01

    We evaluated the therapeutic effect of radiofrequency ablation (RFA) on hepatocellular carcinoma (HCC) according to the number of positive tumor markers. The subjects of this study were 160 patients who underwent percutaneous and surgical RFA for HCC. Patients were divided into negative (n = 51), single- (n = 69), double- (n = 31), and triple-positive (n = 9) tumor marker groups according to the pre-treatment expression of these markers. We looked for any relationships among clinical parameters, outcomes, and tumor markers. The 3-year recurrence-free and overall survival rates of the negative, single-, double-, and triple-positive groups were 30, 19, 16, and 11 % (P = 0.02), and 94, 88, 67, and 37 % (P tumor marker profile was independently associated with local recurrence [hazard ratio (HR) 5.48, 95 % confidence interval (CI) 2.44-12.33, P tumor markers.

  13. Actual role of radiofrequency ablation of liver metastases

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Philippe L. [Eberhard-Karls-University of Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany)

    2007-08-15

    The liver is, second only to lymph nodes, the most common site for metastatic disease irrespective of the primary tumour. More than 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improved survival in patients with colorectal metastases, only approximately 20% of patients are eligible for surgery. Thermal ablation and especially radiofrequency ablation emerge as an important additional therapy modality for the treatment of liver metastases. RF ablation shows a benefit in life expectancy and may lead in a selected patient group to cure. Percutaneous RF ablation appears safer (versus cryotherapy), easier (versus laser), and more effective (versus ethanol instillation and transarterial chemoembolisation) compared with other minimally invasive procedures. RF ablation can be performed by a percutaneous, laparoscopical or laparotomic approach, and may be potentially combined with chemotherapy and surgery. At present ideal candidates have tumours with a maximum diameter less than 3.5 cm. An untreatable primary tumour or a systemic disease represents contraindications for performing local therapies. Permanent technical improvements of thermal ablation devices and a better integration of thermal ablation in the overall patient care may lead to prognosis improvement in patients with liver metastases. (orig.)

  14. Actual role of radiofrequency ablation of liver metastases

    International Nuclear Information System (INIS)

    Pereira, Philippe L.

    2007-01-01

    The liver is, second only to lymph nodes, the most common site for metastatic disease irrespective of the primary tumour. More than 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improved survival in patients with colorectal metastases, only approximately 20% of patients are eligible for surgery. Thermal ablation and especially radiofrequency ablation emerge as an important additional therapy modality for the treatment of liver metastases. RF ablation shows a benefit in life expectancy and may lead in a selected patient group to cure. Percutaneous RF ablation appears safer (versus cryotherapy), easier (versus laser), and more effective (versus ethanol instillation and transarterial chemoembolisation) compared with other minimally invasive procedures. RF ablation can be performed by a percutaneous, laparoscopical or laparotomic approach, and may be potentially combined with chemotherapy and surgery. At present ideal candidates have tumours with a maximum diameter less than 3.5 cm. An untreatable primary tumour or a systemic disease represents contraindications for performing local therapies. Permanent technical improvements of thermal ablation devices and a better integration of thermal ablation in the overall patient care may lead to prognosis improvement in patients with liver metastases. (orig.)

  15. Radiofrequency Ablation of Lung Malignancies: Where Do We Stand?

    International Nuclear Information System (INIS)

    Lencioni, Riccardo; Crocetti, Laura; Cioni, Roberto; Mussi, Alfredo; Fontanini, Gabriella; Ambrogi, Marcello; Franchini, Chiara; Cioni, Dania; Fanucchi, Olivia; Gemignani, Raffaello; Baldassarri, Rubia; Angeletti, Carlo Alberto; Bartolozzi, Carlo

    2004-01-01

    Percutaneous radiofrequency (RF) ablation is a minimally invasive technique used to treat solid tumors. Because of its ability to produce large volumes of coagulation necrosis in a controlled fashion, this technique has gained acceptance as a viable therapeutic option for unresectable liver malignancies. Recently, investigation has been focused on the clinical application of RF ablation in the treatment of lung malignancies. In theory, lung tumors are well suited to RF ablation because the surrounding air in adjacent normal parenchyma provides an insulating effect, thus facilitating energy concentration within the tumor tissue. Experimental studies in rabbits have confirmed that lung RF ablation can be safely and effectively performed via a percutaneous, transthoracic approach, and have prompted the start of clinical investigation. Pilot clinical studies have shown that RF ablation enables successful treatment of relatively small lung malignancies with a high rate of complete response and acceptable morbidity, and have suggested that the technique could represent a viable alternate or complementary treatment method for patients with non-small cell lung cancer or lung metastases of favorable histotypes who are not candidates for surgical resection. This article gives an overview of lung RF ablation, discussing experimental animal findings, rationale for clinical application, technique and methodology, clinical results, and complications

  16. Percutaneous transhepatic sphincterotomy

    International Nuclear Information System (INIS)

    Gandin, G.; Zanon, E.; Righi, D.; Fonio, P.; Ferrari, A.; Recchia, S.

    1990-01-01

    The authors describe the techique employed for percutaneous trans-hepatic sphincterotomy as performed on 3 patients with common bile duct (CBD) stones. In all patients, previous endoscopic attempt had failed for anatomical reasons (Billroth II gastric resection or partial gastric resection with brown anastomosis), and the ampulla could not be correctly incannulated with the sphincterotome. In all aptients endoscopy was useful to check the position of the diethermic loop inserted percutaneously. Conplete and immediate success was obtained in all 3 cases. No major complications occurred during transhepatic treatment. To date, 1 recurrence has been observed, and the patient has been retreated with bilioplasty. All patients were followed after 5-6 months with US, plain X-rays of the abdomen and blood tests (γGt, alkaline phosphatase, and bilirubinemia). The authors suggest that percutaneous transhepatic sphincterotomy be employed electively in patients with biliary tree diseases in case the endoscopic approach failes

  17. Percutaneous Penetration - Methodological Considerations

    DEFF Research Database (Denmark)

    Holmgaard, Rikke; Benfeldt, Eva; Nielsen, Jesper B

    2014-01-01

    developed to replace methods involving experimental animals. The results obtained from these methods are decided not only by the chemical or product tested, but to a significant degree also by the experimental set-up and decisions made by the investigator during the planning phase. The present Mini......Studies on percutaneous penetration are needed to assess the hazards after unintended occupational skin exposures to industrial products as well as the efficacy after intended consumer exposure to topically applied medicinal or cosmetic products. During recent decades, a number of methods have been...... and their relevance for the prediction of percutaneous penetration are given. Which method to prefer will depend on the product to be tested and the question asked. Regulatory guidelines exist for studies on percutaneous penetration, but researchers as well as regulatory bodies need to pay specific attention...

  18. Percutaneous intervention in obstructive

    International Nuclear Information System (INIS)

    Souftas, V.

    2012-01-01

    Percutaneous intervention procedures in obstructive uropathy include percutaneous nephrostomy tube placements, nephroureteral stents, percutaneous nephrostomy combined with ureteral embolization, percutaneous management of stone disease, suprapubic tube placements into the bladder, and perinephric/retroperitoneal urinomas/abscesses drainages. Percutaneous nephrostomy is performed to relieve urinary obstruction or divert the urinary stream away from the ureter or bladder. Patients are given preprocedure antibiotics. Percutaneous nephrostomies can be emergent cases because of risk of pyuria and sepsis from a stagnant urine collection. The procedure is performed using both ultrasound and fluoroscopy (or fluoroscopy alone using anatomic landmarks, or an internal radiopaque calculus, or delayed phase excretion of the contrast into the renal collecting system) under local anesthesia or conscious sedation. Ureteral stents are placed to bypass an obstructing stone or to stent across of an area of stricture or ureteral laceration. Stents may be placed by the urologist via a transurethral approach or by the interventional radiologist via a percutaneous approach. The decision as to method of stent placement is based upon the location and accessibility of the ureteral pathology. Ureteral embolization is performed in patients with unresectable tumors of the pelvis with long-standing nephrostomy tubes and distal urine leaks refractory to other treatments. Coils, gelfoam and liquid embolic materials can be used. Ureteral embolization for ureteral fistulas and incontinence is technically successful in 100% of the patients. Complications include bleeding, infection, ureteral or renal injury, and deployment (or movement) of the coils within the renal pelvis. Percutaneous management of stone disease, including renal, ureteral, and bladder stones requires close cooperation between the urologist and interventional radiologist, because of availability of sonographic lithotripsy

  19. Percutaneous transluminal angioplasty of an occluded surgical splenorenal shunt in a 4-year-old child after liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Yussim, Ethan; Belenky, Alexander; Atar, Eli [Department of Diagnostic Radiology, Rabin Medical Center, Vascular and Interventional Radiology Unit, Petah Tikva (Israel); Shapiro, Rivka [Schneider Children' s Medical Center, Institute of Pediatric Gastroenterology and Nutrition, Petah Tikva (Israel); Mor, Eytan [Rabin Medical Center, Department of Organ Transplantation, Petah Tikva (Israel)

    2005-07-01

    Percutaneous transluminal angioplasty is increasingly used in children. We present a case of successful balloon angioplasty of an occluded surgical splenorenal shunt in a 4-year-old child who underwent liver transplantation because of biliary atresia. Percutaneous reopening of the shunt is a relatively safe procedure that may spare patients of surgical intervention. (orig.)

  20. Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Martel, Jose [Departamento de Diagnostico por Imagen, Fundacion Hospital Alcorcon, Alcorcon, Madrid (Spain)], E-mail: jmartel@fhalcorcon.es; Bueno, Angel [Departamento de Diagnostico por Imagen, Fundacion Hospital Alcorcon, Alcorcon, Madrid (Spain); Nieto-Morales, M Luisa [Servicio de Radiologia, Hospital Universitario de Tenerife (Spain); Ortiz, Eduardo J. [Departamento de Cirugia Ortopedica, Fundacion Hospital Alcorcon, Alcorcon, Madrid (Spain)

    2009-09-15

    CT-guided percutaneous radiofrequency ablation and laser photocoagulation have become the methods of choice for the treatment of all osteoid osteomas except those in contact with neural structures. We report 10 patients with spinal osteoid osteoma adjacent to the neural elements treated with 12 sessions of CT-guided monopolar radiofrequency ablation. The size range of the lesion was 3-14 mm (mean, 7.5 mm) and the distance between the nidus and the adjacent spinal cord or nerve root was 2-12 mm (mean, 5 mm). No intact cortex between the tumor and the spinal cord or nerve roots constituted an exclusion criterion because of a higher risk of undesirable neurotoxic effects. Patients were under general anesthesia. After location of the lesion, a 11G-bone biopsy was introduced into the nidus. The radiofrequency electrode was inserted through the biopsy needle and heated at 90 deg. C for 4 min. Primary success was obtained in eight patients. At follow-up (mean, 19.5 months; range, 6-24 months), pain persisted in two patients after 2 months. Both of them were re-treated. All patients are currently pain-free and complications were not detected. In our opinion, radiofrequency ablation can also be considered the treatment of choice for spinal osteoid osteoma.

  1. 12-month efficacy of a single radiofrequency ablation on autonomously functioning thyroid nodules.

    Science.gov (United States)

    Bernardi, Stella; Stacul, Fulvio; Michelli, Andrea; Giudici, Fabiola; Zuolo, Giulia; de Manzini, Nicolò; Dobrinja, Chiara; Zanconati, Fabrizio; Fabris, Bruno

    2017-09-01

    Radiofrequency ablation has been advocated as an alternative to radioiodine and/or surgery for the treatment of autonomously functioning benign thyroid nodules. However, only a few studies have measured radiofrequency ablation efficacy on autonomously functioning benign thyroid nodules. The aim of this work was to evaluate the 12-month efficacy of a single session of radiofrequency ablation (performed with the moving shot technique) on solitary autonomously functioning benign thyroid nodules. Thirty patients with a single, benign autonomously functioning benign thyroid nodules, who were either unwilling or ineligible to undergo surgery and radioiodine, were treated with radiofrequency ablation between April 2012 and May 2015. All the patients underwent a single radiofrequency ablation, performed with the 18-gauge needle and the moving shot technique. Clinical, laboratory, and ultrasound evaluations were scheduled at baseline, and after 1, 3, 6, and 12 months from the procedure. A single radiofrequency ablation reduced thyroid nodule volume by 51, 63, 69, and 75 % after 1, 3, 6, and 12 months, respectively. This was associated with a significant improvement of local cervical discomfort and cosmetic score. As for thyroid function, 33 % of the patients went into remission after 3 months, 43 % after 6 months, and 50 % after 12 months from the procedure. This study demonstrates that a single radiofrequency ablation allowed us to withdraw anti-thyroid medication in 50 % of the patients, who remained euthyroid afterwards. This study shows that a single radiofrequency ablation was effective in 50 % of patients with autonomously functioning benign thyroid nodules. Patients responded gradually to the treatment. It is possible that longer follow-up studies might show greater response rates.

  2. Percutaneous thermal ablation of renal neoplasms; Perkutane Thermoablation von Nierentumoren

    Energy Technology Data Exchange (ETDEWEB)

    Tacke, J. [Inst. fuer Diagnostische und Interventionelle Radiologie/Neuroradiologie, Klinikum Passau (Germany); Mahnken, A.H.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum Aachen (Germany)

    2005-12-15

    Due to modern examination techniques such as multidetector computed tomography and high-field magnetic resonance imaging, the detection rate of renal neoplasms is continually increasing. Even though tumors exceeding 4 cm in diameter rarely metastasize, all renal lesions that are possible neoplasms should be treated. Traditional treatment techniques include radical nephrectomy or nephron-sparing resection, which are increasingly performed laparoscopically. Modern thermal ablation techniques such as hyperthermal techniques like radiofrequency ablation RFA, laser induced thermal ablation LITT, focused ultrasound FUS and microwave therapy MW, as well as hypothermal techniques (cryotherapy) may be a useful treatment option for patients who are unfit for or refuse surgical resection. Cryotherapy is the oldest and best known thermal ablation technique and can be performed laparoscopically or percutaneously. Since subzero temperatures have no antistyptic effect, additional maneuvers must be performed to control bleeding. Percutaneous cryotherapy of renal tumors is a new and interesting method, but experience with it is still limited. Radiofrequency ablation is the most frequently used method. Modern probe design allows volumes between 2 and 5 cm in diameter to be ablated. Due to hyperthermal tract ablation, the procedure is deemed to be safe and has a low complication rate. Although there are no randomized comparative studies to open resection, the preliminary results for renal RFA are promising and show RFA to be superior to other thermal ablation techniques. Clinical success rates are over 90% for both, cryo- and radiofrequency ablation. Whereas laser induced thermal therapy is established in hepatic ablation, experience is minimal with respect to renal application. For lesions of more than 2 cm in diameter, additional cooling catheters are required. MR thermometry offers temperature control during ablation. Microwave ablation is characterized by small ablation volumes

  3. Sedation Monitoring and Management during Percutaneous Endoscopic Lumbar Discectomy

    Directory of Open Access Journals (Sweden)

    Menekse Oksar

    2016-01-01

    Full Text Available Percutaneous endoscopic laser discectomy (PELD is a painful intervention that requires deep sedation and analgesia. However, sedation should be light at some point because cooperation by the patient during the procedure is required for successful surgical treatment. Light sedation poses a problem for endotracheal intubation, while patients placed in the prone position during percutaneous endoscopic discectomy pose a problem for airway management. Therefore, under these conditions, sedation should be not deeper than required. Here we report the sedation management of three cases that underwent PELD, with a focus on deep and safe sedation that was monitored using bispectral index score and observer’s assessment of alertness/sedation score.

  4. Percutaneous biliary drainage in patients with cholangiocarcinoma

    International Nuclear Information System (INIS)

    Mehta, A.C.; Gobel, R.J.; Rose, S.C.; Hayes, J.K.; Miller, F.J.

    1990-01-01

    This paper determines whether radiation therapy (RT) is a risk factor for infectious complications (particularly hepatic abscess formation) related to percutaneous biliary drainage (PBD). The authors retrospectively reviewed the charts of 98 consecutive patients who had undergone PBD for obstruction. In 34 patients with benign obstruction, three infectious complications occurred, none of which were hepatic abscess or fatal sepsis. In 39 patients who had malignant obstruction but did not have cholangiocarcinoma, 13 infectious complications occurred, including two hepatic abscesses and three cases of fatal sepsis. Of the 25 patients with cholangiocarcinoma, 15 underwent RT; in these 15 patients, 14 infectious complications occurred, including six hepatic abscesses and two cases of fatal sepsis

  5. A prospective clinical study to evaluate the safety and performance of wireless localization of nonpalpable breast lesions using radiofrequency identification technology.

    Science.gov (United States)

    Dauphine, Christine; Reicher, Joshua J; Reicher, Murray A; Gondusky, Christina; Khalkhali, Iraj; Kim, Michelle

    2015-06-01

    The purpose of this study was to evaluate the safety and performance of localizing nonpalpable breast lesions using radiofrequency identification technology. Twenty consecutive women requiring preoperative localization of a breast lesion were recruited. Subjects underwent placement of both a hook wire and a radiofrequency identification tag immediately before surgery. The radiofrequency identification tag was the primary method used by the operating surgeon to localize each lesion during excision, with the hook wire serving as backup in case of tag migration or failed localization. Successful localization with removal of the intended lesion was the primary outcome measured. Tag migration and postoperative infection were also noted to assess safety. Twenty patients underwent placement of a radiofrequency identification tag, 12 under ultrasound guidance and eight with stereotactic guidance. In all cases, the radiofrequency identification tag was successfully localized by the reader at the level of the skin before incision, and the intended lesion was removed along with the radiofrequency identification tag. There were no localization failures and no postoperative infections. Tag migration did not occur before incision, but in three cases, occurred as the lesion was being retracted with fingers to make the final cut along the deep surface of the specimen. In this initial clinical study, radiofrequency tags were safe and able to successfully localize nonpalpable breast lesions. Radiofrequency identification technology may represent an alternative method to hook wire localization.

  6. Percutaneous Dilatational Tracheostomy via Griggs Technique.

    Science.gov (United States)

    Karimpour, Hasan Ali; Vafaii, Kamran; Chalechale, Maryam; Mohammadi, Saeed; Kaviannezhad, Rasool

    2017-01-01

    Tracheostomy is considered the airway management of choice for patients who need prolonged mechanical ventilation support. Percutaneous Dilatational Tracheotomy (PDT) is a technique that can be performed easily and rapidly at bedside and is particularly useful in the intensive care setting. The Griggs percutaneous tracheotomy is unique in its utilization of a guide wire dilator forceps. We aimed to describe the early perioperative and late postoperative complications of PDT using the Griggs technique in patients in the intensive care unit (ICU). This cross-sectional study was conducted on all patients who underwent tracheostomy in the ICU of the Imam Reza Hospital of Kermanshah, Iran, from June 2011 to June 2015. PDT was performed in 184 patients with the Griggs technique. Demographic variables, as well as perioperative and late postoperative complications were recorded. The mean age of patients was 57.3 ± 15.37 years. The most common primary causes of tracheostomy were hypoxic brain damage disorders (43.2%) and pneumonia (14.8%). Perioperative and early complications occurred in 16.7 % of procedures, of which 9.3% were bleedings (minor, significant and major). Furthermore, the incidence of late complications was 8.6%, including: stomal infection, difficult replace tracheostomy tube, tracheoesophageal fistula, tracheal stenosis, and tracheomalacia. PDT via Griggs technique is a safe, quick, and effective method. The low incidence of complications indicates that bedside percutaneous tracheostomy can be performed safely as a routine procedure for daily care implemented in the ICU.

  7. Percutaneous Zenith endografting for abdominal aortic aneurysms.

    Science.gov (United States)

    Heyer, Kamaldeep S; Resnick, Scott A; Matsumura, Jon S; Amaranto, Daniel; Eskandari, Mark K

    2009-03-01

    A completely percutaneous approach to infrarenal abdominal aortic aneurysm (AAA) endografting has the theoretic benefits of being minimally invasive and more expedient. Our goal was to demonstrate the utility of this approach using a suprarenal fixation device and a suture-mediated closure system. We conducted a single-institution, retrospective review of 14 patients who underwent percutaneous AAA repair with the Zenith device between August 2003 and March 2007. Immediate and delayed access-related outcomes were examined over a mean follow-up of 12.1+/-2.0 months. Mean AAA size was 5.6 cm. Immediate arterial closure and technical success rate was 96% (27/28 vessels). One immediate hemostatic failure required open surgical repair. Over follow-up, one vessel required operative repair for new-onset claudication. No other immediate or delayed complications (thrombosis, pseudoaneurysm, infection, or deep venous thrombosis) were detected. A percutaneous approach for the treatment of AAA has several advantages over femoral artery cutdown but also has its own unique set of risks in the immediate and late postoperative period. Ultimately, the "preclose technique" can be safely applied for the Zenith device despite its large-bore delivery system.

  8. Treatment of compensatory hyperhidrosis of the trunk with radiofrequency ablation.

    Science.gov (United States)

    Deniz, Süleyman; Kavaklı, Kuthan; Çaylak, Hasan; Purtuloğlu, Tarık; Sapmaz, Ersin; İnangil, Gökhan; Atım, Abdulkadir; Gürkök, Sedat; Kurt, Ercan

    2015-01-01

    Although Endoscopic Thoracic Sympathectomy is a widely accepted treatment method for patients with palmar hyperhidrosis, compensatory hyperhidrosis of the trunk remains a challenging side effect of the procedure. No satisfactory treatment options for this side effect were available until now. In this study, we aimed to define a new procedure for the treatment of compensatory hyperhidrosis of the trunk. A total of 10 patients admitted our institution for the treatment of compensatory hyperhidrosis of the trunk were enrolled in the study between November 2010 and January 2012 in a prospective manner. Sympathetic blockage was achieved via radiofrequency thermo-ablation technique. The results of treatment were evaluated via telephone calls. Ten patients (2 females, 8 males) underwent radiofrequency thermo-ablation of T6 sympathetic ganglion for compensatory hyperhidrosis of the trunk. The mean age was 29.2 years and the median duration of symptom was 10.5 months. The median follow-up period was 14 months. Six of ten patients (60%) were treated successfully. There was no procedure related complication. The radiofrequency treatment for patients with compensatory hyperhidrosis of the trunk is an alternative option with promising results.

  9. Percutaneous Transhepatic Cholangiography

    African Journals Online (AJOL)

    1974-03-30

    Mar 30, 1974 ... Percutaneous transhepatic cholangiography can play a major role in expediting the early diagnosis of surgically correctable jaundice. The need for this is emphasised by the fact that in a group of 46 patients the delay between the onset of jaundice and diagnosis ranged from 20 to 90 days. Transhepatic ...

  10. A Rare Incidence of Breakage of tip of Micropituitary Forceps during Percutaneous Discectomy - How to Remove it: A Case Report

    Directory of Open Access Journals (Sweden)

    Sureisen M

    2015-11-01

    Full Text Available Breakage of the tip of the micropituitary forceps during spine surgery is a rare occurrence. Retrieval of the broken tip could be a challenge in minimally invasive surgeries due to limitation of access and retrieval instruments. We describe our experience in handling such a situation during percutaneous radiofrequency discectomy. The removal was attempted, without converting into open surgery, by utilising percutaneous endoscopic lumbar discectomy working cannula and guided by image intensifier. We were able to remove the fragment without any significant morbidity to the patient. This technique for removal has not been reported previously in the literature.

  11. The radio-frequency quadrupole

    CERN Document Server

    Vretenar, Maurizio

    2013-01-01

    Radio-frequency quadrupole (RFQ) linear accelerators appeared on the accelerator scene in the late 1970s and have since revolutionized the domain of low-energy proton and ion acceleration. The RFQ makes the reliable production of unprecedented ion beam intensities possible within a compact radio-frequency (RF) resonator which concentrates the three main functions of the low-energy linac section: focusing, bunching and accelerating. Its sophisticated electrode structure and strict beam dynamics and RF requirements, however, impose severe constraints on the mechanical and RF layout, making the construction of RFQs particularly challenging. This lecture will introduce the main beam optics, RF and mechanical features of a RFQ emphasizing how these three aspects are interrelated and how they contribute to the final performance of the RFQ.

  12. Radiofrequency Ablation of Hepatic Cysts : Case Report

    International Nuclear Information System (INIS)

    Lee, Ye Ri; Kim, Pyo Nyun

    2005-01-01

    Radiofrequency ablation has been frequently performed on intra-hepatic solid tumor, namely, hepatocellular carcinoma, metastatic tumor and cholangio carcinoma, for take the cure. But, the reports of radiofrequency ablation for intrahepatic simple cysts are few. In vitro experiment of animal and in vivo treatment for intrahepatic cysts of human had been reported in rare cases. We report 4 cases of radiofrequency ablation for symptomatic intrahepatic cysts

  13. A case that underwent bilateral video-assisted thoracoscopic ...

    African Journals Online (AJOL)

    No Abstract Available A case that underwent bilateral video-assisted thoracoscopic surgical (VATS) biopsy combined with pneumonectomy is presented. The patient developed hypoxia during the contralateral VATS biopsy. His hypoxia was treated with positive expiratory pressure (PEEP) to the dependent lung and apneic ...

  14. Prognostic factors for long-term outcome after percutaneous thermal ablation for hepatocellular carcinoma: a survival analysis of 137 consecutive patients

    International Nuclear Information System (INIS)

    Xu, H.-X.; Lu, M.-D.; Xie, X.-Y.; Yin, X.-Y.; Kuang, M.; Chen, J.-W.; Xu, Z.-F.; Liu, G.-J.

    2005-01-01

    AIM: To identify prognostic factors for long-term outcome for patients with hepatocellular carcinoma (HCC) after percutaneous microwave or radiofrequency ablation. MATERIALS AND METHODS: In total, 137 consecutive patients with HCC underwent microwave or radiofrequency ablation with curative intent; 16 possible prognostic factors were evaluated for their association with overall survival (OS) and disease-free survival (DFS) using univariate and multivariate analysis. RESULTS: The median OS and DFS were 27.0 months and 8.2 months, respectively. OS rates for all patients at 1, 2, 3, 4 and 5 years were 73.9%, 52.1%, 42.8%, 26.2% and 20.1%, respectively. DFS rates at 1, 2, 3 and 4 years were 38.1%, 21.9%, 18.8%, and 14.1%, respectively. Pretreatment serum alpha-fetoprotein (AFP) >200 ng/ml, pretreatment serum albumin ≤35 g/dl, liver function Child's class C and incomplete ablation were found to be significant predictors for OS by univariate analysis. Using multivariate analysis, incomplete ablation was identified to be the most significant independent predictor for OS. Other independent predictors for OS were serum albumin level, serum AFP level and Child-Pugh classification. Recurrence after hepatectomy and prothrombin time >14 s were identified to be significant predictors for DFS by univariate analysis, and the former was the only independent predictor for DFS by multivariate analysis. CONCLUSION: Prognosis for patients with HCC after thermal ablation with curative intent was determined by treatment response to ablation, pretreatment serum AFP, and liver function reserve. Tumour response to treatment was the most predictive factor for long-term survival and was related to tumour size, thus careful selection of patients for ablation therapy is recommended

  15. Percutaneous radiofrequency rhizotomy and neurovascular decompression of the trigeminal nerve for the treatment of facial pain Rizotomia percutânea por radiofreqüência e a descompressão neurovascular do nervo trigêmeo no tratamento das algias faciais

    Directory of Open Access Journals (Sweden)

    Manoel J. Teixeira

    2006-12-01

    Full Text Available OBJECTIVE: To determine the outcomes of 354 radiofrequency rhizotomies and 21 neurovascular decompressions performed as treatment for 367 facial pain patients (290 idiopathic trigeminal neuralgia, 52 symptomatic trigeminal neuralgia, 16 atypical facial pain, 9 post-herpetic neuralgia. METHOD: Clinical findings and surgery success rate were considered for evaluation. A scale of success rate was determined to classify patients, which considered pain relief and functional/sensorial deficits. RESULTS: Radiofrequency rhizotomy was performed in 273 patients with idiopathic trigeminal neuralgia and in all other patients, except for trigeminal neuropathy; neurovascular decompression was performed in 18 idiopathic trigeminal neuralgia patients; 100% idiopathic trigeminal neuralgia, 96.2% symptomatic trigeminal neuralgia, 37.5% atypical facial pain and 88.9% post-herpetic neuralgia had pain relief. CONCLUSION: Both techniques for idiopathic trigeminal neuralgia are usefull. Radiofrequency rhizotomy was also efficient to treat symptomatic facial pain, and post-herpetic facial pain, but is not a good technique for atypical facial pain.OBJETIVO: Determinar eficácia e achados pós-operatórios após 354 rizotomias por radiofreqüência e 21 descompressões neurovasculares como tratamento de 367 pacientes com dor facial (290 neuralgia idiopática do trigêmeo, 52 neuralgia sintomática do trigêmeo, 16 dor facial atípica, 9 neuralgia pós-herpética. MÉTODO: Achados clínicos e taxa de sucesso das cirurgias foram considerados para a avaliação. Uma escala avaliando alívio da dor e complicações sensoriais e funcionais foi utilizada para classificar os pacientes. RESULTADOS: A rizotomia por radiofreqüência foi realizada em 273 pacientes com neuralgia idiopática do trigêmeo e em todos os outros pacientes, exceto neuropatia trigeminal; descompressão neurovascular foi realizada em 18 pacientes com neuralgia idiopática do trigêmeo; 100% dos pacientes

  16. Laparoscopic liver resection with radiofrequency.

    Science.gov (United States)

    Croce, E; Olmi, S; Bertolini, A; Erba, L; Magnone, S

    2003-01-01

    In this report, the feasibility, efficacy and safety of laparoscopic liver resection with radiofrequency has been evaluated in a small series of patients. From January 1993 to May 2002 we carried out 7 laparoscopic liver resections (3 men and 4 women), five of which were for benign pathology and two for metastases from colorectal cancer. In four of the above resections we used an argon coagulator; the last three were accomplished by means of a radiofrequency instrument. We had no perioperative or postoperative complications in this small series of patients. There were no deaths. Perioperative blood loss was of 120 mL (range 80-200) and the procedure took about 90 minutes (range 80-110). Hospitalization was of 4 days and pain was adequately controlled by 2 mL of Toradol twice a day. We think that the advantages of laparoscopic techniques together with the efficacy of the radiofrequency instrument in hepatic surgery will allow the diffusion of this method and its extension to safe execution of major resections.

  17. Percutaneous vertebroplasty in osteoporotic vertebral body compression fracture

    International Nuclear Information System (INIS)

    Kim, Hyuk Jung; Lee, Seon Kyu; Hwang, Hee Young; Kim, Hyung Sik; Ko, Joon Seok; Park Si Hyun; Park, Cheol Hee

    2001-01-01

    To determine the clinical efficacy of percutaneous vertebroplasty in cases of painful and medically intractable osteoporotic vertebral compression fracture. Ninety-eight patients (20 men and 78 women: mean age, 69 years) underwent 122 percutaneous vertebroplasty procedures for the treatment of osteoporotic vertical compression fracture. For the evaluation of bone mass, bone densitometry was performed in 45 patients, and to assess the recent evolution of the fracture, all 98 underwent MRI. Percutaneous vertebroplasty involves percutaneous transpedicular puncture of the involved verteb666rae followed by the injection of a polymethylmethacrylate(PMMA)-Barium mixture into the vertebral body. To assess leakage of the mixture into the epidural tissue, neural foramina, venous plexus and paravertebral tissue, we then immediately obtained a computerized tomographic (CT) scan, assessing the clinical efficacy of the procedure on the basis of time required for pain relief (defined as more than 60% reduction of initial pain), and time required for ambulation without significant pain. Percutaneous vertebroplasty was successful in all patients. Pain relief was accomplished within 1-5 (mean, 1.8) days and early ambulation without significant pain was possible within 2-15 (mean, 3.3) days. Post-procedural CT scanning revealed leakage of the PMMA-barium mixture into paravertebral tissue(n=41).the paravertebral venous plexus (n=34) and epidural tissue (n=4). No neural foraminal leakage was identified, and no procedure-related complication requiring surgical treatment occurred. Percutaneous vertebroplasty is an effective new interventional procedure for the treatment of osteoporotic vertebral compression fracture. It relieves pain, provides early mobilization, and strengthens involved vertebral bodies

  18. Percutaneous nephrolithotomy in children: A preliminary report.

    Science.gov (United States)

    Elderwy, Ahmad A; Gadelmoula, Mohamed; Elgammal, Mohamed A; Osama, Ehab; Al-Hazmi, Hamdan; Hammouda, H; Osman, Esam; Abdullah, Medhat A; Neel, Khalid Fouda

    2014-07-01

    The recurrence of pediatric nephrolithiasis, the morbidity of repeated open surgical treatment as well as our experience in percutaneous nephrolithotomy (PNL) in adult patients, all derived us to shift to PNL for managing renal stones >1.5 cm in pediatric patients. Our aim of this study is to evaluate the safety and efficacy of PNL in pediatric patients. During the period of the month between May 2011 and April 2013, 38 children (47 renal units) underwent PNL for renal stones 1.5-5 cm in length. Patient demographics, stone characteristics, and clinical outcome were prospectively studied. Data of those who underwent conventional and tubeless PNL were compared. Median follow-up period was 12 months (range: 6-24). The median age at presentation was 8-year (range: 3-12). The operative time ranged from 30 to 120 min (median 90). Overall stone clearance rate was 91.5% after single PNL. The median hospital stay was 3 days. Auxiliary procedures were successful for the remaining 4 patients (nephroscopic clearance in one and shockwave lithotripsy in 3). Tubeless PNL was performed in 17 renal units with a comparable outcome to conventional ones. The perioperative complications were noted in 5/47 (10.6%) of all procedures (Clavien Grade II in 4 and Clavien Grade IIIa in 1) and were managed conservatively. Percutaneous nephrolithotomy for renal stones in pediatric patients is safe and feasible if performed by a well-experienced endourologist. Tubeless PNL is a better choice for children.

  19. Percutaneous cryotherapy for inoperable lung malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eun Hae; Jin, Gong Yong; Han, Young Min; Lee, Yong Chul; Kwon, Keun Sang [Chonbuk National Univ. Medical School and Hospital, Jeonju, (Korea, Republic of)

    2012-05-15

    To evaluate the therapeutic efficacy of percutaneous cryotherapy for inoperable patients with malignant pulmonary nodules. We enrolled 14 patients (7 males, 7 females, average age 68.8 years) who had inoperable lung malignancy in this study from August 2006 through July 2009. We evaluated the therapeutic efficacy of cryotherapy for complete or incomplete ablation by follow up chest CT. Using Kaplan Meier statistical methods, we estimated the survival of patients who had undergone cryotherapy and we investigated post cryotherapy complications. Five of the 14 patients underwent complete ablation (35.7%), while 9 of 14 patients underwent incomplete ablation (64.3%). The change in mean size before procedure and at last follow up CT in the complete and incomplete ablation were as follows: 13.2 {+-} 7.6 mm {yields} 3.8 {+-} 2.7 mm, and 18.1 {+-} 6.2 mm {yields} 33.7 {+-} 17.9 mm, respectively. The median survival of patients in the complete and the incomplete groups were 51.5 months and 24 months, respectively. One patient developed a small pneumothorax, which resolved spontaneously. Two patients developed hemoptysis after the procedure, which was controlled within a day. Percutaneous cryotherapy may be an effective and safe therapeutic method for inoperable patients with malignant pulmonary nodules.

  20. Percutaneous cryotherapy for inoperable lung malignancy

    International Nuclear Information System (INIS)

    Park, Eun Hae; Jin, Gong Yong; Han, Young Min; Lee, Yong Chul; Kwon, Keun Sang

    2012-01-01

    To evaluate the therapeutic efficacy of percutaneous cryotherapy for inoperable patients with malignant pulmonary nodules. We enrolled 14 patients (7 males, 7 females, average age 68.8 years) who had inoperable lung malignancy in this study from August 2006 through July 2009. We evaluated the therapeutic efficacy of cryotherapy for complete or incomplete ablation by follow up chest CT. Using Kaplan Meier statistical methods, we estimated the survival of patients who had undergone cryotherapy and we investigated post cryotherapy complications. Five of the 14 patients underwent complete ablation (35.7%), while 9 of 14 patients underwent incomplete ablation (64.3%). The change in mean size before procedure and at last follow up CT in the complete and incomplete ablation were as follows: 13.2 ± 7.6 mm → 3.8 ± 2.7 mm, and 18.1 ± 6.2 mm → 33.7 ± 17.9 mm, respectively. The median survival of patients in the complete and the incomplete groups were 51.5 months and 24 months, respectively. One patient developed a small pneumothorax, which resolved spontaneously. Two patients developed hemoptysis after the procedure, which was controlled within a day. Percutaneous cryotherapy may be an effective and safe therapeutic method for inoperable patients with malignant pulmonary nodules

  1. Percutaneous endoscopic gastrostomy in children.

    Science.gov (United States)

    Park, Jye Hae; Rhie, Seonkyeong; Jeong, Su Jin

    2011-01-01

    Percutaneous endoscopic gastrostomy (PEG) can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6) months. Mean patient age was 9.4 (4.5) years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD). The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87%) had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

  2. Percutaneous Management of Ureteral Injuries that are Diagnosed Late After Cesarean Section

    Energy Technology Data Exchange (ETDEWEB)

    Ustunsoz, Bahri; Ugurel, Sahin; Duru, Namik Kemal; Ozgok, Yasar; Ustunsoz, Ayfer [GATA Medical Faculty, Ankara (Turkmenistan)

    2008-08-15

    We wanted to present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS). Twenty-two cases with 24 ureteral injuries that were diagnosed late after CS underwent percutaneous nephrostomy (PN), antegrade double J (DJ) catheter placement and balloon dilatation or a combination of these. The time for making the diagnosis was 21 +- 50.1 days. The injury site was the distal ureter in all cases (the left ureter: 13, the right ureter: 7 and bilateral: 2). Fifteen complete ureteral obstructions were detected in 13 cases. Ureteral leakage due to partial (n = 4) or complete (n = 3) rupture was noted in seven cases. Two cases had ureterovaginal fistula. All the cases were initially confirmed with antegrade pyelography and afterwards they underwent percutaneous nephrostomy. Balloon dilatation was needed in three cases. Antegrade DJ stents were placed in 10 cases, including the three cases with balloon dilatation. Repetititon of percutaneous nephrostomy with balloon dilatation and DJ stent placement was needed in one case with complete obstruction. All the cases were followed-up with US in their first week and then monthly thereafter for up to two years. Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%). Percutaneous management is a good alternative for the treatment of post-CS ureteral injuries that are diagnosed late after CS. Percutaneous management is at least preparatory for a quarter of the cases where surgery is unavoidable

  3. Percutaneous Management of Ureteral Injuries that are Diagnosed Late After Cesarean Section

    International Nuclear Information System (INIS)

    Ustunsoz, Bahri; Ugurel, Sahin; Duru, Namik Kemal; Ozgok, Yasar; Ustunsoz, Ayfer

    2008-01-01

    We wanted to present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS). Twenty-two cases with 24 ureteral injuries that were diagnosed late after CS underwent percutaneous nephrostomy (PN), antegrade double J (DJ) catheter placement and balloon dilatation or a combination of these. The time for making the diagnosis was 21 ± 50.1 days. The injury site was the distal ureter in all cases (the left ureter: 13, the right ureter: 7 and bilateral: 2). Fifteen complete ureteral obstructions were detected in 13 cases. Ureteral leakage due to partial (n = 4) or complete (n = 3) rupture was noted in seven cases. Two cases had ureterovaginal fistula. All the cases were initially confirmed with antegrade pyelography and afterwards they underwent percutaneous nephrostomy. Balloon dilatation was needed in three cases. Antegrade DJ stents were placed in 10 cases, including the three cases with balloon dilatation. Repetititon of percutaneous nephrostomy with balloon dilatation and DJ stent placement was needed in one case with complete obstruction. All the cases were followed-up with US in their first week and then monthly thereafter for up to two years. Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%). Percutaneous management is a good alternative for the treatment of post-CS ureteral injuries that are diagnosed late after CS. Percutaneous management is at least preparatory for a quarter of the cases where surgery is unavoidable

  4. Percutaneous drainage for post-traumatic hepatic abscess in children under ultrasound imaging

    International Nuclear Information System (INIS)

    Taguchi, T.; Ikeda, K.; Yakabe, S.; Kimura, S.

    1988-01-01

    Hepatic abscess is rare in children. A patient with a post-traumatic hepatic abscess was successfully treated by ultrasound-guided percutaneous drainage. Although he underwent a drainage operation for the perihepatic abscesses, high fever continued. It was then considered that the traumatic hematoma had been infected and had become an abscess. Sonographically-guided percutaneous aspiration is useful for the definite diagnosis of hepatic abscess. Subsequent percutaneous drainage under ultrasound imaging is a safe und useful therapeutic method even in a poor-risk patient. (orig.)

  5. Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan, E-mail: akhano@tr.net; Akkaya, Selçuk, E-mail: selcuk.akkaya85@gmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Dağoğlu, Merve Gülbiz, E-mail: drmgkartal@gmail.com [Istanbul University, Department of Radiology, Istanbul School of Medicine (Turkey); Akpınar, Burcu, E-mail: burcu-akpinar@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Erbahçeci, Aysun, E-mail: aysunerbahceci@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Department of Radiology (Turkey); Çiftçi, Türkmen, E-mail: turkmenciftci@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Köroğlu, Mert, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology (Turkey); Akıncı, Devrim, E-mail: akincid@hotmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey)

    2016-03-15

    PurposeCystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.Materials and MethodsTwelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.ResultsEight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.ConclusionThe advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.

  6. NUTRITION SUPPORT COMPLICATIONS IN PATIENT WHO UNDERWENT CARDIAC SURGERY

    OpenAIRE

    Krdžalić, Alisa; Kovčić, Jasmina; Krdžalić, Goran; Jahić, Elmir

    2016-01-01

    Background: The nutrition support complications after cardiac surgery should be detected and treated on time. Aim: To show the incidence and type of nutritional support complication in patients after cardiac surgery. Methods: The prospective study included 415 patients who underwent cardiac surgery between 2010 and 2013 in Clinic for Cardiovascular Disease of University Clinical Center Tuzla. Complications of the delivery system for nutrition support (NS) and nutrition itself were analy...

  7. Percutaneous lumbar discectomy

    International Nuclear Information System (INIS)

    Xiao Chengjiang; Su Huanbin; Xu Sui; He Xiaofeng; Li Yanhao

    2004-01-01

    Objective: To probe the therapeutic effects, indications and safety of the percutaneous lumbar discectomy (PLDP). Methods: To ameliorate percutaneous punctured route based on classic PLD and modified jaw structure of pulpiform nacleus forceps, with statistic analysis of the therapeutic results of 352 cases of patient undergone PLDP and follow up ranging from 6 to 38 months retrospectively. Results: The effective ratios were excellent in 45.5%, good for 45.4% and bad in 9.1%. 44 of 352 cases with pulps prolapse were cured. No intervertebral inflammation and paradisc hematoma took place. One case complicated with cauda equina injury and 4 cases with appliances broken inside the disc. Conclusions: PLDP is effective and safe, not only adaptive to the contained disc herniation, but also for noncontained herniation. (authors)

  8. Percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    Przybojewski, J.Z.; Weich, H.F.H.

    1984-01-01

    The purpose of this article is to review PTCA, percutaneous transluminal coronary angioplasty, which can be considered to be a truly revolutionary and fairly simple invasive form of intervention to atherosclerotic obstruction. The 'epidemic' of IHD, ischaemic heart disease, in the Republic of South Africa calls for the employment of this technique, which has already been carried out in a few teaching hospitals in this country. Very recently, modified balloon dilatation catheters have been used percutaneously in the non-operative transluminal correction of congenital coarctation of the aorta in infants and children, congenital pulmonary value stenosis, and hypoplasia and stenosis of the pulmonary arteries. It has also been employed for PTCA and for the simultaneous occlusion of coronary-bronchial artery anastomosis using a detachable balloon. The isotopes thallium 201 and technetium 99 were also used in scintiscanning

  9. Hyperkalaemia after radiofrequency ablation of hepatocellular carcinoma

    NARCIS (Netherlands)

    Verhoevena, BH; Haagsma, EB; Appeltans, BMG; Slooff, MJH; de Jong, KP

    Radiofrequency ablation of liver tumours is a useful therapy for otherwise unresectable tumours. The complication rate is said to be low. In this case report we describe hyperkalaemia after radiofrequency ablation of a hepatocellular carcinoma in a patient with end-stage renal insufficiency. (C)

  10. Radiofrequency Physics for Minimally Invasive Aesthetic Surgery.

    Science.gov (United States)

    Levy, Adam S; Grant, Robert T; Rothaus, Kenneth O

    2016-07-01

    Radiofrequency energy has a wide range of medical applications, including noninvasive treatment of wrinkles and body contouring. This technology works by differential heating of skin and soft tissue layers causing dermal remodeling or adipolysis, ultimately leading to observable effects. This article reviews the physics of radiofrequency as applied clinically. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Alternative Treatment for Bleeding Peristomal Varices: Percutaneous Parastomal Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Pabon-Ramos, Waleska M., E-mail: waly.pr@duke.edu [Duke University Hospital, Department of Radiology (United States); Niemeyer, Matthew M. [Washington University Medical Center, Mallinckrodt Institute of Radiology (United States); Dasika, Narasimham L., E-mail: narasimh@med.umich.edu [University of Michigan Health System, Department of Radiology (United States)

    2013-10-15

    Purpose: To describe how peristomal varices can be successfully embolized via a percutaneous parastomal approach. Methods: The medical records of patients who underwent this procedure between December 1, 2000, and May 31, 2008, were retrospectively reviewed. Procedural details were recorded. Median fluoroscopy time and bleeding-free interval were calculated. Results: Seven patients underwent eight parastomal embolizations. The technical success rate was 88 % (one failure). All embolizations were performed with coils combined with a sclerosant, another embolizing agent, or both. Of the seven successful parastomal embolizations, there were three cases of recurrent bleeding; the median time to rebleeding was 45 days (range 26-313 days). The remaining four patients did not develop recurrent bleeding during the follow-up period; their median bleeding-free interval was 131 days (range 40-659 days). Conclusion: This case review demonstrated that percutaneous parastomal embolization is a feasible technique to treat bleeding peristomal varices.

  12. Image-guided radiofrequency ablation (RFA) of spinal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Gevargez, Athour [Groenemeyer Institute of MicroTherapy, Bochum (Germany); Department of Radiology and Microtherapy, University of Witten/Herdecke, Bochum (Germany)], E-mail: gevargez@microtherapy.de; Groenemeyer, Dietrich H.W. [Groenemeyer Institute of MicroTherapy, Bochum (Germany); Department of Radiology and Microtherapy, University of Witten/Herdecke, Bochum (Germany)

    2008-02-15

    Purpose: To evaluate retrospectively the efficacy and safety of radiofrequency ablation (RFA) in patients with spinal tumors. Materials and methods: Forty-one patients (25 men, 16 women; age range, 46-82 years) with nonresectable primary or secondary tumor involvement of the spine unresponsive to chemo- and radiotherapy received RFA treatment. Two radiofrequency ablation systems, one with a cool-tip electrode and one with an expandable electrode catheter, were used. Both systems work impedance controlled with a power output of 150- 200 W. Each coagulation cycle lasted 12-15 min depending on tumor impedance. Several single RFA cycles of 15 min each were used for overlapping RFAs in tumors with diameters of more than 3 cm. Temperature was kept between 50 deg. C and 120 deg. C and was chosen according to spinal cord distance and patient heat tolerance during the ablation. Multi-slice computed tomography (CT) combined with C-arm fluoroscopy guided the intervention. Efficacy outcomes were assessed after about 6 weeks, 6 months, and more than 6 months using standardized questionnaires and indices regarding tumor pain, pain disability, functional activities, quality of life, neurological status, and tumor progression. Results: RFA significantly reduced tumor-induced pain within 6 weeks, improved daily activities, and maintained quality of life. Mean time to tumor progression was 730 {+-} 54 days (Kaplan-Meier estimate). No RFA-associated complications were reported. Conclusion: RFA of primary and secondary spinal tumors, which were unresponsive to chemo- and radiotherapy and prone to progression, is a safe, resource-saving, and highly effective percutaneous technique in patients with nonresectable spinal tumors.

  13. Aesthetic Applications of Radiofrequency Devices.

    Science.gov (United States)

    Sadick, Neil; Rothaus, Kenneth O

    2016-07-01

    Radiofrequency (RF)-based devices are used to improve face and neck laxity, a major feature of aging that until recently could only be addressed with surgery. Although these treatments are not meant to replace surgical procedures, patient satisfaction studies have been consistently high. For physicians offering these skin rejuvenation procedures, it is essential to have intimate knowledge of how the devices work, select appropriate candidates, set realistic expectations, and combine treatments to optimize outcomes. This article discusses the various noninvasive RF technologies currently in use and reviews pertinent clinical studies evaluating their efficacy and safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Percutaneous Transhepatic Cholangiography | Goldin | South ...

    African Journals Online (AJOL)

    Percutaneous Transhepatic Cholangiography. AR Goldin, EM Bass. Abstract. Our experience with percutaneous transhepatic cholangiography in 46 cases is presented and compared with other series. The technique is safe, simple and accurate and can play a major role in the early diagnosis of obstructive jaundice.

  15. 47 CFR 2.801 - Radiofrequency device defined.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Radiofrequency device defined. 2.801 Section 2... MATTERS; GENERAL RULES AND REGULATIONS Marketing of Radio-frequency Devices § 2.801 Radiofrequency device defined. As used in this part, a radiofrequency device is any device which in its operation is capable of...

  16. 21 CFR 882.4725 - Radiofrequency lesion probe.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiofrequency lesion probe. 882.4725 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4725 Radiofrequency lesion probe. (a) Identification. A radiofrequency lesion probe is a device connected to a radiofrequency (RF...

  17. [PERCUTANEOUS ENCOSCOPIC GASTROSTOMY

    Science.gov (United States)

    Tagle A, Martín

    1998-01-01

    Percutaneous endoscopic gastrostomy is an increasingly utilized method of enteral nutrition in patients who for a variety of reasons, are unable to swallow or possess a high risk of aspiration. This method has replaced both surgical gastrostomy and the prolonged used of nasogastric tubes since its creation, in 1980. The most frequent indications are severe neurological diseases such as cerebrovascular accidents, Parkinson's, multiple sclerosis and other processes such as severe trauma, multi-infarct dementia or diverse head and neck tumors. The procedure involves the performance of an upper endoscopy in the usual manner, followed by an insertion of a plastic catheter percutaneously in the area of maximum contact between the gastric and abdominal walls, under direct endoscopic view. Then, a guidewire is introduced through the lumen of the catheter and is enlaced by a polypectomy snare passed through the working channel of the endoscope, utilizing the guidewire to tie the distal portion of the feeding tube, which will be pulled to its final position. The complications associated to this procedure are minimal, most of them related to the endoscopy itself, like reactions to sedation, aspiration of oropharyngeal secretions, etc. There is also a possibility of local infection at the insertion site, perforation of the colon and excessive leaking of gastric contents around the tube, and for these reasons the procedure should only be performed by trained physicians, familiarized with the management of these events. The goal of this review is to illustrate the reader about the indications, contral indications, complications and general considerations in the patients who will have a percutaneous endoscopic gastrostomy.

  18. Pigmented Villonodular Synovitis in a Patient who Underwent Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Nevzat Dabak

    2014-09-01

    Full Text Available Pigmented villonodular synovitis (PVNS is a rare, benign, but a locally aggressive tumor. It is characterized by the proliferation of synovial membrane, but it can also be seen in tendon sheaths and bursae. Clinical presentation of solitary lesions include compression and locking of the joint suggesting loose bodies in the joint and a subsequent findings of an effusion, whereas diffuse lesions manifest with pain and chronic swelling. In this article, we presented a curious case of PVNS in a female patient who have been followed up due to an acetabular cystic lesion. She underwent total hip arthroplasty for severe osteoarthritis of the hip joint and associated pain. The diagnosis of PVNS was established intraoperatively. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 235-7

  19. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2015-09-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  20. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2013-01-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  1. Radiofrequency ablation for hepatocellular carcinoma: utility of conventional ultrasound and contrast-enhanced ultrasound in guiding and assessing early therapeutic response and short-term follow-up results.

    Science.gov (United States)

    Du, Jing; Li, Hong-Li; Zhai, Bo; Chang, Samuel; Li, Feng-Hua

    2015-09-01

    The purpose of this study was to assess the efficacy of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in guiding and assessing early therapeutic response to radiofrequency (RF) ablation for hepatocellular carcinomas (HCCs; up to 3 lesions, each ≤3 cm in diameter) and to report the short-term follow-up results. Between September 2011 and January 2013, 63 patients with 78 HCCs (≤3 cm) underwent conventional US- and CEUS-guided percutaneous RF ablation. CEUS was repeated after 20-30 min to assess therapeutic response, and local efficacy was further confirmed by contrast-enhanced magnetic resonance imaging (MRI) 1 mo after tumor ablation. Patients were followed periodically to look for local tumor or disease progression. Survival probability was estimated with the Kaplan-Meier method. Complete ablation was achieved for 76 (97.4%) of 78 HCCs in one (n = 73) or two (n = 3) sessions. No major complications were observed in any patient. The overall concordance in assessment of therapeutic efficacy of RF ablation between CEUS and MRI was 97.4% (76/78 tumors). The concordance test gave a value of κ = 0.74 (p therapeutic response to RF ablation. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  2. Comparison of treatment methods in lumbar spinal stenosis for geriatric patient: nerve block versus radiofrequency neurotomy versus spinal surgery.

    Science.gov (United States)

    Park, Chang Kyu; Kim, Sung Bum; Kim, Min Ki; Park, Bong Jin; Choi, Seok Geun; Lim, Young Jin; Kim, Tae Sung

    2014-09-01

    The incidence of spinal treatment, including nerve block, radiofrequency neurotomy, instrumented fusions, is increasing, and progressively involves patients of age 65 and older. Treatment of the geriatric patients is often a difficult challenge for the spine surgeon. General health, sociofamilial and mental condition of the patients as well as the treatment techniques and postoperative management are to be accurately evaluated and planned. We tried to compare three treatment methods of spinal stenosis for geriatric patient in single institution. The cases of treatment methods in spinal stenosis over than 65 years old were analyzed. The numbers of patients were 371 underwent nerve block, radiofrequency neurotomy, instrumented fusions from January 2009 to December 2012 (nerve block: 253, radiofrequency neurotomy: 56, instrumented fusions: 62). The authors reviewed medical records, operative findings and postoperative clinical results, retrospectively. Simple X-ray were evaluated and clinical outcome was measured by Odom's criteria at 1 month after procedures. We were observed excellent and good results in 162 (64%) patients with nerve block, 40 (71%) patient with radIofrequency neurotomy, 46 (74%) patient with spinal surgery. Poor results were 20 (8%) patients in nerve block, 2 (3%) patients in radiofrequency neurotomy, 3 (5%) patient in spinal surgery. We reviewed literatures and analyzed three treatment methods of spinal stenosis for geriatric patients. Although the long term outcome of surgical treatment was most favorable, radiofrequency neurotomy and nerve block can be considered for the secondary management of elderly lumbar spinals stenosis patients.

  3. Percutaneous cholecystostomy at the community hospital: value evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Lee, Mi Suk; Lee, Jin Hee; Ym, Seong Hee; Yoon, Young Gun [Namwon Medical Center, Namwon (Korea, Republic of); Sohn, Myung Hee; Kim, Chong Soo; Han, Young Min; Choi, Ki Chul [Chonbuk National Univ., Chonju (Korea, Republic of)

    1997-10-01

    To assess the role of percutaneous cholecystostomy as a therapeutic maneuver in patients critically ill with acute cholecystitis in community hospitals. Eighteen patients, 11 with suspected acute calculous cholecystits and seven with acute acalulous cholecystitis underwent emergency percutaneous cholecystostomy. All demonstrated a variety of high risk factors for cholecystectomy:liver cirrhosis(n=3D2), diabetes mellitus(n=3D3), cardiac disease(n=3D3), underlying malignancy(n=3D2), pulmonary dysfunction(n=3D1), septic cholangitis(n=3D5), and old age(n=3D2). All percutaneous cholecystostomies were performed with ultrasound guidance and preferably using the transhepatic route. All procedures but one were successful, and most cholecystostomies were performed within 5-20 minutes. Technical problems were as follows: guide-wire buckling during catheter insertion(n=3D2) and procedure failure(n=3D1). The only major problem was a case of localized bile peritonitis due to procedural failure, but a few minor complications were encountered:catheter dislodgment(n=3D3), and significant abdominal pain during the procedure(2). After successful cholecystostomy, a dramatic improvement in clinical condition was observed in 16 of 17 patients(94%) within 48 hours. Ten of 16 patients who responded to percutaneous cholecystostomy underwent elective cholecystectomy after the improvement of clinical symptoms, and the remaining six patients improved without other gallbladder interventions. Percutaneous cholecystostomy is not only an effective procedure for acute cholecystitis, but also has a definite role in the management of these high-risk patients in community hospitals.=20.

  4. Survival after Radiofrequency Ablation for 100 Cases of Lung Neoplasms

    Directory of Open Access Journals (Sweden)

    Baodong LIU

    2011-04-01

    Full Text Available Background and objective Surgical resection is the preferred treatment in selected patients with pulmonary neoplasms. In older than 70 years or have compromised cardiopulmonary status or coexistent medical problems patients, radiofrequency ablation (RFA may offer an alternative option. The aim of this study is to evaluate the therapeutic effects after RFA in 100 patients with pulmonary neoplasms. Methods One handred cases of unresectable lung tumors with 106 lesions were underwent RFA therapy. To evaluate the therapeutic effect and complications of lung tumors using spiral CT scanning and SPECT in 1-3 months after RFA. Results One hundred patients underwent RFA for lung neoplasms (62 men, 38 women; median age, 66.6 years; range, 36 to 91 years. Eighty-six patients with primary lung neoplasms and 14 patients with pulmonary metastases underwent RFA. Treatment was complete in all cases, no treatment-related deaths occurred in all of the 100 patients and serious morbidity associated with the procedures. The median overall survival for the entire group of patients was 13.0 months, the one and two years overall survival for total of were 51% and 32.5% respectively. No differences in overall survival noted between patients with primary and metastases lung neoplasms (P=0.922. The median overall survival for the early stage of patients was 28.0 months, 2-year overall survival for early stage primary lung cancer patients were 57.7%. Conclusion RFA is a safe and effective procedure in selective lung tumors. CT-guided radiofrequency ablation is a minimally invasive treatment option. RFA could act as an alternative treatment to inoperable lung cancer.

  5. Percutaneous management of prosthetic valve thrombosis.

    Science.gov (United States)

    Hariram, Vuppaladadhiam

    2014-01-01

    Thrombosis of a prosthetic valve is a serious complication in patients with prosthetic heart valves. Thrombolysis is the initial choice of treatment. Patients who do not respond to thrombolysis are subjected to surgery which carries a high risk. We report a case series of 5 patients with prosthetic mitral valve thrombosis who did not respond to thrombolysis and were subjected to percutaneous manipulation of the prosthetic valves successfully and improved. Five patients who were diagnosed to have prosthetic mitral valve thrombosis and failed to respond to a minimum of 36 h of thrombolysis (persistent symptoms with increased gradients, abnormal findings on fluoroscopy),were subjected to percutaneous treatment after receiving proper consent. None of them had a visible thrombus on transthoracic echocardiogram. All patients underwent transseptal puncture following which a 6F JR4 guiding catheter was passed into the left atrium. The valve leaflets were repeatedly hit gently under fluoroscopic guidance till they regained their normal mobility. Mean age was 38.8 years. Average peak and mean gradients prior to the procedure were 38 and 25 and after the procedure were 12 and 6 mm of Hg respectively. All patients had successful recovery of valve motion on fluoroscopy with normalization of gradients and complete resolution of symptoms. None of the patients had any focal neurological deficits, embolic manifestations or bleeding complications. Percutaneous manipulation of prosthetic valves in selected patients with prosthetic valve thrombosis who do not respond to thrombolytic therapy is feasible and can be used as an alternative to surgery. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  6. Percutaneous endoscopic gastrostomy in children

    Directory of Open Access Journals (Sweden)

    Jye Hae Park

    2011-01-01

    Full Text Available Purpose: Percutaneous endoscopic gastrostomy (PEG can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. Methods: We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6 months. Results: Mean patient age was 9.4 (4.5 years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD. The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87% had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. Conclusion: PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

  7. Complications of Percutaneous Nephrolithotomy and their Management

    Directory of Open Access Journals (Sweden)

    Neeraj Thapa

    2016-11-01

    Full Text Available Introduction: Increasing global prevalence of nephrolithiasis has resulted in the development of new minimally invasive techniques and has also led to the resurgence of established methods such as percutaneous nephrolithotomy (PCNL. This procedure is now recommended as the first option for the treatment of single large or multiple renal stones and those in the inferior calyx. This study was done to assess the complications of PCNL and their management, in our centre. Methods: Medical records of 144 patients who underwent PCNL at Lumbini Medical College Teaching Hospital, during the last one year were reviewed. The demographic data, size, tract number and location of the calculi, and intraoperative and postoperative complications were evaluated. The various parameters of the calculi were evaluated. Descriptive analysis with frequencies was done. Results: Complications occurred in 13 (9.02% patients. Post operative bleeding occurred in seven (4.8% patients, out of which one patient developed pseudoaneurysms and the other developed arteriovenous fistula. One patient developed hypovolemic shock immediately after surgery. Frequent blockage of urine, excessive drainage of urine from the drain site, hemothorax and colonic perforation was seen in one  patient each. One patient had mortality due to post operative bleeding. Complications increased with the number and size of stones and number and site of the tracts. Conclusion: Percutaneous nephrolithotomy has low complication rate in experienced hands and complications depend upon stone size, history of open stone surgery, tract number, and tract location.

  8. Percutaneous cholecystostome; 60 cases of experience

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Sung Gwon; Song, Ho Young; Yoon, Hyun Ki; Lee, Young Suk; Ki, Won Woo; Sung, Gyu Bo [Ulsan Univ College of Medicine, Seoul (Korea, Republic of)

    1996-01-01

    To review the effectiveness and complication of percutaneous cholecystostomy (PCCS). We performed PCCS in 60 patient who presented with acute cholecystitis. The causes of acute cholecystitis were as follows; acalculous cholecystitis(n=8), calculous cholecystitis(n=23), GB hydrops (n=3), GB empyema(n=15), septic cholangitis(n=11). Of 60 patients, 36 patients had high risk factor for cholecystectomy; underlying malignancy(n=13), severe trauma(n=6). Cholecystostomy was done under ultrasonographic and fluoroscopic guide. The cholecystostomy was successfully in 59 patients, and failed in 1 patient. 15 patients improved without other procedure. 16 patients underwent cholecystectomy after improvement of their general condition. Severe complications of PCCS are as follows; bile peritonitis(n=6), hemoperitoneum(n=1), subphrenic abscess(n=1). Mild complication, such as pain, occurred in most patients. Emergency operation was done in one patient who developed bile peritonitis. Cholecystostomy is effective and safe, especially in cases of inoperable patients who represent acute cholecystitis. Percutaneous cholecystostomy may substitute surgical cholecystostomy.

  9. Percutaneous drainage of pelvic fluid collection

    International Nuclear Information System (INIS)

    Lee, Eun Young; Sohn, Cheol Ho

    1995-01-01

    To evaluate safe access route and success rate of percutaneous drainage of pelvic fluid collection. The 35 percutaneous drainages of pelvic fluid collection under the CT and fluorosocpic guidance were done in 32 patients. The anterior transabdominal approach was done in 20 patients, while the nine patients used the transgluteal approach through greater sciatic foramen. Three patients, who had septated or noncommunicating abscesses, underwent drainage using both approaches. The catheter was removed when the patient's symptom and laboratory data were improved or the amount of drainage and the size of fluid collection were markedly reduced. Success, partial success and failure were classified. The causes of fluid collection were complication of intraabdominal operation in 27 patient. The diagnosis after drainage included abscess (21), loculated ascites (6), and hematoma (4). The 27 cases (30 procedure) were treated successfully and the mean duration of catheter insertion was 10 days. The partial successes were two cases (2 procedures), which had palliative purpose. Three cases (3 procedures) were failed, which were multiple loculated ascites of pancreatic origin (2) and recurrent abscess (1). The significant complication during the procedure or drainage was not noted

  10. INTRAOPERATIVE RADIOFREQUENCY AND CRYOABLATION FOR ATRIAL FIBRILLATION IN PATIENTS WITH VALVULAR HEART DISEASE

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    N. Maghamipour N. Safaie

    2007-05-01

    Full Text Available Patients with valvular heart disease and suffering atrial fibrillation of more than 12 months duration have a low probability of remaining in sinus rhythm after valve surgery alone. We performed intra-operative radiofrequency ablation or cryoablation as an alternative to surgical maze ІІІ procedure to create linear lesion lines for conversion of this arrhythmia to sinus rhythm. A total of 30 patients with valvular heart disease and chronic persistent atrial fibrillation underwent different combinations of valve surgery and concomitant maze procedure with radiofrequency or cryo probes. These patients aged 48.10 ± 9.84 years in radiofrequency ablation group and 51.10 ± 13.93 years in cryoablation group. Both atrial ablation with radiofrequency probes, needed 26.15 ± 3.67 min extra ischemic time and ablation by mean of cryo-probes needed an extra ischemic time of 29.62 ± 4.27 min. There was one in hospital death postoperatively because of respiratory failure but no other complication. 6 months after the operation, among 30 patients with both atrial ablations, 25 patients were in sinus rhythm, no patient had junctional rhythm and 5 patients had persistent atrial fibrillation. At 12 months follow up, freedom from atrial fibrillation was 85% in radiofrequency group and 80% in cryo group. Doppler echocardiography in these patients demonstrated atrial contractility in 70% of the patients. Intraoperative radiofrequency or cryo-ablation of both atriums are effective and less invasive alternatives for the original maze procedure to eliminate the atrial fibrillation, and can be done in patients with valvular heart disease without increasing the risk of operation.

  11. Frequency of Helicobacter pylori in patients underwent endoscopy

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    Ahmet Tay

    2012-06-01

    Full Text Available Objectives: The aim of this study was to investigate thefrequency of Helicobacter pylori in patients underwent endoscopyeastern Anatolia.Materials and methods: The patients whose endoscopicantral biopsies were taken for any reason in our endoscopyunit in February-June 2010 period were includedand retrospectively investigated. The frequency of Helicobacterpylori was determined as separating the patientsaccording to general, sex and the age groups. Antral biopsieswere stained with hematoxylin-eosin and modified giemsamethod and examined under light microscope andreported as (+ mild, (++ moderate, (+++ severe positiveaccording to their intensities.Results: Biopsy specimens of 1298 patients were includedinto the study. The mean age was 47.5 ± 17.5 years(range 14-88 and 607 of these patients (47% were male.Histopathological evaluation revealed that, 918 of the patientswere (71% positive and 379 (29% were negativefor Helicobacter pylori. Approximately 60% of our patientshad mild, 29% had moderate and 11% had severe positivityfor Helicobacter pylori. No significant difference wasfound in the frequency of Helicobacter pylori betweenwomen and men. The frequencies of Helicobacter pyloriwere 73.2%, 71.5%, 68.6% and 70.4%, respectively, inthe age groups of 14-30 years, 31-45 years, 46-60 yearsand 61-88 years.Conclusion: The frequency of Helicobacter pylori was71% in Eastern Anatolia Region. No statistically significantdifference was found between genders and agegroups in term of the frequency of Helicobacter pylori.

  12. Percutaneous screw configuration versus perimeter plating of calcaneus fractures: a cadaver study.

    Science.gov (United States)

    Smerek, Jonathan P; Kadakia, Anish; Belkoff, Stephen M; Knight, Trevor A; Myerson, Mark S; Jeng, Clifford L

    2008-09-01

    Percutaneous screw configuration has been used clinically to reduce the high rate of wound complications associated with the extensile approach of standard open reduction and internal plate fixation. The aim of this cadaveric biomechanical study was to compare the strength of the standard perimeter plating with that of the percutaneous screw configuration for a Sanders type-2B calcaneus fracture. Ten pairs of fresh-frozen cadaveric lower limbs were prepared and osteotomized to create a Sanders type-2B fracture. Of each pair, one specimen underwent open reduction and internal fixation with standard perimeter plating; the other was stabilized with the percutaneous screw configuration. Each foot was compressed axially via the talar dome (1 mm/sec) until failure occurred. Differences in treatment groups were analyzed for significance (p plate and percutaneous fixation, respectively (p = 0.18). Failure occurred at an average of 1156 +/- 513 and 1064 +/- 540 N for the plate and percutaneous construct, respectively (p = 0.65). The results suggest that open reduction and internal fixation with percutaneous screw configuration for Sanders type-2B calcaneus fractures provides a strength similar to that of perimeter plating. Percutaneous screw fixation of calcaneus fractures may provide fracture reduction similar to plate fixation.

  13. Radiofrequência na dor crônica Radiofrecuencia en el dolor crónico Radiofrequency in chronic pain

    Directory of Open Access Journals (Sweden)

    José Luciano Braun Filho

    2009-06-01

    algunos aspectos importantes del mecanismo y evolución de la radiofrecuencia en el dolor crónico. Serán abordados los aspectos básicos de la física y el mecanismo de acción de la RF, método que ha sido usado para tratar dolores crónicos de diferentes etiologías, además de la evolución con el advenimiento de la radiofrecuencia pulsátil.El uso de la radiofrecuencia en el manejo del dolor crónico es una herramienta útil en diferentes condiciones dolorosas y ha sido usado con suceso por más de 25 años. Su mecanismo de acción aun no está totalmente elucidado. La radiofrecuencia pulsátil es en particular una técnica mínimamente destructiva y podrá ser una alternativa a la forma convencional para el tratamiento de dolor por radiofrecuencia.Radiofrequency (RF is a minimally invasive target-selective technique that has been used with success for many years in the treatment of different pathologies, like low back pain, trigeminal neuralgia and others. RF is an alternating electric field with oscillation in the frequency of 500.000 Hz that flows through a percutaneously introduced electrode. The heat will be produced around the electrode, because the tissue acts as a resistor. Therefore, radiofrequency may be used to ablate nervous tissue in the treatment of chronic pain. The objective of this study was to review a few important aspects of the mechanism and evolution of radiofrequency in chronic pain. The basic aspects of Physics and the mechanism of radiofrequency, a method which has been used to treat different etiologies of chronic pain, besides the evolution that came with the introduction of pulsed radiofrequency will be herein elucidated. The application of radiofrequency in the management of chronic pain may be a useful tool in the management of several chronic pain conditions and have been successfully used in clinical practice for more than 25 years. Its mechanism of action has not been totally elucidated yet. Pulsed radiofrequency, in private, is a

  14. A safety and feasibility study of a novel radiofrequency-assisted liposuction technique.

    Science.gov (United States)

    Blugerman, Guillermo; Schavelzon, Diego; Paul, Malcolm D

    2010-03-01

    The feasibility, safety, and efficacy of a novel radiofrequency device for radiofrequency-assisted liposuction were evaluated in various body areas. From July to December of 2008, 23 subjects underwent radiofrequency-assisted liposuction using the BodyTite system. Information regarding aesthetic results and local and systemic complications was collected immediately after the procedure and at 6- and 12-week follow-up. The mean age of the patients was 38.8 +/- 12.4 years, and 87 percent were women. Radiofrequency-assisted liposuction was performed successfully in all cases; volume aspirated per patient was 2404 +/- 1290 ml, whereas operative time was 158 +/- 44 minutes. All patients underwent liposuction at the hip and low abdominal areas, bilaterally. Body contour improvement was observed postoperatively in all patients and there were no severe systemic or local complications, although postoperative pain was minimal in all patients. Weight and circumference reductions were significant at both 6-week and 3-month follow-up. Skin tightening was judged optimal by the surgeon in all patients. The authors' study suggests that the removal of moderate volumes of fat with concurrent subdermal tissue contraction can be performed safely and effectively with radiofrequency-assisted liposuction. Additional benefits of this technique are excellent patient tolerance and fast recovery time. Nonetheless, a larger sample is required to confirm the authors' results and guarantee the efficacy and safety of the procedure. Direct comparison with traditional liposuction or energy-assisted liposuction techniques may provide some insights to tailor future indications of this novel technique.

  15. Radiofrequency ablation of the supra-orbital nerve in the treatment algorithm of hemicrania continua.

    Science.gov (United States)

    Weyker, Paul; Webb, Christopher; Mathew, Leena

    2012-01-01

    Hemicrania continua (HC) is an uncommon primary headache disorder in which the diagnosis centers on unilaterality and its absolute responsiveness to indomethacin. We describe 3 patients with a long standing history of headache diagnosed as hemicrania continua. There was profound response to indomethacin which was limited by side effects. In one patient the therapy with indomethacin was limited secondary to co-morbidities. Initial diagnostic blockade provided significant relief of symptoms based on which radio-frequency ablation of the supraorbital nerve was performed with substantial improvement in symptoms. Traditionally, hemicrania continua has been managed exclusively with oral analgesics and is defined by its singular response to indomethacin. Radio-frequency ablation (RFA) has been reported in the literature for multiple indications. This case series is unique in that it describes 3 patients diagnosed with hemicrania continua with pain referred in the supraorbital nerve distribution, who underwent radiofrequency ablation of the supraorbital nerve with resultant resolution of headaches. Traditionally, hemicrania continua has been managed exclusively with oral analgesics and is defined by its singular response to indomethacin. This report is unique in that it describes three patients diagnosed with hemicrania continua with pain referred in the supraorbital nerve distribution who underwent radiofrequency ablation of the supraorbital nerve with resultant resolution of headaches. After the RFA medical management was minimal to none in both patients. Though the utility and cost efficacy of RFA of peripheral nerves needs to be confirmed in well-designed trials we present these cases as an example of how this minimally invasive technique can safely provide analgesia in a difficult to treat cephalgia. Moreover if precise anatomical localization of the headache is possible then diagnostic blockade of the appropriate peripheral nerve may be performed followed by

  16. [Radiofrequency in the treatment of the renal neoplasias].

    Science.gov (United States)

    Fiorini, Fulvio; Granata, Antonio; Mereghetti, Marco; D'Amelio, Alessandro; Meloni, Maria Franca

    2015-01-01

    The tumors of the kidney are around the 3% of the neoplasia in adult patients and, at the postmortem examination, the renal neoplasias has a frequency of 1/300 for tumors diameter of 1 to 2 cms. In the treatment of the small neoplasias, techniques of nephron sparing and enucleation are used. These techniques have shown the same therapeutic effectiveness of the radical nephrectomy in patients with tumors smaller than 4 centimeters, with reduction of morbidity. However, there are few clinical situation in which the surgery has a high risk: patients with solitary kidney, chronic renal failure, multiple localizations involving also contralateral kidney, in patients with other malignancies and in von Hippel-Lindau Syndrome. Recently, percutaneous mininvasive techniques have been applied (ex. thermoablation): these techniques allow to reduce the duration of general anesthesia, they offer the possibility to use spinal anaesthesia (besides deep sedation and general anaesthesia) with reduction in mortality during surgery. The most commonly used among interstitial therapies is the radiofrequency (RF), which changes electromagnetic waves into heat. RF used both tomography and ultrasound-guided. The latter is the most recommended because it allows to follow the procedure in real-time. The treatment of renal tumors with RF, in which surgery is inadvisable, is safe and effective especially in peripheral and/or exophytic lesions lower than 4 cm. However the larger tumors can also be treated successfully with combined therapy or multiple sessions.

  17. Delayed Development of Pneumothorax After Pulmonary Radiofrequency Ablation

    International Nuclear Information System (INIS)

    Clasen, Stephan; Kettenbach, Joachim; Kosan, Bora; Aebert, Hermann; Schernthaner, Melanie; Kroeber, Stefan-Martin; Boemches, Andrea; Claussen, Claus D.; Pereira, Philippe L.

    2009-01-01

    Acute pneumothorax is a frequent complication after percutaneous pulmonary radiofrequency (RF) ablation. In this study we present three cases showing delayed development of pneumothorax after pulmonary RF ablation in 34 patients. Our purpose is to draw attention to this delayed complication and to propose a possible approach to avoid this major complication. These three cases occurred subsequent to 44 CT-guided pulmonary RF ablation procedures (6.8%) using either internally cooled or multitined expandable RF electrodes. In two patients, the pneumothorax, being initially absent at the end of the intervention, developed without symptoms. One of these patients required chest drain placement 32 h after RF ablation, and in the second patient therapy remained conservative. In the third patient, a slight pneumothorax at the end of the intervention gradually increased and led into tension pneumothorax 5 days after ablation procedure. Underlying bronchopleural fistula along the coagulated former electrode track was diagnosed in two patients. In conclusion, delayed development of pneumothorax after pulmonary RF ablation can occur and is probably due to underlying bronchopleural fistula, potentially leading to tension pneumothorax. Patients and interventionalists should be prepared for delayed onset of this complication, and extensive track ablation following pulmonary RF ablation should be avoided.

  18. A prospective randomized study comparing percutaneous nephrolithotomy under combined spinal-epidural anesthesia with percutaneous nephrolithotomy under general anesthesia.

    Science.gov (United States)

    Singh, Vishwajeet; Sinha, Rahul Janak; Sankhwar, S N; Malik, Anita

    2011-01-01

    A prospective randomized study was executed to compare the surgical parameters and stone clearance in patients who underwent percutaneous nephrolithotomy (PNL) under combined spinal-epidural anesthesia (CSEA) versus those who underwent PNL under general anesthesia (GA). Between January 2008 to December 2009, 64 patients with renal calculi were randomized into 2 groups and evaluated for the purpose of this study. Group 1 consisted of patients who underwent PNL under CSEA and Group 2 consisted of patients who underwent PNL under GA. The operative time, stone clearance rate, visual pain analog score, mean analgesic dose and mean hospital stay were compared amongst other parameters. The difference between visual pain analog score after the operation and the dose of analgesic requirement was significant on statistical analysis between both groups. PNL under CSEA is as effective and safe as PNL under GA. Patients who undergo PNL under CESA require lesser analgesic dose and have a shorter hospital stay. Copyright © 2011 S. Karger AG, Basel.

  19. Percutaneous Nephrolithotomy and Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Sairam, Krish; Scoffone, Cesare M; Alken, Peter

    2012-01-01

    by glomerular filtration rate, including chronic kidney disease stages 0/I/II-greater than 60, stage III-30 to 59 and stages IV/V-less than 30 ml/minute/1.73 m(2). Patient characteristics, operative characteristics, outcomes and morbidity were assessed. RESULTS: Estimated glomerular filtration rate data were...... available on 5,644 patients, including 4,436 with chronic kidney disease stages 0/I/II, 994 with stage III and 214 with stages IV/V. A clinically significant minority of patients with nephrolithiasis presented with severe chronic kidney disease. A greater number of patients with stages IV/V previously...... underwent percutaneous nephrolithotomy, ureteroscopy or nephrostomy and had positive urine cultures than less severely affected patients, consistent with the higher incidence of staghorn stones in these patients. Patients with chronic kidney disease stages IV/V had statistically significantly worse...

  20. Percutaneous Vertebroplasty in Painful Schmorl Nodes

    International Nuclear Information System (INIS)

    Masala, Salvatore; Pipitone, Vincenzo; Tomassini, Marco; Massari, Francesco; Romagnoli, Andrea; Simonetti, Giovanni

    2006-01-01

    The Schmorl node represents displacement of intervertebral disc tissue into the vertebral body. Both Schmorl nodes and degenerative disc disease are common in the human spine. We performed a retrospective study, for the period from January 2003 to February 2005, evaluating 23 patients affected by painful Schmorl nodes, who underwent in our department percutaneous transpedicular injection of polymethylmethacrylate (vertebroplasty) in order to solve their back pain not responsive to medical and physical management. Eighteen patients reported improvement of the back pain and no one reported a worsening of symptoms. Improvement was swift and persistent in reducing symptoms. Painful Schmorl nodes, refractory to medical or physical therapy, should be considered as a new indication within those vertebral lesions adequately treatable utilizing Vertebroplasty procedure

  1. QT Dispersion: Does It Change after Percutaneous Coronary Intervention?

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    Mahsa Asadi Moghaddam

    2011-02-01

    Full Text Available Background: Myocardial ischemia is one of several causes of prolonged QT dispersion. The aim of this study was to evaluate the effect that percutaneous coronary intervention has on the depolarization and repolarization parameters of surface electrocardiography in patients with chronic stable angina.Methods: We assessed the effects of full revascularization in patients with chronic stable angina and single-vessel disease who underwent percutaneous coronary intervention. Twelve-lead electrocardiograms were recorded before intervention and 24 hours subsequently. We measured parameters including QRS duration, QT and corrected QT durations, and JT and corrected JT duration in both electrocardiograms and compared the values.Results: There were significant differences between the mean QRS interval (0.086 ± 0.01sec vs. 0.082 ± 0.01 second; p value = 0.01, mean corrected QT dispersion (0.080 ± 0.04 sec vs. 0.068 ± 0.04 sec; p value = 0.001, and mean corrected JT dispersion (0.074 ± 0.04 sec vs. 0.063 ± 0.04 sec; p value = 0.001 before and after percutaneous coronary intervention. No significant differences were found between the other ECG parameters.Conclusion: Our data indicate that the shortening of corrected QT dispersion and corrected JT dispersion in patients undergoing percutaneous coronary intervention is prominent.

  2. Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

    Directory of Open Access Journals (Sweden)

    Michael Y. Wang

    2012-01-01

    Full Text Available Introduction. Adult spinal deformity (ASD surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females. Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

  3. Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter

    International Nuclear Information System (INIS)

    Oh, Jung Suk; Lee, Hae Giu; Chun, Ho Jong; Choi, Byung Gil; Lee, Sang Hoon; Hahn, Seong Tai; Ohm, Joon Young

    2013-01-01

    Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6–20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6–38) after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5–14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10–58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites

  4. Enhanced high-energy protocol using a fractional bipolar radiofrequency device combined with bipolar radiofrequency and infrared light for improving facial skin appearance and wrinkles.

    Science.gov (United States)

    Gold, Michael H; Biesman, Brian S; Taylor, Mark

    2017-06-01

    Fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light have been shown in previous trials to safely and effectively improve the appearance of facial wrinkles. To evaluate a high-energy protocol with combined bipolar radiofrequency and infrared light energies for improvement in photoaged facial skin. Seventy-two patients presenting with mild to moderate facial wrinkles underwent a single full-face treatment (n=54) or two treatments (n=18) at 6-week intervals. Independent blinded assessment and investigator assessment were performed, using the Fitzpatrick Wrinkle and Elastosis Scale (0-9) and the Global Aesthetic Improvement scale. Patients also completed a self-assessment questionnaire concerning satisfaction with the treatment. All patients achieved some degree of improvement in their wrinkles and skin appearance, following a single treatment or two treatments with the enhanced-energy protocol. Blinded evaluation demonstrated 71% and 70% of the patients showing improvement of one unit or greater on the Fitzpatrick Scale, at the 12-week and 24-week follow-ups post-treatment, respectively. Similar results were reported by investigators. Under the Global Aesthetic Improvement Scale, investigators observed 87%, 91% and 81% of patients showing improvement at the 6-, 12-, and 24-week post-treatment end, respectively. Patients tolerated the treatments well and were satisfied with the clinical results. The enhanced-energy treatment protocol, with fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light applications, yields significant improvement of skin texture, wrinkling, and overall appearance following a single treatment. The results appear gradually over time and are maintained for at least 6 months' post-treatment. © 2017 Wiley Periodicals, Inc.

  5. Percutaneous nephrolithotomy in children: A preliminary report

    Directory of Open Access Journals (Sweden)

    Ahmad A. Elderwy

    2014-01-01

    Full Text Available Objectives: The recurrence of pediatric nephrolithiasis, the morbidity of repeated open surgical treatment as well as our experience in percutaneous nephrolithotomy (PNL in adult patients, all derived us to shift to PNL for managing renal stones >1.5 cm in pediatric patients. Our aim of this study is to evaluate the safety and efficacy of PNL in pediatric patients. Materials and Methods: During the period of the month between May 2011 and April 2013, 38 children (47 renal units underwent PNL for renal stones 1.5-5 cm in length. Patient demographics, stone characteristics, and clinical outcome were prospectively studied. Data of those who underwent conventional and tubeless PNL were compared. Median follow-up period was 12 months (range: 6-24. Results: The median age at presentation was 8-year (range: 3-12. The operative time ranged from 30 to 120 min (median 90. Overall stone clearance rate was 91.5% after single PNL. The median hospital stay was 3 days. Auxiliary procedures were successful for the remaining 4 patients (nephroscopic clearance in one and shockwave lithotripsy in 3. Tubeless PNL was performed in 17 renal units with a comparable outcome to conventional ones. The perioperative complications were noted in 5/47 (10.6% of all procedures (Clavien Grade II in 4 and Clavien Grade IIIa in 1 and were managed conservatively. Conclusions: Percutaneous nephrolithotomy for renal stones in pediatric patients is safe and feasible if performed by a well-experienced endourologist. Tubeless PNL is a better choice for children.

  6. Radial scars without atypia in percutaneous biopsy specimens: can they obviate surgical biopsy?

    Science.gov (United States)

    Mesa-Quesada, J; Romero-Martín, S; Cara-García, M; Martínez-López, A; Medina-Pérez, M; Raya-Povedano, J L

    To evaluate the need for surgical biopsy in patients diagnosed with radial scars without atypia by percutaneous biopsy. In this retrospective observational study, we selected patients with a histological diagnosis of radial scar in specimens obtained by percutaneous biopsy during an 8-year period. The statistical analysis was centered on patients with radial scar without atypia (we assessed the radiologic presentation, the results of the percutaneous biopsy, and their correlation with the results of surgical biopsy and follow-up) and we added the patients with atypia and cancer in the elaboration of the diagnostic indices. We identified 96 patients with radial scar on percutaneous biopsy; 54 had no atypia, 18 had atypia, and 24 had cancer. Among patients with radial scar without atypia, there were no statistically significant differences between patients who underwent imaging follow-up and those who underwent surgical biopsy (p>0.05). The rate of underdiagnosis for percutaneous biopsy in patients without atypia was 1.9%. The rates of diagnosis obtained with percutaneous biopsy in relation to follow-up and surgical biopsy in the 96 cases were sensitivity 92.3%, specificity 100%, positive predictive value 100%, negative predictive value 97.2%, and accuracy 97.9%. The area under the ROC curve was 0.96 (p<0.001), and the kappa concordance index was 0.95 (p<0.001) CONCLUSIONS: We consider that it is not necessary to perform surgical biopsies in patients with radial scars without atypia on percutaneous biopsies because the rate of underestimation is very low and the concordance between the diagnosis reached by percutaneous biopsy and the definitive diagnosis is very high. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Percutaneously inserted central catheter - infants

    Science.gov (United States)

    PICC - infants; PQC - infants; Pic line - infants; Per-Q cath - infants ... A percutaneously inserted central catheter (PICC) is a long, very thin, soft plastic tube that is put into a small blood vessel. This article addresses PICCs in ...

  8. Percutaneous Nephrolithotomy in Children

    Directory of Open Access Journals (Sweden)

    Romano T. DeMarco

    2011-01-01

    Full Text Available The surgical management of pediatric stone disease has evolved significantly over the last three decades. Prior to the introduction of shockwave lithotripsy (SWL in the 1980s, open lithotomy was the lone therapy for children with upper tract calculi. Since then, SWL has been the procedure of choice in most pediatric centers for children with large renal calculi. While other therapies such as percutaneous nephrolithotomy (PNL were also being advanced around the same time, PNL was generally seen as a suitable therapy in adults because of the concerns for damage in the developing kidney. However, recent advances in endoscopic instrumentation and renal access techniques have led to an increase in its use in the pediatric population, particularly in those children with large upper tract stones. This paper is a review of the literature focusing on the indications, techniques, results, and complications of PNL in children with renal calculi.

  9. Fistulas of the lower urinary tract: percutaneous approaches for the management of a difficult clinical entity.

    Science.gov (United States)

    Avritscher, Rony; Madoff, David C; Ramirez, Pedro T; Wallace, Michael J; Ahrar, Kamran; Morello, Frank A; Gupta, Sanjay; Murthy, Ravi; Wright, Kenneth C; Hicks, Marshall E

    2004-10-01

    Fistulas of the lower urinary tract are uncommon conditions that may occur spontaneously or after therapy in patients with various pelvic abnormalities. When present, these fistulas are associated with urine leakage, which is often socially distressing and disabling. Unfortunately, factors that lead to the formation of genitourinary fistulas often increase their complexity or preclude surgical repair. A high failure rate is associated with surgical repair, and many patients are not optimal surgical candidates. For such patients, a percutaneous treatment approach is highly desirable. Percutaneous ureteral occlusion combined with insertion of a functioning nephrostomy tube allows complete diversion of urine in those patients in whom nephrostomy alone does not provide adequate relief. Many approaches to percutaneous ureteral occlusion have been used with variable success, including coils and gelatin sponge, isobutyl-2-cyanoacrylate, detachable balloons, radiofrequency electrocautery, ureteral clipping, and solid and soft polymer agents. Furthermore, percutaneous or retrograde ureteral stents may be used to preserve antegrade urine flow, and surgical options are also available. It is essential that the interventional radiologist involved in the care of these patients be familiar with these different techniques as well as with the limitations, pitfalls, and possible complications of their use. Copyright RSNA, 2004.

  10. Treatment of intervertebral disc degenerative disease using percutaneous nucleotomy–an overview of less invasive procedures

    Directory of Open Access Journals (Sweden)

    Miran Jeromel

    2014-04-01

    Full Text Available Background: Less invasive treatment methods for intervertebral disc disease and decompression of neural structures as a consequence of contained disc herniation represent an alternative to surgical procedure. Percutaneus nucleotomy uses a percutaneous approach to the intervertebral disc. The article presents the evolution of numerous procedureds in clinical practice.Methods: Percutaneous nucleoplasty is a fluoroscopy-guided procedure which enables controlled and safe entrance into the intervertebral disc. The procedure is performed under strict aseptic conditions, using a local anaesthesia with the patient under analgosedation. Based on the principle of therapeutic intradiscal action, the procedures can be divided into three groups: chemical (chemonucleolysis with chimopapain, alcohol, ozone, mechanical (automated percutaneous lumbar discectomy – APLD, arthroscopic discectomy and thermical methods (laser, radiofrequency ablation, intradiscal electrothermal annuloplasty – IDET, Coblation®.Results: Percutaneous nucleotomy by the majority of the mentioned procedures results in a therapeutic effect (reduction of pain and decompression of neural structures. Fast recovery represents a major advantage of less invasive treatment.Conclusions: Less invasive method (nucleotomy using different procedures represents a successful alternative approach to surgical discectomy. Proper patient selection and safe technique are mandatory in order to achieve a good clinical outcome.

  11. Outcome of Percutaneous Nephrolithotomy

    International Nuclear Information System (INIS)

    Ali, S.; Kumar, N.; Baloch, U.

    2014-01-01

    Objective: To assess the implementation of Percutaneous Nephrolithotomy (PCNL) in renal stone management and evaluate the factors for efficacy and safety of PCNL. Study Design: Case series. Place and Duration of Study: Department of Urology at Jinnah Postgraduate Medical Centre, Karachi, from January 2008 to December 2011. Methodology: Patients aged above 12 years of age, irrespective of gender with normal renal function, mean stone size > 2 cm, lower pole stones > 1 cm, and ESWL failure were selected. After the procedure, on the first postoperative day, a plain abdominal radiograph was obtained to verify stone clearance. A nephrostomy tube was clamped overnight and subsequently removed when no residual stone which needs second sitting was seen. Results: In 175 patients, 62.86% (n=110) were male and the mean age was 35 A +- 9.56 years. One hundred and seventeen (66.85%) patients were primarily stone free and 13.71% (n=24) patients needed a second look procedure, thus, a total of 80.57% (n=141) patients were stone free in the same admission. Complications included failure in 4.0% (n=7) patients, bleeding in 8.57% (n=15) patients, a small residual stone in 15.43% (n=27) patients; and puncture site pain almost in every patient. Transient fever occurred in 55.43% (n=97) patients, urinary leakage in 8.57% (n=15) patients, urinary tract infections in 5.14% (n=9) patients, ureteric colic in 3.43% (n=6) patients, colonic injury in 0.57% (n=1) patient; and nephrectomy was required in 0.57% (n=1) patient due to severe bleeding. One patient (0.57%) expired due to anaesthesia complications. Conclusion: Percutaneous nephrolithotomy (PCNL) has a good success rate. There is minimal blood loss, and few major complications. (author)

  12. Results of percutaneous abscess drainage

    International Nuclear Information System (INIS)

    Daehnert, W.; Guenther, R.; Klose, K.; Gamstaetter, G.

    1983-01-01

    Between 1978 and 1983 fifty-two abdominal abscesses in 44 patients were drained percutaneously, 79% of the abscesses occurred as postoperative complications. The overall success rate was 60%, whereas only 42% of left subphrenic abscesses were cured. Complications were encountered in 4.5%. Reasons for drainage failures were: liver sequestration, loculation, fistulae and recurrences. Percutaneous abscess drainage in an alternative, and valuable addition, to surgery. (orig.) [de

  13. Oxidative and pre-inflammatory stress in wedge resection of pulmonary parenchyma using the radiofrequency ablation technique in a swine model

    Directory of Open Access Journals (Sweden)

    Karaiskos Theodoros

    2012-01-01

    Full Text Available Abstract Background Radiofrequency ablation (RFA is a thermal energy delivery system used for coagulative cellular destruction of small tumors through percutaneous or intraoperative application of its needle electrode to the target area, and for assisting partial resection of liver and kidney. We tried to evaluate the regional oxidative and pre-inflammatory stress of RFA-assisted wedge lung resection, by measuring the MDA and tumor Necrosis Factor Alpha (TNF-α concentration in the resected lung tissue of a swine model. Method Fourteen white male swines, divided in two groups, the RFA-group and the control group (C-group underwent a small left thoracotomy and wedge lung resection of the lingula. The wedge resection in the RFA-group was performed using the RFA technique whereas in C-group the simple "cut and sew" method was performed. We measured the malondialdehyde (MDA and TNF-α concentration in the resected lung tissue of both groups. Results In C-group the MDA mean deviation rate was 113 ± 42.6 whereas in RFA-group the MDA mean deviation rate was significantly higher 353 ± 184 (p = 0.006. A statistically significant increase in TNF-α levels was also observed in the RFA-group (5.25 ± 1.36 compared to C-group (mean ± SD = 8.48 ± 2.82 (p = 0.006. Conclusion Our data indicate that RFA-assisted wedge lung resection in a swine model increases regional MDA and TNF-a factors affecting by this oxidative and pre-inflammatory stress of the procedure. Although RFA-assisted liver resection can be well tolerated in humans, the possible use of this method to the lung has to be further investigated in terms of regional and systemic reactions and the feasibility of performing larger lung resections.

  14. Percutaneous thermal ablation for stage IA non-small cell lung cancer: long-term follow-up.

    Science.gov (United States)

    Narsule, Chaitan K; Sridhar, Praveen; Nair, Divya; Gupta, Avneesh; Oommen, Roy G; Ebright, Michael I; Litle, Virginia R; Fernando, Hiran C

    2017-10-01

    Surgical resection is the most effective curative therapy for non-small cell lung cancer (NSCLC). However, many patients are unable to tolerate resection secondary to poor reserve or comorbid disease. Radiofrequency ablation (RFA) and microwave ablation (MWA) are methods of percutaneous thermal ablation that can be used to treat medically inoperable patients with NSCLC. We present long-term outcomes following thermal ablation of stage IA NSCLC from a single center. Patients with stage IA NSCLC and factors precluding resection who underwent RFA or MWA from July 2005 to September 2009 were studied. CT and PET-CT scans were performed at 3 and 6 month intervals, respectively, for first 24 months of follow-up. Factors associated with local progression (LP) and overall survival (OS) were analyzed. Twenty-one patients underwent 21 RFA and 4 MWA for a total of 25 ablations. Fifteen patients had T1a and six patients had T1b tumors. Mean follow-up was 42 months, median survival was 39 months, and OS at three years was 52%. There was no significant difference in median survival between T1a nodules and T1b nodules (36 vs . 39 months, P=0.29) or for RFA and MWA (36 vs . 50 months, P=0.80). Ten patients had LP (47.6%), at a median time of 35 months. There was no significant difference in LP between T1a and T1b tumors (22 vs . 35 months, P=0.94) or RFA and MWA (35 vs . 17 months, P=0.18). Median OS with LP was 32 months compared to 39 months without LP (P=0.68). Three patients underwent repeat ablations. Mean time to LP following repeat ablation was 14.75 months. One patient had two repeat ablations and was disease free at 40-month follow-up. Thermal ablation effectively treated or controlled stage IA NSCLC in medically inoperable patients. Three-year OS exceeded 50%, and LP did not affect OS. Therefore, thermal ablation is a viable option for medically inoperable patients with early stage NSCLC.

  15. The wedding cake solution: A percutaneous correction of a form fruste superior sinus venosus atrial septal defect.

    Science.gov (United States)

    Crystal, Matthew A; Vincent, Julie A; Gray, William A

    2015-12-01

    We present the case of a patient with a superior sinus venosus defect (SSVD), with the atypical finding of an intact atrial septum and posterior atrial wall, which underwent percutaneous closure in the cardiac catheterization laboratory for repair. SSVDs are rare congenital cardiac anomalies, but when the anatomy is amenable to percutaneous strategies, a collaborative and creative approach can result in a safe and effective result. © 2015 Wiley Periodicals, Inc.

  16. Percutaneous Disc Coagulation Therapy (PDCT) comparing with Automated Percutaneous Lumbar Discectomy (APLD) in Patients of Herniated Lumbar Disc Disease: Preliminary Report.

    Science.gov (United States)

    Park, Cheon Wook; Lee, Joo Yong; Choi, Woo Jin; Chang, Sang Keun

    2012-09-01

    Percutaneous techniques are rapidly replacing traditional open surgery. This is a randomized controlled trial study of clinical outcomes of Percutaneous Plasma Disc Coagulation Therapy (PDCT) in patients with HLD(herniated lumbar disc) as a new percutaneous access in comparison with Automated Percutaneous Lumbar Discectomy (APLD) in its clinical application and usefulness as a reliable alternative method. The authors analyzed 25 patients who underwent PDCT randomized 1:1 to 25 who underwent APLD between June, 2010 and October, 2011. All patients had herniated lumbar disc diseases. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. The age of the patients who underwent PDCT ranged from 29 to 88 years with a mean age of 51.8 years. The age of the APLD undergone patients' population ranged from 30 to 66 with a mean age of 46.0 years. The average preoperative VAS score in PDCT was 7.60 and 1.94 at 7months post-operatively, and in APLD was 7.32, and 3.53 at 7 months post-operatively (pherniated lumbar disc. PDCT showed to be more effective than APLD in this study, allowing stable decompression and safe minimally invasive operation to an area desired by the operator in lumbar disc herniation patients, although further long term clinical evaluations are still necessary.

  17. Gender Differences in Long-Term Clinical Outcomes After Percutaneous Coronary Intervention of Chronic Total Occlusions

    NARCIS (Netherlands)

    Claessen, Bimmer E.; Chieffo, Alaide; Dangas, George D.; Godino, Cosmo; Lee, Seung-Whan; Obunai, Kotaro; Carlino, Mauro; Chantziara, Vaso; Apostolidou, Irini; Henriques, José P. S.; Leon, Martin B.; Di Mario, Carlo; Park, Seung-Jung; Stone, Gregg W.; Moses, Jeffrey W.; Colombo, Antonio; Mehran, Roxana

    2012-01-01

    Introduction. Little is known about gender differences among patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Methods. A total of 1791 patients with 1852 CTOs underwent PCI at 3 centers in the United States, Italy, and South Korea between 1998 and 2007.

  18. Subcutaneous Transitional Cell Cancer After Percutaneous Nephrolithotomy: A Case Report

    Directory of Open Access Journals (Sweden)

    Lokman Ižrkilata

    2013-10-01

    Full Text Available Transitional cell carcinomas of the upper urinary tract are rare but, highly predisposing to tumoral seeding. Percutaneous lithotripsy (PNL recently has expanded the therapeutic choices for patients with kidney stones and gained popularity by urologic surgeons. Although unusual, renal collecting system tumours may be encountered during PNL. We present and discuss the clinical course of a 48 years old male patient who underwent PNL surgery for kidney stone in whom transitional cell carcinoma in the renal collecting system obscured by stone left undiagnosed. Three months later following PNL he admitted with a bulge on lumbar region. Excisional biopsy revealed carcinoma and therefore, he was directed to chemoradiotherapy and died 21 months later. Renal collecting system tumors undiagnosed during surgery may progress and demonstrate local invasion in a short period of time. Therefore, we recommend to take more caution during any percutaneous access and to exclude the possible existence of tumor.

  19. Postoperative complications following percutaneous endoscopic gastrostomy are common in children

    DEFF Research Database (Denmark)

    Halvard Hansen, Erik Sören; Qvist, N.; Rasmussen, L.

    2017-01-01

    Aim: Inserting a feeding tube using percutaneous endoscopic gastrostomy may be necessary to ensure that children with eating problems receive sufficient enteral nutrition. The aim of this study was to investigate the perioperative and postoperative complications of percutaneous endoscopic...... gastrostomy when the pull-through method was the standard procedure. Methods: This was a retrospective review of 229 children (50.7% male) who underwent a gastrostomy procedure at Odense University Hospital, Denmark, from January 1, 2000 to December 31, 2012. The median age of the children was 1.6 years...... were grade 3b complications. No gastrostomy-related deaths were observed, and no single preoperative risk factor was identified. Perioperative complications were experienced by 2.6% of the patients. Conclusion: Gastrostomy feeding tube placement was associated with a high rate of postoperative...

  20. Percutaneous Sacroplasty for Sacral Metastatic Tumors Under Fluoroscopic Guidance Only

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Ji; Wu, Chun Gen; Gu, Yi Feng; Li, Ming Hua [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2008-12-15

    Percutaneous sacroplasty is a safe and effective procedure for sacral insufficient fractures under CT or fluoroscopic guidance; although, few reports exist about sacral metastatic tumors. We designed a pilot study to treat intractable pain caused by a sacral metastatic tumor with sacroplasty. A 62-year-old man and a 38-year-old woman with medically intractable pain due to metastatic tumors of S1 from lymphoma and lung cancer, respectively, underwent percutaneous sacroplasty. Over the course of the follow-up period, the two patients experienced substantial and immediate pain relief that persisted over a 3-month and beyond. The woman had deposition of PMMA (polymethyl methacrylate) in the needle track, but did not experience significant symptoms. No other peri-procedural complications were observed for either patient.

  1. Percutaneous treatment of calcaneus fractures associated with underlying bone cysts.

    Science.gov (United States)

    Chen, Linwei; Zhang, Guoyou; Li, Shi; Wu, Zhipeng; Yuan, Wen; Hong, Jianjun

    2012-05-01

    Calcaneal bone cysts with pathological fractures are rare. There is no clear consensus on their management with a few reports of open curettage, bone grafting and internal fixation in the treatment of pathological calcaneal fractures. No minimally invasive management has been reported before. We reviewed our experience in treating five patients with pathologic calcaneus fractures associated with pre-existing bone cysts who underwent percutaneous cyst curettage, fracture reduction, screw fixation and calcium sulfate cement injection between 2004 and 2009. All of the pathologic fractures healed with satisfactory radiological results. There were no soft tissue complications or cyst recurrences. Partial weightbearing with plaster cast immobilization was allowed at 4 weeks postoperatively and full weightbearing was allowed at 6 weeks postoperatively. This percutaneous technique provided a minimally invasive option for treatment of a calcaneal bone cyst with pathologic fracture.

  2. Arrhythmia-free survival and pulmonary vein reconnection patterns after second-generation cryoballoon and contact-force radiofrequency pulmonary vein isolation.

    Science.gov (United States)

    Buist, Thomas J; Adiyaman, Ahmet; Smit, Jaap Jan J; Ramdat Misier, Anand R; Elvan, Arif

    2018-02-06

    The aim of this study was to compare second-generation cryoballoon and contact-force radiofrequency point-by-point pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients with regard to pulmonary vein reconnection and arrhythmia-free survival. Altogether, 269 consecutive patients with drug-refractory AF undergoing PVI were included and randomly allocated to second-generation cryoballoon or contact-force point-by-point radiofrequency ablation. Median follow-up duration was 389 days (interquartile range 219-599). Mean age was 59 years (71% male); 136 patients underwent cryoballoon and 133 patients underwent radiofrequency ablation. Acute electrical PVI was 100% for both techniques. Procedure duration was significantly shorter in cryoballoon vs radiofrequency (166.5 vs 184.13 min P = 0.016). Complication rates were similar (6.0 vs 6.7%, P = 1.00). Single procedure freedom of atrial arrhythmias was significantly higher in cryoballoon as compared to radiofrequency (75.2 vs 57.4%, P = 0.013). In multivariate analysis, persistent AF, AF duration, and cryoballoon ablation were associated with freedom of atrial tachyarrhythmias. The number of repeat ablation procedures was significantly lower in the cryoballoon compared to radiofrequency (15.0 vs 24.3%, P = 0.045). At repeat ablation, pulmonary vein reconnection rate was significantly lower after cryoballoon as compared to radiofrequency ablation (36.8 vs 58.1%, P = 0.003). Improved arrhythmia-free survival and more durable pulmonary vein isolation is seen after PVI using second-generation cryoballoon as compared to contact-force radiofrequency, in patients with drug-refractory paroxysmal AF. Complication rates for both ablation techniques are low.

  3. New resonant circuits for the ISOLTRAP radiofrequency quadrupole trap

    CERN Document Server

    SENECAL, Pierre

    2015-01-01

    This report describes my work during my Summer Student Program. My main project was building and testing a resonance-circuit box for a radio-frequency power supply used with the radio-frequency cooler and buncher.

  4. Percutaneous umbilical cord blood sampling - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100196.htm Percutaneous umbilical cord blood sampling - series—Normal anatomy To use the ... or blood disorder, your doctor may recommend percutaneous umbilical cord blood sampling (PUBS), which is performed at 18 ...

  5. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    2011-06-15

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various ...

  6. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

  7. Duodenal perforation during percutaneous nephrolithotomy (PCNL ...

    African Journals Online (AJOL)

    A. Bansal

    2016-06-03

    Jun 3, 2016 ... Calculus;. Duodenum;. Injury;. Paediatric;. Percutaneous nephrolithotomy. Abstract. Introduction: Colonic perforations are known complications of percutaneous nephrolithotomy (PCNL). However, to the best of our knowledge, small bowel perforation has rarely been reported.. Observation: We report the ...

  8. A Retrospective Evaluation of Subsurface Monopolar Radiofrequency for Lifting of the Face, Neck, and Jawline.

    Science.gov (United States)

    Dendle, Julia; Wu, Douglas C; Fabi, Sabrina G; Melo, Diana; Goldman, Mitchel P

    2016-11-01

    Subsurface monopolar radiofrequency (SMRF) has emerged as a new method for reducing skin laxity via the controlled delivery of thermal energy below the skin using a radiofrequency probe. To evaluate the overall efficacy of the treatment and satisfaction ratings of subjects who underwent a single SMRF treatment to the face, neck, or jawline (or some combination). A retrospective, single-center study was conducted in which data were obtained via subject follow-ups at 90 and 180 days posttreatment. A total of 35 subjects, 6 men and 29 women, underwent a single SMRF treatment. Overall, 77% of subjects reported improvement, and 64% reported satisfaction with the treatment site at Day 180 posttreatment. Subsurface monopolar radiofrequency represents an effective modality to achieve skin tightening of the face, neck, and jawline. The data suggest that there is an energy delivery threshold, above which a higher percentage of subjects report satisfaction. Analysis of treatments parameters suggests an optimal treatment time and tissue temperature that should be achieved to maximize results.

  9. A survey on monopolar radiofrequency treatment.

    Science.gov (United States)

    Suh, Dong Hye; Hong, Eun Sun; Kim, Hyun Joo; Lee, Sang Jun; Kim, Hei Sung

    2017-09-01

    This questionnaire-based study was aimed to measure the level of appreciation, awareness of the special tips, and practice patterns of monopolar radiofrequency among Korean dermatologists practicing a specific monopolar radiofrequency device (Thermage® Inc., Hayward, CA). A total of 82 surveys were analyzed to show that the majority of participants (78.8%) were highly satisfied with the outcomes of monopolar radiofrequency treatment. All respondents were aware of the Eye Tip 0.25 cm 2 , and the majority knew the difference between the Face tip (blue) and the Total tip (orange). Most (86.3%) agreed to the statement that 900 shots were appropriate for facial tightening in those between the ages of 35 and 65 years. 66.2% of participants reported to have perform monopolar radiofrequency to extra-facial sites within the past year. As for the tips, the Total tip was most popular for all body sties and the Big tip was favored for the abdomen, thighs and buttock. We hope our data allow dermatologists to better utilize monopolar radiofrequency. © 2017 Wiley Periodicals, Inc.

  10. Percutaneous transbiliary biopsy.

    Science.gov (United States)

    Andrade, Gustavo Vieira; Santos, Miguel Arcanjo; Meira, Marconi Roberto; Meira, Mateus Duarte

    2017-01-01

    Percutaneous drainage of the bile ducts is an established procedure for malignant obstructions, in which a histological diagnosis is often not obtained. We describe the biopsy technique of obstructive lesions through biliary drainage access, using a 7F endoscopic biopsy forceps, widely available; some are even reusable. This technique applies to lesions of the hepatic ducts, of the common hepatic duct and of all extension of the common bile duct. RESUMO A drenagem percutânea das vias biliares é um procedimento estabelecido para obstruções malignas, nos quais, muitas vezes, não se consegue um diagnóstico histológico. Descrevemos a técnica de biópsia da lesão obstrutiva através do acesso de drenagem biliar, utilizando um fórcipe de biópsia endoscópica 7F, amplamente disponível e alguns reutilizáveis. Esta técnica aplica-se a lesões dos ductos hepáticos, do hepático comum e de toda extensão do colédoco.

  11. Radiofrequency ablation of lung tumours. New perspective in treatment of lung neoplasms

    International Nuclear Information System (INIS)

    Kocijancic, K.; Kocijancic, I.

    2007-01-01

    Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique used to treat solid tumours. Because of its ability to produce large volume of coagulation necrosis in controlled fashion this technique has been progressively tested as a possible treatment of lung malignancies. Recent clinical studies have shown that RFA enables successful treatment of relatively small lung malignancies with high rate of complete response and acceptable morbidity and have suggested that the technique could represent a viable alternate or complementary method for patients with non-small cell lung cancer or lung metastases of favourable histotypes who are not candidates for surgical resection. Initial international studies as well as the clinical experience of Institute of Radiology in Clinical Center Ljubljana, although limited, indicated that RFA is mostly well tolerated by patients and also, that it can result in complete necrosis of targeted lesion. Pneumothorax is most common procedure related complication, occurring in up to 40% of cases, with approx. half of them requiring drainage. (author)

  12. Mechanisms for enlarging lesion size during irrigated tip radiofrequency ablation

    DEFF Research Database (Denmark)

    Petersen, Helen Høgh; Roman-Gonzalez, Javier; Johnson, Susan B

    2004-01-01

    INTRODUCTION: Irrigated tip radiofrequency ablation of cardiac arrhythmias was developed to increase the size of the radiofrequency-induced lesion, since cooling of the electrode tip allows use of higher power settings. The purpose of this study was to determine if the increased lesion size during......(3) (P radiofrequency irrigated-tip ablation is that higher power levels can be used...

  13. 47 CFR 1.1310 - Radiofrequency radiation exposure limits.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Radiofrequency radiation exposure limits. 1... Procedures Implementing the National Environmental Policy Act of 1969 § 1.1310 Radiofrequency radiation... exposure to radiofrequency (RF) radiation as specified in § 1.1307(b), except in the case of portable...

  14. 78 FR 33633 - Human Exposure to Radiofrequency Electromagnetic Fields

    Science.gov (United States)

    2013-06-04

    ..., and 15, et al. Human Exposure to Radiofrequency Electromagnetic Fields; Reassessment of Exposure to Radiofrequency Electromagnetic Fields Limits and Policies; Final Rule and Proposed Rule #0;#0;Federal Register... Radiofrequency Electromagnetic Fields AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY...

  15. Radiofrequency ablation of liver metastases; Radiofrequenzablation von Lebermetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, P.L.; Clasen, S.; Schmidt, D.; Wiskirchen, J.; Tepe, G.; Claussen, C.D. [Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Boss, A. [Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Sektion fuer Experimentelle Radiologie der Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Gouttefangeas, C. [Abt. Immunologie des Inst. fuer Zellbiologie, Eberhard-Karls-Univ. Tuebingen (Germany); Burkart, C. [Zentrum fuer gastroenterologische Onkologie der Medizinischen Klinik, Eberhard-Karls-Univ. Tuebingen (Germany)

    2004-04-01

    The liver is the second only to lymph nodes as the most common site of metastatic disease irrespective of the primary tumor. Up to 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improvement of the survival time, only approximately 20% of the patients are eligible for surgical intervention. Radiofrequency (RF) ablation represents one of the most important alternatives as well as complementary methods for the therapy of liver metastases. RF ablation can lead in a selected patient group to a palliation or to an increased life expectancy. RF ablation appears either safer (vs. cryotherapy) or easier (vs. laser) or more effective (percutaneous ethanol instillation [PEI]), transarterial chemoembolisation [TACE] in comparison with other minimal invasive procedures. RF ablation can be performed percutaneously, laparoscopically or intraoperatively and may be combined with chemotherapy as well as with surgical resection. Permanent technical improvements of RF systems, a better understanding of the underlying electrophysiological principles and an interdisciplinary approach will lead to a prognosis improvement in patients with liver metastases. (orig.) [German] Die Leber ist unabhaengig vom Primaertumor nach den Lymphknoten die zweithaeufigste Lokalisation von Metastasen. Bis zu 50% aller Patienten mit malignen Erkrankungen werden im Verlauf ihrer Erkrankung Lebermetastasen entwickeln, die mit einer signifikanten Morbiditaet und Mortalitaet verbunden sind. Obwohl die chirurgische Resektion zu einer verlaengerten Ueberlebenszeit fuehrt, sind nur ca. 20% der Patienten fuer einen chirurgischen Eingriff geeignet. Die Radiofrequenz-(RF-)Ablation stellt derzeit eine der effektivsten Alternativen und komplementaeren Methoden bei der Therapie von Lebermetastasen dar. In einem selektierten Patientengut fuehrt die RF-Ablation ueber den palliativen Einsatz hinaus zu einer

  16. Longitudinal outcomes of radiofrequency ablation versus surveillance endoscopy for Barrett's esophagus with low-grade dysplasia.

    Science.gov (United States)

    Kahn, A; Al-Qaisi, M; Kommineni, V T; Callaway, J K; Boroff, E S; Burdick, G E; Lam-Himlin, D M; Temkit, M; Vela, M F; Ramirez, F C

    2017-09-27

    Radiofrequency ablation of Barrett's esophagus with low-grade dysplasia is recommended in recent American College of Gastroenterology guidelines, with endoscopic surveillance considered a reasonable alternative. Few studies have directly compared outcomes of radiofrequency ablation to surveillance and those that have are limited by short duration of follow-up. This study aims to compare the long-term effectiveness of radiofrequency ablation versus endoscopic surveillance in a large, longitudinal cohort of patients with Barrett's esophagus, and low-grade dysplasia.We conducted a retrospective analysis of patients with confirmed low-grade dysplasia at a single academic medical center from 1991 to 2014. Patients progressing to high-grade dysplasia or esophageal adenocarcinoma within one year of index LGD endoscopy were defined as missed dysplasia and excluded. Risk factors for progression were assessed via Cox proportional hazards model. Comparison of progression risk was conducted using a Kaplan-Meier analysis. Subset analyses were conducted to examine the effect of reintroducing early progressors and excluding patients diagnosed prior to the advent of ablative therapy. Of 173 total patients, 79 (45.7%) underwent radiofrequency ablation while 94 (54.3%) were untreated, with median follow up of 90 months. Seven (8.9%) patients progressed to high-grade dysplasia or adenocarcinoma despite ablation, compared with 14 (14.9%) undergoing surveillance (P = 0.44). This effect was preserved when patients diagnosed prior to the introduction of radiofrequency ablation were excluded (8.9% vs 13%, P = 0.68). Reintroduction of patients progressing within the first year of follow-up resulted in a trend toward significance for ablation versus surveillance (11.1% vs 23.8%, P = 0.053).In conclusion, progression to high-grade dysplasia or adenocarcinoma was not significantly reduced in the radiofrequency ablation cohort when compared to surveillance. Despite recent studies

  17. Radio-frequency integrated-circuit engineering

    CERN Document Server

    Nguyen, Cam

    2015-01-01

    Radio-Frequency Integrated-Circuit Engineering addresses the theory, analysis and design of passive and active RFIC's using Si-based CMOS and Bi-CMOS technologies, and other non-silicon based technologies. The materials covered are self-contained and presented in such detail that allows readers with only undergraduate electrical engineering knowledge in EM, RF, and circuits to understand and design RFICs. Organized into sixteen chapters, blending analog and microwave engineering, Radio-Frequency Integrated-Circuit Engineering emphasizes the microwave engineering approach for RFICs. Provide

  18. Ultra-mini-percutaneous nephrolithotomy: A minimally-invasive option for percutaneous stone removal

    Directory of Open Access Journals (Sweden)

    Madhu Sudan Agrawal

    2016-01-01

    Full Text Available Introduction: Percutaneous nephrolithotomy (PCNL has witnessed rapid advancements, the latest being ultra-mini-percutaneous nephrolithotomy (UMP, which makes the use of 11-13F sheaths as compared to 24-30F sizes used in conventional PCNL. This miniaturization aims to reduce morbidity and improve patient outcomes. We evaluated the safety and efficacy of UMP and report our ourtcomes. Patients and Methods: A total of 120 patients underwent UMP from July 2012 to March 2014. These patients had a single unilateral renal stone measuring between 8 and 20 mm. All patients underwent UMP using a 3F nephroscope, 7.5F inner sheath, and 11F or 13F outer metallic cannula, which served as the Amplatz sheath. Stone fragmentation and clearance were achieved with holmium laser. No nephrostomy or stent was used routinely. Results: Complete stone fragmentation was achieved in 114 out of 120 patients (95% using UMP; whereas the remaining 6 were converted into mini-PCNL using a 12.5F nephroscope and 15F Amplatz sheath. The mean operative time was 39.7 ± 15.4 min, and the mean postoperative hospital stay was 22.3 ± 2.2 h. Postoperatively, 6 (5% patients had residual fragments measuring ≤4 mm. At the 2 weeks follow-up, the stone-free status was >99% (119/120. There were no significant postoperative complications. Conclusion: This study shows UMP to be an effective and safe procedure for managing stones up to 20 mm. This procedure offers an attractive alternative to shock wave lithotripsy and retrograde intrarenal surgery for managing small stones.

  19. Innervation of the Anterior Capsule of the Human Knee: Implications for Radiofrequency Ablation.

    Science.gov (United States)

    Franco, Carlo D; Buvanendran, Asokumar; Petersohn, Jeffrey D; Menzies, Robert D; Menzies, Linda Pham

    2015-01-01

    Chronic knee pain is common in all age groups. Some patients who fail conservative therapy benefit from radiofrequency neurotomy. Knowledge of the anatomy is critical to ensure a successful outcome. The purpose of this study was to reanalyze the innervation to the anterior knee capsule from the perspective of the interventional pain practitioner. The study included a comprehensive literature review followed by dissection of 8 human knees to identify the primary capsular innervation of the anterior knee joint. Photographs and measurements were obtained for each relevant nerve branch. Stainless-steel wires were placed along the course of each primary innervation, and radiographs were obtained. Literature review revealed a lack of consensus on the number and origin of nerve branches innervating the anterior knee capsule. All dissections revealed the following 6 nerves: superolateral branch from the vastus lateralis, superomedial branch from the vastus medialis, middle branch from the vastus intermedius, inferolateral (recurrent) branch from the common peroneal nerve, inferomedial branch from the saphenous nerve, and a lateral articular nerve branch from the common peroneal nerve. Nerve branches showed variable proximal trajectories but constant distal points of contact with femur and tibia. The inferolateral peroneal nerve branch was found to be too close to the common peroneal nerve, making it inappropriate for radiofrequency neurotomy. The innervation of the anterior capsule of the knee joint seems to follow a constant pattern making at least 3 of these nerves accessible to percutaneous ablation. To optimize clinical outcome, well-aligned radiographs are critical to guide lesion placement.

  20. The radiofrequency frontier: a review of radiofrequency and combined radiofrequency pulsed-light technology in aesthetic medicine.

    Science.gov (United States)

    Sadick, Neil; Sorhaindo, Lian

    2005-05-01

    Radiofrequency (RF) and combined RF light source technologies have established themselves as safe and effective treatment modalities for several dermatologic procedures, including skin tightening, hair and leg vein removal, acne scarring, skin rejuvenation, and wrinkle reduction. This article reviews the technology, clinical applications, and recent advances of RF and combined RF light/laser source technologies in aesthetic medicine.

  1. Biliary peritonitis due to gall bladder perforation after percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Nikhil Ranjan

    2015-01-01

    Full Text Available A 19-year-old male patient underwent right percutaneous nephrolithotomy (PNL for right renal 1.5 × 1.5 cm lower pole stone. The procedure was completed uneventfully with complete stone clearance. The patient developed peritonitis and shock 48 h after the procedure. Exploratory laparotomy revealed a large amount of bile in the abdomen along with three small perforations in the gall bladder (GB and one perforation in the caudate lobe of the liver. Retrograde cholecystectomy was performed but the patient did not recover and expired post-operatively. This case exemplifies the high mortality of GB perforation after PNL and the lack of early clinical signs.

  2. Percutaneous fusion of lumbar facet with bone allograft

    Directory of Open Access Journals (Sweden)

    Félix Dolorit Verdecia

    2015-03-01

    Full Text Available OBJECTIVE: To assess the evolution of the cases treated with percutaneous facet fusion with bone allograft in lumbar facet disease. METHOD: Between 2010 and 2014, 100 patients (59 women and 41 men diagnosed with lumbar facet disease underwent surgery. RESULTS: The lumbar facet fusion with bone allograft shows good clinical results, is performed on an outpatient basis, and presents minimal complications and rapid incorporation of the patient to the activities of daily living. CONCLUSIONS: The lumbar facet fusion with bone allograft appears to be an effective treatment for lumbar facet disease.

  3. Percutaneous left atrial appendage closure for stroke prevention

    DEFF Research Database (Denmark)

    De Backer, Ole; Loupis, Anastasia M; Ihlemann, Nikolaj

    2014-01-01

    as an alternative option for stroke prevention in AF patients with contraindication(s) for OAC treatment. MATERIAL AND METHODS: A total of 42 patients underwent percutaneous LAA closure. In this report, we describe our experience with this procedure. RESULTS: The patients treated were AF patients with a high stroke...... and bleeding risk. However, long-term follow-up studies are needed before this procedure can be recommended for routine clinical use. FUNDING: Grant funding was received (St Jude Medical) for research, but there are no other competing interests. TRIAL REGISTRATION: Not relevant....

  4. CT guided percutaneous biopsy of the cervical spine

    International Nuclear Information System (INIS)

    Yuan Huishu; Li Xuan; Liang Kunru

    1997-01-01

    To evaluate the effects of CT guided biopsy of cervical spine in clinical treatment, and discuss the technique involved, ten patients underwent percutaneous biopsy of cervical lesions under CT guidance. Anterior approach with the patient sitting and the needle passing through the mouth was done in one case; latero posterior approach with patient in lateral decubitus position in 5 cases; and lateral approach with 3 patients supine and 1 in lateral decubitus. Nine of ten patients had definitive histological diagnosis, the accuracy of biopsy was 90%, no complications were found. CT guided biopsy of cervical spine is safe and effective, with rare complications, providing important information for clinical treatment

  5. Effects of heating with radiofrequency power on myocardial impulse conduction: is radiofrequency ablation exclusively thermally mediated?

    NARCIS (Netherlands)

    Simmers, T. A.; de Bakker, J. M.; Wittkampf, F. H.; Hauer, R. N.

    1996-01-01

    Although it is generally accepted that radiofrequency (RF) ablation causes exclusively thermally mediated effects, it has never been proved. In a previous report, temperatures required to induce conduction block in superfused canine epicardial ventricular myocardium were identified by exposure to

  6. Predictors of Luminal Loss in Pulmonary Veins After Radiofrequency Ablation.

    Science.gov (United States)

    Martín-Garre, Susana; Pérez-Castellano, Nicasio; Quintanilla, Jorge G; Ferreiros, Joaquín; Pérez-Villacastín, Julián

    2015-12-01

    The reported incidences of stenosis after radiofrequency ablation of pulmonary veins are highly variable. Moreover, most studies have focused on severe stenosis and have overlooked mild stenosis. Our aims were to study postablation morphological changes in the pulmonary veins and to evaluate preablation magnetic resonance imaging predictors for stenosis. Eighty consecutive patients with atrial fibrillation underwent cardiac magnetic resonance imaging before undergoing radiofrequency ablation. Magnetic resonance imaging was repeated a median of 95 days after ablation. Ostium area/ellipticity and atrial volume were blindly assessed. We evaluated the presence of stenosis and classified it as mild ( 70%). Postablation stenosis was identified in 78 of 322 veins (24.2%). The stenosis was mild in 66 (84.6%), moderate in 11 (14.1%), and severe in 1 (1.3%). All of them were asymptomatic. The left inferior pulmonary vein showed the highest frequency of stenosis, which was detected in 26% of them (P < .001). A multiple regression analysis revealed that left inferior pulmonary vein (odds ratio = 3.089; P = .02) and a greater preablation ostium area (odds ratio = 1.009; P < .001) were independent predictors for postablation stenosis. Age (odds ratio = 1.033) showed a strong trend to statistical significance (P = .06). After ablation, vein ostia size is reduced and stenosis is detected in less than one third of patients. Most cases are mild, and severe stenosis is rare. Postablation stenosis is more likely to develop in older patients, those with larger vein ostia, and in the left inferior pulmonary veins. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Direct Percutaneous Jejunostomy-An Underutilized Interventional Technique?

    International Nuclear Information System (INIS)

    Sparrow, Patrick; David, Elizabeth; Pugash, Robyn

    2008-01-01

    Our aim in this study was to report our single-center experience with direct percutaneous jejunostomy over a 4-year period with regard to technical success rate, immediate and late complications, and patient tolerance of the procedure. Institutional records of 22 consecutive patients who underwent radiological insertion of a percutaneous jejunostomy for a variety of indications were reviewed. The proximal jejunum was punctured under either fluoroscopic or ultrasonic guidance, and following placement of retention sutures, a 10- to 12-Fr catheter inserted. There was a 100% technical success rate in placement involving a total of seven operators. The indications for placement were prior gastric resection, newly diagnosed resectable esophageal or gastric carcinoma, unresectable gastric carcinoma with outlet obstruction, and palliative drainage of bowel obstruction. Mean duration of follow-up was 100 days, and catheter placement 57.7 days. There were six minor early complications, consisting of loss of two retention anchors requiring repuncture, three cases of localized excessive postprocedural pain, and one failed relief of symptoms of small bowel obstruction. Four tubes developed late complications (two blocked, one catheter cracked, and one inadvertently pulled out). Three of the four were successfully replaced through the existing tracts. One patient subsequently developed a minor skin infection, while another developed late pericatheter leakage from ascites. We conclude that direct percutaneous jejunostomy is a valuable treatment modality applicable to a number of clinical scenarios, with a high technical success rate and low serious complication rate

  8. Endoscopic colostomy with percutaneous colopexy: an animal feasibility study

    Directory of Open Access Journals (Sweden)

    Leonardo Alfonso Bustamante-López

    Full Text Available Background: Indications for colostomy in colorectal diseases are obstruction of the large bowel, such as in cancer, diverticular disease in the acute phase, post-radiotherapy enteritis, complex perirectal fistulas, anorectal trauma and severe anal incontinence. Some critically ill patients cannot tolerate an exploratory laparotomy, and laparoscopic assisted colostomy also requires general anesthesia. Objective: To evaluate the feasibility, safety and efficacy of performing colostomy assisted by colonoscopy and percutaneous colopexy. Materials and methods: Five pigs underwent endoscopic assisted colostomy with percutaneous colopexy. Animals were evaluated in post-operative days 1, 2, 5 and 7 for feeding acceptance and colostomy characteristics. On day 7 full colonoscopy was performed on animals followed by exploratory laparotomy. Results: Average procedure time was 27 minutes (21-54 min. Postoperative mobility and feeding of animals were immediate after anesthesia recovery. Position of the colostomy, edges color, appearance of periostomal area, as well as its function was satisfactory in four animals. Retraction of colostomy was present in one pig. The colonoscopy and laparotomy control on the seventh day were considered as normal. A bladder perforation that was successfully repaired through the colostomy incision occurred in one pig. The main limitation of this study is its experimental nature. Conclusion: Endoscopic assisted colostomy with percutaneous colopexy proves to be a safe and effective method with low morbidity for performing colostomy in experimental animals, with possible clinical application in humans.

  9. Human Thrombin Injection for the Percutaneous Treatment of Iatrogenic Pseudoaneurysms

    International Nuclear Information System (INIS)

    Elford, Julian; Burrell, Christopher; Freeman, Simon; Roobottom, Carl

    2002-01-01

    Purpose: Thrombin injection is becoming well established for the percutaneous management of iatrogenic pseudoaneurysms. All the published series to date use bovine thrombin,and there have been reports of adverse immunologic effects following its use. Our study aimed to assess the efficacy of human thrombin injection for pseudoaneurysm occlusion. Methods:Fourteen patients with iatrogenic pseudoaneurysms underwent a color Doppler ultrasound examination to assess their suitability for percutaneous human thrombin injection. Human thrombin 1000 IU was then injected into the pseudoaneurysm sac under sterile conditions and with ultrasound guidance. A further color Doppler ultrasound examination was performed 24 hr later to confirm occlusion. Results: All 14 pseudoaneurysms were successfully occluded by human thrombin injection. In two cases a second injection of thrombin was required,but there were no other complications, and all pseudoaneurysms remained occluded at 24 hr. Conclusion: Ultrasound-guided human thrombin injection is simple to perform, effective and safe. We recommend that human thrombin becomes the agent of choice for percutaneous injection into iatrogenic pseudoaneurysms

  10. Ultrasound-guided percutaneous core needle biopsy of splenic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Park, SangIk; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo Nyun; Lee, Moon Gyu [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-05-15

    To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy of splenic lesions. This retrospective study included 30 patients who underwent percutaneous core needle biopsy of their splenic lesions using 18- or 20-gauge needles between January 2001 and July 2016 in a single tertiary care center. The characteristics of the splenic lesions were determined by reviewing the ultrasound and computed tomography examinations. Acquisition rate and diagnostic accuracy were calculated, using pathologic results of the splenectomy specimen, clinical course and/or imaging follow-up as a reference standard. Post-procedure complications were identified from electronic medical records, laboratory findings and computed tomography images. Seventy-three specimens were obtained from the 30 patients and splenectomy was performed in 2 patients. Twenty-nine of the 30 patients had focal splenic lesions, while the remaining patient had homogeneous splenomegaly. Acquisition rate and diagnostic accuracy were 80.0% (24/30) and 76.7% (23/30), respectively. Perisplenic hemorrhage without hemodynamic instability developed in one patient. Ultrasound-guided percutaneous core needle biopsy of splenic lesions is a safe method for achieving a histopathologic diagnosis and can be considered as an alternative to splenectomy in patients with a high risk of splenectomy-related complications.

  11. Ultrasound-guided percutaneous core needle biopsy of splenic lesions

    International Nuclear Information System (INIS)

    Park, SangIk; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo Nyun; Lee, Moon Gyu

    2017-01-01

    To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy of splenic lesions. This retrospective study included 30 patients who underwent percutaneous core needle biopsy of their splenic lesions using 18- or 20-gauge needles between January 2001 and July 2016 in a single tertiary care center. The characteristics of the splenic lesions were determined by reviewing the ultrasound and computed tomography examinations. Acquisition rate and diagnostic accuracy were calculated, using pathologic results of the splenectomy specimen, clinical course and/or imaging follow-up as a reference standard. Post-procedure complications were identified from electronic medical records, laboratory findings and computed tomography images. Seventy-three specimens were obtained from the 30 patients and splenectomy was performed in 2 patients. Twenty-nine of the 30 patients had focal splenic lesions, while the remaining patient had homogeneous splenomegaly. Acquisition rate and diagnostic accuracy were 80.0% (24/30) and 76.7% (23/30), respectively. Perisplenic hemorrhage without hemodynamic instability developed in one patient. Ultrasound-guided percutaneous core needle biopsy of splenic lesions is a safe method for achieving a histopathologic diagnosis and can be considered as an alternative to splenectomy in patients with a high risk of splenectomy-related complications

  12. Percutaneous Retrieval of Permanent Inferior Vena Cava Filters

    Energy Technology Data Exchange (ETDEWEB)

    Tamrazi, Anobel, E-mail: atamraz1@jhmi.edu; Wadhwa, Vibhor, E-mail: vwadhwa1@jhmi.edu; Holly, Brian, E-mail: bholly3@jhmi.edu [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States); Bhagat, Nikhil, E-mail: nikhibhagat@gmail.com [Kaiser Permanente, Division of Vascular & Interventional Radiology (United States); Marx, Jonathan K., E-mail: jmarx9@jhmi.edu [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States); Streiff, Michael, E-mail: mstreif@jhmi.edu [Johns Hopkins University School of Medicine, Department of Hematology (United States); Lessne, Mark L., E-mail: mlessne@gmail.com [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States)

    2016-04-15

    PurposeTo evaluate the feasibility, risks, and techniques of percutaneous removal of permanent TrapEase and Simon Nitinol IVC filters.Materials and MethodsBetween August 2011 and August 2015, 12 patients (5 women, 7 men; age range, 26–75 years) underwent an attempt at percutaneous removal of permanent TrapEase (10) and Simon Nitinol (2) IVC filters due to a history of IVC filter complications or need for lifelong anticoagulation due to the filter. Medical records were reviewed for filter dwell time, presence of iliocaval deep venous thrombosis, procedural technique, and complications.ResultsFilter dwell times ranged from 7 days to 15 years (mean 5.1 years). Successful removal of permanent IVC filters was possible in 11 of 12 patients (91.6 %). In 1 patient, a chronically thrombosed IVC filter could not be removed despite laser sheath assistance, but was successfully recanalized with the PowerWire RF guidewire. In the failed retrieval attempt, a stent was placed through the chronically thrombosed IVC filter with restoration of in-line flow. One major complication of large venous groin hematoma was encountered.ConclusionsIn carefully selected patients, percutaneous removal of permanent IVC filters can be performed safely despite prolonged filter dwell times. Extraction of chronically embedded permanent IVC filters may be facilitated by jugular and femoral approaches, often with laser sheath assistance. Chronic filter thrombosis and caval scarring may increase the risk of retrieval failure.

  13. Management of trigeminal neuralgia by radiofrequency ...

    African Journals Online (AJOL)

    The outcome depends on the type of TN with best results with classical idiopathic type. Also better results occurred with isolated V3 affection. The radiofrequency thermocoagulation of trigeminal nerve is a low risk, highly effective and minimally invasive procedure that should be started with in all cases of TN.

  14. Modes of oscillation in radiofrequency Paul traps

    DEFF Research Database (Denmark)

    Landa, H.; Reznik, B.; Drewsen, M.

    2012-01-01

    We examine the time-dependent dynamics of ion crystals in radiofrequency traps. The problem of stable trapping of general threedimensional crystals is considered and the validity of the pseudopotential approximation is discussed. We analytically derive the micromotion amplitude of the ions...

  15. Radiofrequency and microwave interactions between biomolecular systems

    Czech Academy of Sciences Publication Activity Database

    Kučera, Ondřej; Cifra, Michal

    2016-01-01

    Roč. 42, č. 1 (2016), s. 1-8 ISSN 0092-0606 R&D Projects: GA ČR(CZ) GA15-17102S Institutional support: RVO:67985882 Keywords : Cell signaling * Radiofrequency * Bioelectrodynamics Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering Impact factor: 1.241, year: 2016

  16. Potential health risks due to telecommunications radiofrequency ...

    African Journals Online (AJOL)

    Background: The global system mobile telecommunications system (GSM) which was recently introduced in Nigeria is now being used by over 40 million people in Nigeria. The use of GSM is accompanied with exposure of the users to radiofrequency radiation (RFR), which if significant, may produce health hazards. This is ...

  17. Assessment of Radiofrequency Power Density Distribution around ...

    African Journals Online (AJOL)

    Background: Global system of mobile communication (GSM) and other telecommunication technologies are now common place in Lagos state Nigeria. The introduction of GSM in 2002 considerably increased radiofrequency (RF) radiation exposure of the public from telecommunications transmitting and receiving antennae ...

  18. Percutaneous nephrolithotomy and its legacy

    NARCIS (Netherlands)

    Skolarikos, A.; Alivizatos, G.; de la Rosette, J. J. M. C. H.

    2005-01-01

    Objective: We review the indications of Percutaneous Nephrolithotomy (PNL), its safety and efficacy when applied to various patient groups as well as the different points of technique, giving emphasis on new tips and ongoing debates. Methods: A literature search was performed using MEDLINE database

  19. Robotics in percutaneous cardiovascular interventions.

    Science.gov (United States)

    Pourdjabbar, Ali; Ang, Lawrence; Behnamfar, Omid; Patel, Mitul P; Reeves, Ryan R; Campbell, Paul T; Madder, Ryan D; Mahmud, Ehtisham

    2017-11-01

    The fundamental technique of performing percutaneous cardiovascular (CV) interventions has remained unchanged and requires operators to wear heavy lead aprons to minimize exposure to ionizing radiation. Robotic technology is now being utilized in interventional cardiology partially as a direct result of the increasing appreciation of the long-term occupational hazards of the field. This review was undertaken to report the clinical outcomes of percutaneous robotic coronary and peripheral vascular interventions. Areas covered: A systematic literature review of percutaneous robotic CV interventions was undertaken. The safety and feasibility of percutaneous robotically-assisted CV interventions has been validated in simple to complex coronary disease, and iliofemoral disease. Studies have shown that robotically-assisted PCI significantly reduces operator exposure to harmful ionizing radiation without compromising procedural success or clinical efficacy. In addition to the operator benefits, robotically-assisted intervention has the potential for patient advantages by allowing more accurate lesion length measurement, precise stent placement and lower patient radiation exposure. However, further investigation is required to fully elucidate these potential benefits. Expert commentary: Incremental improvement in robotic technology and telecommunications would enable treatment of an even broader patient population, and potentially provide remote robotic PCI.

  20. An update on percutaneous nephrolithotomy

    DEFF Research Database (Denmark)

    Tefekli, A; Cordeiro, E; de la Rosette, J J M C H

    2013-01-01

    Since its introduction in late 1970's, percutaneous nephrolithotomy (PNL) has undergone an evolution in both equipment and technique. This evolution still continues today in the era of minimally invasive treatment options, and is evidenced by the numerous publications. PNL is generally advantageo...

  1. Percutaneous Dilational Tracheotomy in Solid-Organ Transplant Recipients.

    Science.gov (United States)

    Ozdemirkan, Aycan; Ersoy, Zeynep; Zeyneloglu, Pinar; Gedik, Ender; Pirat, Arash; Haberal, Mehmet

    2015-11-01

    Solid-organ transplant recipients may require percutaneous dilational tracheotomy because of prolonged mechanical ventilation or airway issues, but data regarding its safety and effectiveness in solid-organ transplant recipients are scarce. Here, we evaluated the safety, effectiveness, and benefits in terms of lung mechanics, complications, and patient comfort of percutaneous dilational tracheotomy in solid-organ transplant recipients. Medical records from 31 solid-organ transplant recipients (median age of 41.0 years [interquartile range, 18.0-53.0 y]) who underwent percutaneous dilational tracheotomy at our hospital between January 2010 and March 2015 were analyzed, including primary diagnosis, comorbidities, duration of orotracheal intubation and mechanical ventilation, length of intensive care unit and hospital stays, the time interval between transplant to percutaneous dilational tracheotomy, Acute Physiology and Chronic Health Evaluation II score, tracheotomy-related complications, and pulmonary compliance and ratio of partial pressure of arterial oxygen to fraction of inspired oxygen. The median Acute Physiology and Chronic Health Evaluation II score on admission was 24.0 (interquartile range, 18.0-29.0). The median interval from transplant to percutaneous dilational tracheotomy was 105.5 days (interquartile range, 13.0-2165.0 d). The only major complication noted was left-sided pneumothorax in 1 patient. There were no significant differences in ratio of partial pressure of arterial oxygen to fraction of inspired oxygen before and after procedure (170.0 [interquartile range, 102.2-302.0] vs 210.0 [interquartile range, 178.5-345.5]; P = .052). However, pulmonary compliance results preprocedure and postprocedure were significantly different (0.020 L/cm H2O [interquartile range, 0.015-0.030 L/cm H2O] vs 0.030 L/cm H2O [interquartile range, 0.020-0.041 L/cm H2O); P = .001]). Need for sedation significantly decreased after tracheotomy (from 17 patients [54.8%] to

  2. Interactions between radiofrequency signals and living organisms

    International Nuclear Information System (INIS)

    Boudin, F.; Hours, M.; Lacronique, J.F.; Conil, E.; Hadjem, A.; El Habachi, A.; Wiart, K.; Mann, S.; Kundi, M.; Marc-Vergnes, J.P.; Roosli, M.; Mohler, E.; Frei, P.; Davis, Ch.C.; Balzano, Q.; Ait-Aissa, S.; Billaudel, B.; Poulletier De Gannes, F.; Hurtier, A.; Haro, E.; Taxile, M.; Veyret, B.; Lagroye, I.; Ait-Aissa, S.; Poulletier De Gannes, F.; Athane, A.; Veyret, B.; Lagroye, I.; Yardin, C.; Perrin, A.; Freire, M.; Bachelet, Ch.; Collin, A.; Pla, S.; Debouzy, J.C.; Leveque, Ph.; Van Nierop, L.E.; Huss, A.; Roosli, M.; Egger, M.; Calvez, M.; Salomon, D.

    2010-01-01

    This dossier is composed of 13 articles dealing with the interactions between radio-frequencies and living organisms. It is an overview of various scientific approaches to the field and is of interest for all citizens as the use of mobile phones is widely spread. In the first article it is shown how a model has been built to assess the distribution of the whole body exposure of the population. The second article reviews the state of the art in personal exposure measurements at radio-frequencies. The third article shows that the knowledge of the mechanism of action by which exposure increases the risk of health hazards is necessary. The fourth article shows that individual neuro-psychic factors take a prominent but maybe not unique, part in electromagnetic hypersensitivity. The fifth article shows that no evidence was found to link health disturbances of electromagnetic hypersensitive individuals with radiofrequency exposure. The sixth article shows that the wireless phone is not an athermal hazard to the brain. The seventh article shows that the in utero and post-natal exposure to Wi-Fi does not damage the brains of young rats. The eighth article concludes that recent studies provide no convincing proof of deleterious effects of radiofrequency exposure on the integrity of the blood-brain barrier for specific absorption rates up to 6 W/kg. The ninth article shows that no co-genotoxic effect of radiofrequency was found at levels of exposure that did not induce heating. The tenth article confirms that industry-sponsored studies were least likely to report results suggesting effects. The last article shows that general practitioners are increasingly questioned by their patients about the issue of electromagnetic waves. (A.C.)

  3. The role of the accessory pathway radiofrequency catheter ablation in the secondary prevention of the malignant tachyarrhythmias in patients with Wolff-Parkinson-White syndrome

    Directory of Open Access Journals (Sweden)

    Mujović Nebojša

    2010-01-01

    Full Text Available Background/Aim. The occurrence of atrial fibrillation (AF in the presence of an accessory pathway (AP that conducts rapidly is potentially lethal because the rapid ventricular response may lead to ventricular fibrillation (VF. The aim of the study was to determine long-term efficacy of AP catheter-ablation using radiofrequency (RF current in secondary prevention of VF in WPW patients. Methods. Study included a total of 192 symptomatic WPW patients who underwent RF catheter-ablation of AP in our institution from 1994 to 2007 and were available for clinical follow-up for more than 3 months after procedure. Results. Before ablation, VF was recorded in total of 27 patients (14.1%. In 14 of patients (51.9% VF was the first clinical manifestation of WPW syndrome. A total of 35 VF episodes were identified in 27 patients. The occurrence of VF was preceded by physical activity or emotional stress in 17.1% of cases, by alcohol abuse in 2.9% and by inappropriate intravenous drug administration in 28.6%. In addition, no clear precipitating factor was identified in 40% of VF cases, while informations about activities preceding 11.4% of VF episodes were not available. The follow-up of 5.7 ± 3.3 years was obtained in all of 27 VF patients. Of the 20 patients who underwent successful AP ablation, all were alive, without syncope or ventricular tachyarrhythmias during long-term follow-up. In 4 of 7 unsuccessfully treated patients, recurrence of supraventricular tachycardia and/or preexcited atrial fibrillation were recorded; one of these patients suddenly died of VF, 6 years after procedure. Conclusion. In significant proportion of WPW patients, VF was the first clinical manifestation of WPW syndrome, often precipitated by physical activity, emotional stress or inappropriate drug administration. Successful elimination of AP by percutaneous RF catheter-ablation is highly effective in secondary prevention of life-threatening tachyarrhythmias in patients with

  4. Unenhanced magnetic resonance imaging immediately after radiofrequency ablation of liver malignancy: preliminary results.

    Science.gov (United States)

    D'Onofrio, Mirko; Cardobi, Nicolò; Ruzzenente, Andrea; Conci, Simone; Ciaravino, Valentina; Guglielmi, Alfredo; Mucelli, Roberto Pozzi

    2017-08-31

    To assess the accuracy of unenhanced magnetic resonance imaging (MRI) immediately after the percutaneous ultrasound-guided radiofrequency ablation (RFA) of liver malignancy in predicting treatment efficacy at CT follow-up. Percutaneous ablation was prospectively performed in 23 liver malignancies (20 hepatocarcinomas and 3 metastases). After the procedure in the same day all patients were studied with unenhanced MRI. The best sequence to detect the coagulative necrosis was visually established. Pre-RFA CT and post-RFA MRI were registered with non-rigid transformation algorithm. Manual segmentation of lesions and ablated areas in pre-RFA CT, post-RFA MRI, and follow-up CT were obtained. Sensitivity, specificity, positive predictive value (PPV), negative predicitve value (NPV), and accuracy of MRI in predicting the correct centering and the complete treatment of the lesion were calculated in respect to the 1-month follow-up CT. Fat-saturated T1-weighted (fs T1-w) was the sequence in which the best conspicuity of the ablated area was depicted. Coagulative necrosis was hyperintense in fs T1-w sequence in 17/23 (74%). In respect to follow-up CT, MRI predicted the correct centering of the lesions in 19/20 lesions with sensitivity, specificity, PPV, NPV, and accuracy of 100%, 75%, 95%, 100%, and 100%, respectively. MRI predicted the complete treatment of the lesions in 17/17 lesions with sensitivity, specificity, PPV, NPV, and accuracy of 100%. MRI with the single fs T1-w sequence was highly accurate in predicting the treatment efficacy of percutaneous ablation of liver malignancies in comparison to follow-up CT control. Unnecessary CT in case of incomplete treatment can be therefore easily avoided.

  5. Diagnosing pancreatic cancer: the role of percutaneous biopsy and CT

    International Nuclear Information System (INIS)

    Amin, Z.; Theis, B.; Russell, R.C.G.; House, C.; Novelli, M.; Lees, W.R.

    2006-01-01

    Aims: To determine the sensitivity and complications of percutaneous biopsy of pancreatic masses, and whether typical computed tomography (CT) features of adenocarcinoma can reliably predict this diagnosis. Materials and methods: A 5 year retrospective analysis of percutaneous core biopsies of pancreatic masses and their CT features was undertaken. Data were retrieved from surgical/pathology databases; medical records and CT reports and images. Results: Three hundred and three patients underwent 372 biopsies; 56 of 87 patients had repeat biopsies. Malignancy was diagnosed in 276 patients, with ductal adenocarcinoma in 259 (85%). Final sensitivity of percutaneous biopsy for diagnosing pancreatic neoplasms was 90%; for repeat biopsy it was 87%. Complications occurred in 17 (4.6%) patients, in three of whom the complications were major (1%): one abscess, one duodenal perforation, one large retroperitoneal bleed. CT features typical of ductal adenocarcinoma were: hypovascular pancreatic mass with bile and/or pancreatic duct dilatation. Atypical CT features were: isodense or hypervascular mass, calcification, non-dilated ducts, cystic change, and extensive lymphadenopathy. Defining typical CT features of adenocarcinoma as true-positives, CT had a sensitivity of 68%, specificity of 95%, positive predictive value (PPV) of 98%, and negative predictive value of 41% for diagnosing pancreatic adenocarcinoma. Conclusion: Final sensitivity of percutaneous biopsy for establishing the diagnosis was 90%. CT features typical of pancreatic adenocarcinoma had high specificity and PPV. On some occasions, especially in frail patients with co-morbidity, it might be reasonable to assume a diagnosis of pancreatic cancer if CT features are typical, and biopsy only if CT shows atypical features

  6. Diagnosing pancreatic cancer: the role of percutaneous biopsy and CT

    Energy Technology Data Exchange (ETDEWEB)

    Amin, Z.; Theis, B.; Russell, R.C.G.; House, C.; Novelli, M.; Lees, W.R

    2006-12-15

    Aims: To determine the sensitivity and complications of percutaneous biopsy of pancreatic masses, and whether typical computed tomography (CT) features of adenocarcinoma can reliably predict this diagnosis. Materials and methods: A 5 year retrospective analysis of percutaneous core biopsies of pancreatic masses and their CT features was undertaken. Data were retrieved from surgical/pathology databases; medical records and CT reports and images. Results: Three hundred and three patients underwent 372 biopsies; 56 of 87 patients had repeat biopsies. Malignancy was diagnosed in 276 patients, with ductal adenocarcinoma in 259 (85%). Final sensitivity of percutaneous biopsy for diagnosing pancreatic neoplasms was 90%; for repeat biopsy it was 87%. Complications occurred in 17 (4.6%) patients, in three of whom the complications were major (1%): one abscess, one duodenal perforation, one large retroperitoneal bleed. CT features typical of ductal adenocarcinoma were: hypovascular pancreatic mass with bile and/or pancreatic duct dilatation. Atypical CT features were: isodense or hypervascular mass, calcification, non-dilated ducts, cystic change, and extensive lymphadenopathy. Defining typical CT features of adenocarcinoma as true-positives, CT had a sensitivity of 68%, specificity of 95%, positive predictive value (PPV) of 98%, and negative predictive value of 41% for diagnosing pancreatic adenocarcinoma. Conclusion: Final sensitivity of percutaneous biopsy for establishing the diagnosis was 90%. CT features typical of pancreatic adenocarcinoma had high specificity and PPV. On some occasions, especially in frail patients with co-morbidity, it might be reasonable to assume a diagnosis of pancreatic cancer if CT features are typical, and biopsy only if CT shows atypical features.

  7. Bilateral CT-guided percutaneous cordotomy for cancer pain relief

    International Nuclear Information System (INIS)

    Yegul, I.; Erhan, E.

    2003-01-01

    AIM: CT-guided percutaneous cordotomy is a useful procedure for treating unilateral cancer pain, however, bilateral cordotomy can be required on some occasions. We evaluated the effectiveness and complications of bilateral cordotomy. MATERIALS AND METHODS: Two hundred and thirty-four patients who suffered from unilateral cancer pain underwent CT-guided percutaneous cordotomy. The procedure was repeated in 22 patients, and nine patients had bilateral cordotomy. Effectiveness and complications were recorded after each procedure. RESULTS: Of nine patents (three women and six men) having bilateral percutaneous cordotomy in our study, four patients had mirror pain after the first procedure. In the remaining five patients the contralateral pain was due to new pain sites. The pain scores before and after the first procedure were 9.3 (range 7-10) and 1.2 (range 0-3), respectively. After the first procedure complete or satisfactory pain relief was achieved in all patients. The duration between the two procedures ranged from 7-243 days (mean 59.8 days). The pain scores before and after the second procedure were 8.4 (range 5-10) and 1.6 (range 0-4), respectively. After the second procedure complete or satisfactory pain relief was reported in all patients. There were no complications in four patients. One patient developed transient motor deficit after the first procedure. Other complications (nausea/vomiting, headache, ipsilateral neck pain, postcordotomy dysesthesia) were mild and transient. CONCLUSION: CT-guided percutaneous cordotomy is a useful procedure for the treatment of severe unilateral cancer pain syndromes. The procedure can be repeated on the other side at least 1 week later. These results show that the success on the second side appears to be similar to the first side with low complication rate for both procedures

  8. Bilateral CT-guided percutaneous cordotomy for cancer pain relief

    Energy Technology Data Exchange (ETDEWEB)

    Yegul, I. E-mail: iyegul@med.ege.edu.tr; Erhan, E. E-mail: elvanerhan@yahoo.com

    2003-11-01

    AIM: CT-guided percutaneous cordotomy is a useful procedure for treating unilateral cancer pain, however, bilateral cordotomy can be required on some occasions. We evaluated the effectiveness and complications of bilateral cordotomy. MATERIALS AND METHODS: Two hundred and thirty-four patients who suffered from unilateral cancer pain underwent CT-guided percutaneous cordotomy. The procedure was repeated in 22 patients, and nine patients had bilateral cordotomy. Effectiveness and complications were recorded after each procedure. RESULTS: Of nine patents (three women and six men) having bilateral percutaneous cordotomy in our study, four patients had mirror pain after the first procedure. In the remaining five patients the contralateral pain was due to new pain sites. The pain scores before and after the first procedure were 9.3 (range 7-10) and 1.2 (range 0-3), respectively. After the first procedure complete or satisfactory pain relief was achieved in all patients. The duration between the two procedures ranged from 7-243 days (mean 59.8 days). The pain scores before and after the second procedure were 8.4 (range 5-10) and 1.6 (range 0-4), respectively. After the second procedure complete or satisfactory pain relief was reported in all patients. There were no complications in four patients. One patient developed transient motor deficit after the first procedure. Other complications (nausea/vomiting, headache, ipsilateral neck pain, postcordotomy dysesthesia) were mild and transient. CONCLUSION: CT-guided percutaneous cordotomy is a useful procedure for the treatment of severe unilateral cancer pain syndromes. The procedure can be repeated on the other side at least 1 week later. These results show that the success on the second side appears to be similar to the first side with low complication rate for both procedures.

  9. Comparison of Two Intravenous Sedation Techniques for Percutaneous Radiofrequency Trigeminal Rhizotomy: A Pilot Study

    OpenAIRE

    Speedie, Lynn J.; Tung, Thomas J.; Shane, Sylvan M.; Chase, Gary A.; Brake, Nancy; Epstein, Melvin H.

    1987-01-01

    Conscious sedation, as used in dentistry and oral surgery, has been used satisfactorily to manage patients undergoing the intense pain encountered in radio frequency trigeminal rhizotomy for tic douloureux. The pain produced by this procedure cannot be blocked by local anesthesia. General anesthesia cannot be used because of the need for sensory testing in an awake, cooperative patient. Conscious sedation using alphaprodine, hydroxyzine, methohexital, and intensive behavioral modification was...

  10. Evaluation of the safety and efficacy of percutaneous radiofrequency ablation for treating multiple breast fibroadenoma

    Directory of Open Access Journals (Sweden)

    Ping Li

    2016-01-01

    Conclusion: Given advantages of high CAR, mild injury, rapid recovery, and cosmetic outcome desired by the patients, RFA has the potential to become the preferred method in the treatment of breast fibroadenoma.

  11. Percutaneous Access via the Recanalized Paraumbilical Vein for Varix Embolization in Seven Patients

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Yeon Jin; Kim, Hyo Cheol; Hur, Sae Beom; Jae, Hwan Jun; Chung, Jin Wook [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Young Whan [Dept. of Radiology, Dongsan Hospital, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2014-10-15

    To evaluate the feasibility of percutaneous access via the recanalized paraumbilical vein for varix embolization. Between July 2008 and Jan 2014, percutaneous access via the recanalized paraumbilical vein for varix embolization was attempted in seven patients with variceal bleeding. Paraumbilical vein puncture was performed under ultrasonographic guidance, followed by introduction of a 5-Fr sheath. We retrospectively evaluated the technical feasibility, procedure-related complications, and clinical outcomes of each patient. Recanalized paraumbilical vein catheterization was performed successfully in all patients. Gastroesophageal varix embolization was performed in six patients, and umbilical varix embolization was performed in one patient. Embolic materials used are N-butyl cyanoacrylate (n = 6) and coil with N-butyl cyanoacrylate (n = 1). There were no procedure-related complications. One patient underwent repeated variceal embolization 6 hours after initial procedure via recanalized paraumbilical vein, due to rebleeding from gastric varix. Percutaneous access via the paraumbilical vein for varix embolization is a simple alternative in patients with portal hypertension.

  12. Understanding the Lung Abscess Microbiome: Outcomes of Percutaneous Lung Parenchymal Abscess Drainage with Microbiologic Correlation.

    Science.gov (United States)

    Duncan, Christopher; Nadolski, Gregory J; Gade, Terence; Hunt, Stephen

    2017-06-01

    Lung parenchymal abscesses represent an uncommon pathology with high mortality if untreated. Although most respond well to antibiotics, the optimal therapy for persistent abscesses is unknown. The purpose of this study was to review the outcomes of percutaneous lung parenchymal abscess catheter drainage after broad-spectrum antibiotic therapy failure and correlate with patient microbiologic samples. Retrospective review of patients who underwent percutaneous lung abscess drainage at a tertiary hospital system from 2005 to 2015 was performed. In total, 19 procedures were identified on 16 different patients; six females and ten males. Mean patient age was 55 years (range 22-81). Median follow-up time was 7 months (range drainage is highly sensitive for microbiologic sampling compared to sputum/bronchoscopic or blood cultures. Additionally, percutaneous drainage of lung parenchymal abscess cavities may promote resolution of the abscess with high rates of therapeutic success and low complications.

  13. Results of Cryoenergy and Radiofrequency-Based Catheter Ablation for Treating Ventricular Arrhythmias Arising From the Papillary Muscles of the Left Ventricle, Guided by Intracardiac Echocardiography and Image Integration.

    Science.gov (United States)

    Rivera, Santiago; Ricapito, Maria de la Paz; Tomas, Leandro; Parodi, Josefina; Bardera Molina, Guillermo; Banega, Rodrigo; Bueti, Pablo; Orosco, Agustin; Reinoso, Marcelo; Caro, Milagros; Belardi, Diego; Albina, Gaston; Giniger, Alberto; Scazzuso, Fernando

    2016-04-01

    Catheter radiofrequency ablation of ventricular arrhythmias (VAs) arising from the left ventricle's papillary muscles has been associated with inconsistent results. The use of cryoenergy versus radiofrequency has not been compared yet. This study compares outcomes and complications of catheter ablation of VA from the papillary muscles of the left ventricle with either cryoenergy or radiofrequency. Twenty-one patients (40±12 years old; 47% males; median ejection fraction 59±7.3%) with drug refractory premature ventricular contractions or ventricular tachycardia underwent catheter cryoablation or radiofrequency ablation. VAs were localized using 3-dimensional mapping, multidetector computed tomography, and intracardiac echocardiography, with arrhythmia foci being mapped at either the anterolateral papillary muscle or posteromedial papillary muscles of the left ventricle. Focal ablation was performed using an 8-mm cryoablation catheter or a 4-mm open-irrigated radiofrequency catheter, via transmitral approach. Acute success rate was 100% for cryoenergy (n=12) and 78% for radiofrequency (n=9; P=0.08). Catheter stability was achieved in all patients (100%) treated with cryoenergy, and only in 2 (25%) patients treated with radiofrequency (P=0.001). Incidence of multiple VA morphologies was observed in 7 patients treated with radiofrequency (77.7%), whereas none was observed in those treated with cryoenergy (P=0.001). VA recurrence at 6 months follow-up was 0% for cryoablation and 44% for radiofrequency (P=0.03). Cryoablation was associated with higher success rates and lower recurrence rates than radiofrequency catheter ablation, better catheter stability, and lesser incidence of polymorphic arrhythmias. © 2016 American Heart Association, Inc.

  14. Radiofrequency ablation of hepatocellular carcinoma: Mono or multipolar?

    Science.gov (United States)

    Cartier, Victoire; Boursier, Jérôme; Lebigot, Jérôme; Oberti, Frédéric; Fouchard-Hubert, Isabelle; Aubé, Christophe

    2016-03-01

    Thermo-ablation by radiofrequency is recognized as a curative treatment for early-stage hepatocellular carcinoma. However, local recurrence may occur because of incomplete peripheral tumor destruction. Multipolar radiofrequency has been developed to increase the size of the maximal ablation zone. We aimed to compare the efficacy of monopolar and multipolar radiofrequency for the treatment of hepatocellular carcinoma and determine factors predicting failure. A total of 171 consecutive patients with 214 hepatocellular carcinomas were retrospectively included. One hundred fifty-eight tumors were treated with an expandable monopolar electrode and 56 with a multipolar technique using several linear bipolar electrodes. Imaging studies at 6 weeks after treatment, then every 3 months, assessed local effectiveness. Radiofrequency failure was defined as persistent residual tumor after two sessions (primary radiofrequency failure) or local tumor recurrence during follow-up. This study received institutional review board approval (number 2014/77). Imaging showed complete tumor ablation in 207 of 214 lesions after the first session of radiofrequency. After a second session, only two cases of residual viable tumor were observed. During follow-up, there were 46 local tumor recurrences. Thus, radiofrequency failure occurred in 48/214 (22.4%) cases. By multivariate analysis, technique (P radiofrequency failure. Failure rate was lower with the multipolar technique for tumors radiofrequency, multipolar radiofrequency improves tumor ablation with a subsequent lower rate of local tumor recurrence. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  15. Combination therapy of temporary tracheal stenting and radiofrequency ablation for multinodular thyroid goiter with airway compression

    International Nuclear Information System (INIS)

    Shin, Ji Hoon; Beak, Jung Hwan; Oh, Yeon Mok; Ha, Eun Ju; Lee, Jeong Hyun

    2013-01-01

    We report a case of multinodular thyroid goiter in an 80-year-old man who successfully underwent tracheal stent placement for respiratory distress caused by the thyroid goiter and following two radiofrequency (RF) ablation sessions performed for thyroid volume reduction. This sequential treatment allowed elective stent removals four weeks after the second RF ablation session because the thyroid volume had been progressively reduced. Combination therapy of temporary airway stenting and RF ablation for the treatment of thyroid goiter has two advantages, i.e., immediate reliefs of dyspnea with airway stenting and reductions of the thyroid volume with RF ablation, and thus, allowing symptom reliefs even after the stent removals.

  16. Combination therapy of temporary tracheal stenting and radiofrequency ablation for multinodular thyroid goiter with airway compression

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ji Hoon; Beak, Jung Hwan; Oh, Yeon Mok; Ha, Eun Ju; Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2013-10-15

    We report a case of multinodular thyroid goiter in an 80-year-old man who successfully underwent tracheal stent placement for respiratory distress caused by the thyroid goiter and following two radiofrequency (RF) ablation sessions performed for thyroid volume reduction. This sequential treatment allowed elective stent removals four weeks after the second RF ablation session because the thyroid volume had been progressively reduced. Combination therapy of temporary airway stenting and RF ablation for the treatment of thyroid goiter has two advantages, i.e., immediate reliefs of dyspnea with airway stenting and reductions of the thyroid volume with RF ablation, and thus, allowing symptom reliefs even after the stent removals.

  17. Transcatheter Arterial Embolization for Hepatic Arterial Injury Related to Percutaneous Transhepatic Portal Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Shimohira, Masashi, E-mail: mshimohira@gmail.com; Hashizume, Takuya [Nagoya City University Graduate School of Medical Sciences, Department of Radiology (Japan); Sasaki, Shigeru [Nagoya City West Medical Center, Department of Radiology (Japan); Ohta, Kengo; Suzuki, Kazushi; Nakagawa, Motoo; Ozawa, Yoshiyuki; Sakurai, Keita; Nishikawa, Hiroko [Nagoya City University Graduate School of Medical Sciences, Department of Radiology (Japan); Hara, Masaki [Nagoya City West Medical Center, Department of Radiology (Japan); Shibamoto, Yuta [Nagoya City University Graduate School of Medical Sciences, Department of Radiology (Japan)

    2017-02-15

    PurposeTo assess the usefulness of transcatheter arterial embolization (TAE) for the hepatic arterial injury related to percutaneous transhepatic portal intervention (PTPI).Materials and MethodsFifty-four patients, 32 males and 22 females with a median age of 68 years (range 43–82 years), underwent PTPI. The procedures consisted of 33 percutaneous transhepatic portal vein embolizations, 19 percutaneous transhepatic variceal embolizations, and 2 percutaneous transhepatic portal venous stent placements. Two patients with gastric varices underwent percutaneous transhepatic variceal embolization twice because of recurrence. Therefore, the total number of procedures was 56. Among them, hepatic arterial injury occurred in 6 PTPIs in 5 patients, and TAE was performed. We assessed technical success, complications related to TAE, and clinical outcome. Technical success was defined as the disappearance of findings due to hepatic arterial injury on digital subtraction angiography.ResultsAs hepatic arterial injuries, 4 extravasations and 2 arterioportal shunts developed. All TAEs were performed successfully. The technical success rate was 100 %. Complication of TAE occurred in 5 of 6 TAEs; 3 were focal liver infarction, not requiring further treatment, and 2 were biloma that required percutaneous drainage. Five TAEs in 4 patients were performed immediately after the PTPI, and these 4 patients were alive. However, one TAE was performed 10 h later, and the patient died due to multiple organ failure 2 months later although TAE was successful.ConclusionTAE is a useful treatment for hepatic arterial injury related to PTPI. However, it should be performed at an early stage.

  18. Radiofrequency ablation of chondroblastoma: procedure technique, clinical and MR imaging follow up of four cases

    Energy Technology Data Exchange (ETDEWEB)

    Christie-Large, M.; Evans, N.; Davies, A.M.; James, S.L.J. [Royal Orthopaedic Hospital Foundation Trust, Department of Radiology, Birmingham (United Kingdom)

    2008-11-15

    The aim of this study is to describe the procedure technique, clinical and imaging outcomes of patients treated with radiofrequency ablation for chondroblastoma. Four patients (female/male, 3:1; mean age, 13 years; age range; 9-16 years) underwent the procedure. All had pre-operative magnetic resonance imaging (MRI) and symptomatic, biopsy-proven chondroblastomas (two proximal femur, two proximal tibia). The lesion size ranged from 1.5 to 2.5 cm in maximal dimension (mean size, 1.8 cm). Bone access was gained with a Bonopty biopsy needle system (mean number of radiofrequency needle placements, 5; mean ablation time, 31 min). Clinical and MRI follow-up was available in all cases (mean, 12.25 months; range, 5-18 months). All patients reported resolution of symptoms at 2-6 weeks post ablation. At their most recent clinical follow-up, three patients remained completely asymptomatic with full return to normal activities and one patient had minor local discomfort (different pain pattern) that was not limiting activity. All four patients' follow-up MRI studies demonstrated resolution of the oedema pattern around the lesion and temporal evolution of the internal signal characteristics with fatty replacement. Radiofrequency ablation for chondroblastoma provides an alternative to surgical curettage, and we have demonstrated both a clinical improvement in symptoms and the follow-up MRI appearances. (orig.)

  19. Radiofrequency-assisted Liposuction for Arm Contouring: Technique under Local Anesthesia.

    Science.gov (United States)

    Theodorou, Spero; Chia, Christopher

    2013-08-01

    Contouring of the arms that does not involve skin excision remains a difficult challenge due to the dependent nature and quality of the skin. Although brachioplasty remains effective, it requires a lengthy incision. Radiofrequency-assisted liposuction (RFAL) may improve skin retraction with a satisfactory aesthetic result without skin resection and the resultant scar. The purpose of this study is to present our experience of RFAL arm contouring under local anesthesia, detailing safety guidelines, the marking technique, operative technique, complications, third-party surgeon appraisal, and patient satisfaction survey. Forty patients underwent RFAL under local tumescent anesthesia for aesthetic arm contouring. Postoperative patient satisfaction surveys were conducted and independent third-party surgeons were surveyed to assess improvements in contour and skin quality with preoperative and postoperative photographs. Complications included 1 burn near the elbow treated successfully with local wound care and 1 seroma that resolved with aspiration. The patient survey indicated that most patients had minimal or no discomfort with the injection of local anesthesia, application of radiofrequency energy, or aspiration of fat. The majority of patients were satisfied with their contouring result and degree of skin tightening. Third-party plastic surgeons found the improvement in contouring and degree of skin tightening good to excellent. In appropriately selected patients, RFAL arm contouring under local anesthesia represents an alternative procedure with acceptably low morbidity and high patient satisfaction. To achieve consistent results while minimizing complications, consideration to anatomic details, infiltration of the local anesthetic, and application of the radiofrequency energy must be given.

  20. Randomised controlled trial of cervical radiofrequency lesions as a treatment for cervicogenic headache [ISRCTN07444684

    Directory of Open Access Journals (Sweden)

    van Kleef Maarten

    2006-02-01

    Full Text Available Abstract Background Cervicogenic headache (CEH is a unilateral headache localised in the neck or occipital region, projecting to the frontal and temporal regions. Since the pathogenesis of this syndrome appears to have an anatomical basis in the cervical region, several surgical procedures aimed at reducing the nociceptive input on the cervical level, have been tested. We developed a sequence of various cervical radiofrequency neurotomies (facet joint denervations eventually followed by upper dorsal root ganglion neurotomies that proved successful in a prospective pilot trial with 15 CEH patients. To further evaluate this sequential treatment program we conducted a randomised controlled trial Methods 30 patients with cervicogenic headache according to the Sjaastad diagnostic criteria, were randomised. 15 patients received a sequence of radiofrequency treatments (cervical facet joint denervation, followed by cervical dorsal root ganglion lesions when necessary, and the other 15 patients underwent local injections with steroid and anaesthetic at the greater occipital nerve, followed by transcutaneous electrical nerve stimulation (TENS when necessary. Visual analogue scores for pain, global perceived effects scores, quality of life scores were assessed at 8, 16, 24 and 48 weeks. Patients also kept a headache diary. Results There were no statistically significant differences between the two treatment groups at any time point in the trial. Conclusion We did not find evidence that radiofrequency treatment of cervical facet joints and upper dorsal root ganglions is a better treatment than the infiltration of the greater occipital nerve, followed by TENS for patients fulfilling the clinical criteria of cervicogenic headache.

  1. [Percutaneous transhepatic bilioplasty: long-term results].

    Science.gov (United States)

    Righi, D; Martina, M C; Tola, E; Fonio, P; Fronda, G R; Gandini, G

    1990-10-01

    We report the results of a long-term follow-up of 40/101 patients with benign biliary strictures treated with percutaneous balloon dilatation (PBD) at the Radiology Department of the University of Turin, from March 1983 to March 1990. We excluded all the patients who were not followed or treated after June 1988, being their follow-up shorter than 18 months. All patients underwent accurate clinical, biological (AST, ALT, gammaGT, alcaline phosphatase) and US controls. Mean follow-up was 33.5 months. Mean success rate was 75% in strictures of bilioenteric anastomosis, 86% in iatrogenic strictures of the common bile duct, 65% in sclerosing cholangitis, 80% in papillary strictures in which endoscopic treatment had not been possible for anatomical reasons. Our results, compared to the most important radiological and surgical series, show PBD to have lower morbidity than surgery and no mortality during the so-called peroperative period (30 days). Moreover, in case of recurrences, PBD can be repeated without further complications and does not affect eventual surgery.

  2. Percutaneous Nephrolithotomy for Paediatric Stone Disease

    Directory of Open Access Journals (Sweden)

    Hüseyin Çelik

    2015-06-01

    Full Text Available We evaluated the outcomes and complications occurring following percutaneous nephrolithotomy (PCNL procedures performed in paediatric patients. There were 291 paediatric patients (293 renal units included in the current study and who underwent PCNL in our clinic between March 1999 and December 2014. We evaluated stone burden, duration of surgery and complications, success (stone-free rate, residual fragments and auxilliary procedures, and follow-up details. The stone-free rate following PCNL was 88.3%. Early postoperative complications included excessive bleeding and transfusion in nine patients, and prolonged urinary extravasation following removal of the nephrostomy tube and requiring JJ stent placement in eight patients. The mean time to catheter removal was 2.8 days and the mean hospitalisation time was 3.5 days. The aim of kidney stone treatment is to achieve minimal kidney damage with the highest success rate. Therefore, minimally invasive procedures are important in the paediatric age group where life expectancy is high. PCNL is a safe and effective procedure for the treatment of kidney stones in children.

  3. Is percutaneous nephrolithotomy in solitary kidneys safe?

    Science.gov (United States)

    Wong, Kathie Alexina; Sahai, Arun; Patel, Amit; Thomas, Kay; Bultitude, Matthew; Glass, Jonathan

    2013-11-01

    To review our experience from a high volume stone center with a focus on efficacy, safety, and renal function. Stones requiring percutaneous nephrolithotomy (PCNL) in patients with solitary kidneys can pose significant anxiety to the urologist. Limited data are available in published reports in this setting. A comprehensive retrospective review of medical records was performed on patients who underwent PCNL and had a solitary kidney or a single functioning renal unit. Data were collected on patient demographics, stone burden, outcomes, complications, and renal function. Of 378 PCNLs performed between January 2003 and September 2011, 22 were performed in 17 patients with a single functioning kidney. Three procedures were performed in a transplanted kidney. In those with solitary calculus, the longest mean length and stone surface area were 37 mm and 825 mm(2), respectively. Stone-free rate was 59%. Auxiliary procedures were required in 6 cases, resulting in a stone-free rate of 77%. Median inpatient stay was 4 days. Serum creatinine values improved from 144 to 126 umol/L before and after the procedure and mean estimated glomerular filtration rate improved similarly from 51 to 59 mls/minute, respectively. Blood transfusion was required in 1 patient, sepsis developed in 3, and 2 patients required a stent for obstruction. PCNL in solitary kidneys is safe with an acceptable complication rate if performed in a high volume center. Outcomes are good, although auxiliary procedures may be necessary. Renal function remains stable or improves after procedure. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Obstructive jaundice: a comparative study of forceps and brush biopsy under percutaneous transhepatic cholangiography

    International Nuclear Information System (INIS)

    Li Yongdong; Han Xinwei; Wu Gang; Ma Bo; Xing Gusheng

    2004-01-01

    Objective: To compare the sensitivity between forceps biopsy and brushing, and to explore a feasible approach to pathological diagnosis of the obstructive jaundice. Methods: 92 consecutive patients with obstructive jaundice underwent transluminal forceps biopsy and brushing during percutaneous transhepatic cholangiography and percutaneous transhepatic cholangiodrainage. The technique was performed through a preexisting percutaneous transhepatic tract with multiple specimens obtained after passing the forceps biopsy or brush into a 8-French sheath. Finally the specimens were fixed with formalin for pathologic or cytologic diagnosis. Results: The histopathologic diagnosis was acquired in 81 out of 92 patients with forceps biopsy reaching the successful rate of 97.83%. Sensitivity of forceps biopsy in 92 patients was higher than that of brush in 84 patients (88.04% vs 76.19% χ 2 =4.251, P= <0.05). Conclusions: Percutaneous transhepatic cholangiobiopsy is a simple technique with minimal invasion, high sensitivity and worthy to be used spread extensively. Percutaneous transluminal brush cytology is also an useful method for establishing a diagnosis of cholangiocarcinoma. (authors)

  5. Feasibility and effectiveness of image-guided percutaneous biopsy of the urinary bladder.

    Science.gov (United States)

    Butros, Selim Reha; McCarthy, Colin James; Karaosmanoğlu, Ali Devrim; Shenoy-Bhangle, Anuradha S; Arellano, Ronald S

    2015-08-01

    To evaluate the indications, technique, results, and complications of image-guided percutaneous biopsy of the urinary bladder. This retrospective study included 15 patients (10 male, 5 female) who underwent image-guided percutaneous biopsy of the urinary bladder between January 1999 and December 2013. The medical records, imaging studies, procedural details, and long-term follow-up of each patient were reviewed in detail to assess the feasibility of percutaneous bladder biopsy. Ten patients had focal bladder masses and 5 patients had asymmetric or diffuse bladder wall thickening. Eleven patients had either negative or unsatisfactory cystoscopies prior to the biopsy. Percutaneous biopsies were performed under computed tomography guidance in 12 patients and ultrasound in 3 patients. All procedures were technically successful and there were no procedural complications. Malignancy was confirmed in 8 patients, among whom 6 had transitional cell carcinoma, 1 cervical cancer, and 1 prostate cancer metastasis. Seven patients had a benign diagnosis, including 3 that were later confirmed by pathology following surgery and 2 patients with a false-negative result. The overall sensitivity was 80% and accuracy was 87%. Image-guided percutaneous biopsy of the urinary bladder is a safe and technically feasible procedure with a high sensitivity and accuracy rate. Although image-guided bladder biopsy is an uncommon procedure, it should be considered in selected cases when more traditional methods of tissue sampling are either not possible or fail to identify abnormalities detected by cross-sectional imaging.

  6. Percutaneous Cholecystostomy for Patients with Acute Cholecystitis and an Increased Surgical Risk

    International Nuclear Information System (INIS)

    Overhagen, Hans van; Meyers, Hjalmar; Tilanus, Hugo W.; Jeekel, Johannes; Lameris, Johan S.

    1996-01-01

    Purpose: To evaluate percutaneous cholecystostomy in patients with acute cholecystitis and an increased surgical risk. Methods: Thirty-three patients with acute cholecystitis (calculous, n= 22; acalculous, n= 11) underwent percutaneous cholecystostomy by means of a transhepatic (n= 21) or transperitoneal (n= 12) access route. Clinical and laboratory parameters were retrospectively studied to determine the benefit from cholecystostomy. Results: All procedures were technically successful. Twenty-two (67%) patients improved clinically within 48 hr; showing a significant decrease in body temperature (n= 13), normalization of the white blood cell count (n= 3), or both (n= 6). There were 6 (18%) minor/moderate complications (transhepatic access, n= 3; transperitoneal access, n= 3). Further treatment for patients with calculous cholecystitis was cholecystectomy (n= 9) and percutaneous and endoscopic stone removal (n= 8). Further treatment for patients with acalculous cholecystitis was cholecystectomy (n= 2) and gallbladder ablation (n= 2). There were 4 deaths (12%) either in hospital or within 30 days of drainage; none of the deaths was procedure-related. Conclusions: Percutaneous cholecystostomy is a safe and effective procedure for patients with acute cholecystitis. For most patients with acalculous cholecystitis percutaneous cholecystostomy may be considered a definitive therapy. In calculous disease this treatment is often only temporizing and a definitive surgical, endoscopic, or radiologic treatment becomes necessary

  7. Percutaneous Aspiration Embolectomy Using Guiding Catheter for the Superior Mesenteric Artery Embolism

    Science.gov (United States)

    Choi, Kyu Sung; Kim, Ji Dae; Min, Sang-Il; Min, Seung-Kee; Jae, Hwan Jun; Chung, Jin Wook

    2015-01-01

    Objective To evaluate the technical feasibility and clinical outcome of percutaneous aspiration embolectomy for embolic occlusion of the superior mesenteric artery (SMA). Materials and Methods Between January 2010 and December 2013, 9 patients with embolic occlusion of the SMA were treated by percutaneous aspiration embolectomy in 2 academic teaching hospitals. The aspiration embolectomy procedure was performed with the 6-Fr and 7-Fr guiding catheter. Thrombolysis was performed with urokinase using a multiple-sidehole infusion catheter. The clinical outcome was investigated retrospectively. Results Superior mesenteric artery occlusion was initially diagnosed by computed tomography (CT) in all patients, and all patients had no obvious evidence of bowel infarction on CT scan. Percutaneous aspiration embolectomy was primarily performed in 6 patients, and thrombolysis was initially performed in 3 patients. In 3 patients who received primary thrombolysis, percutaneous aspiration was undertaken because the emboli were resistant to urokinase. Complete angiographic success was achieved in 6 patients and partial angiographic success was accomplished in 3 patients. One patient underwent bowel resection. One patient died of whole bowel necrosis and sepsis, and 8 patients survived without complications. Conclusion Percutaneous aspiration embolectomy is a useful tool in recanalization of embolic occlusion of the SMA in select patients. PMID:26175572

  8. Management of trigeminal neuralgia by radiofrequency ...

    African Journals Online (AJOL)

    Wael Fouad

    2011-06-24

    Jun 24, 2011 ... Abstract Introduction: The trigeminal neuralgia (TN) which is resistant to medical treatment has been benefited from many surgical techniques. Opinions differ regarding the best surgical treatment. Objective: This study was done to evaluate the functional results of percutaneous radiofre-.

  9. Percutaneous tracheostomy: a comprehensive review

    Science.gov (United States)

    Rashid, Ashraf O.

    2017-01-01

    Tracheostomy is a common procedure. It can be done surgically or percutaneously by dilating the stoma using Seldinger technique. Percutaneous tracheostomy (PT) is now routinely performed by surgeons and non-surgeons such as intensivists and anesthesiologists in the intensive care units (ICU) all over the world. Although obesity, emergent tracheostomy, coagulopathy, inability to extend the neck and high ventilator demand (HVD) were initially thought to be a relative contraindication, recent data suggest safety of PT in these patient population. Ultrasound can be helpful in limited cases to identify the neck structure especially in patients with a difficult anatomy. Bronchoscopy during PT can shorten the duration and avoid complications. PT has favorable complication rate, lower infection rate, shorter procedural duration and is cost-effective. Experience with the technique and careful planning is needed to minimize any avoidable potential complication. PMID:29214070

  10. Transvenous Radiofrequency Ablation Therapy in the Treatment of Arrhythmias: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Tayyar Gökdeniz

    2013-03-01

    Full Text Available Introduction: Radiofrequency ablation of tachyarrhythmia is effective in the treatment of tachycardia. In this study, we evaluated the results of radiofrequency catheter ablation of tachyarrhythmia.Patients and Methods: From December 2010 to January 2012, 114 consecutive patients with symptomatic drug-resistant typical slow-fast atrioventricular nodal reentrant tachycardia, 17 patients with atrioventricular reentrant tachycardia (five Wolf Parkinson White syndrome, eight patients with atrial tachycardia, seven patients with atrial flutter, five patients with right ventricular outflow tract tachycardia and three patients with atrial fibrillation underwent an invasive electrophysiology study and radiofrequency ablation. Results: The 154 patients (age: 39.1 ± 17.2 years, body mass index: 24.3 ± 5.2 kg/m2, waist/hip ratio: 0.88 ± 5.2, systolic blood pressure: 128.3 ± 22.4 mmHg, diastolic blood pressure: 75.30 ± 9.0 mmHg, resting heart rate: 76.10 ± 8.2 beat/minute with tachycardia (89 women, 65 men were ablated. Procedure and fluoroscopy times were 57.5 ± 19.0 and 14.4 ± 4.1 minute respectively. The mean follow up period was 10.2 ± 4.3 months. During follow up period three patients with atrioventricular nodal reentrant tachycardia, two patients with atrioventricular reentrant tachycardia, one patient with right ventricular outflow tract tachycardia and one patient with atrial fibrillation had recurrence.Conclusion: The transvenous radiofrequency ablation therapy is a safe and effective approach for the treatment of tachyarrhythmia under experienced hands.

  11. Percutaneous Fixation of Displaced Calcaneal Fracture

    Directory of Open Access Journals (Sweden)

    Yeung Yip-Kan

    2011-06-01

    Conclusion: Percutaneous fixation of displaced tongue-type calcaneal fractures is an effective treatment with acceptable clinical outcome, short hospital stay, minimal skin complications, and quick recovery.

  12. CT-guided percutaneous drainage within intervertebral space for pyogenic spondylodiscitis with psoas abscess

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Tomohiro; Morishita, Hiroyuki; Lida, Shigeharu; Asai, Shunsuke; Masui, Koji; Sato, Osamu (Department of Diagnostic Radiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto (Japan)), Email: t-matsu@koto.kpu-m.ac.jp; Yamagami, Takuji; Nishimura, Tsunehiko (Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto (Japan)); Yamazoe, Shoichi (Department of Orthopedic Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto (Japan))

    2012-02-15

    Background. Reports on CT-guided percutaneous drainage within the intervertebral space for pyogenic spondylodiscitis with a secondary psoas abscess are limited. Purpose. To evaluate CT-guided percutaneous drainage within the intervertebral space for pyogenic spondylodiscitis and a secondary psoas abscess in which the two sites appear to communicate. Material and Methods. Eight patients with pyogenic spondylodiscitis and a secondary psoas abscess showing communication with the intradiscal abscess underwent CT-guided percutaneous drainage within the intervertebral space. The clinical outcome was retrospectively assessed. Results. An 8-French pigtail catheter within the intervertebral space was successfully placed in all patients. Seven patients responded well to this treatment. The one remaining patient who had developed septic shock before the procedure died on the following day. The mean duration of drainage was 32 days (13-70 days). Only one patient with persistent back pain underwent surgery for stabilization of the spine after the improvement of inflammation. Among seven patients responding well, long-term follow-up (91-801 days, mean 292 days) was conducted in six patients excluding one patient who died of asphyxiation due to aspiration unrelated to the procedure within 30 days after the procedure. In these six patients, no recurrence of either pyogenic spondylodiscitis or the psoas abscess was noted. Conclusion. CT-guided percutaneous drainage within the intervertebral space can be effective for patients with pyogenic spondylodiscitis and a secondary psoas abscess if the psoas abscess communicates with the intradiscal abscess

  13. Prevalence of patent foramen ovale and usefulness of percutaneous closure device in carcinoid heart disease.

    Science.gov (United States)

    Mansencal, Nicolas; Mitry, Emmanuel; Pillière, Rémy; Lepère, Céline; Gérardin, Benoît; Petit, Jérôme; Gandjbakhch, Iradj; Rougier, Philippe; Dubourg, Olivier

    2008-04-01

    The aim of this study was to assess (1) the incidence of patent foramen ovale (PFO) in carcinoid syndrome (CS) and (2) the feasibility of percutaneous closure procedure in selected patients with CS. One hundred eight patients were prospectively studied: 54 with CS and an age- and gender-matched control group. All patients underwent conventional and contrast echocardiography. Patients with clinical signs of dyspnea (New York Heart Association class > or =III), cyanosis, carcinoid heart disease (CHD), and severe PFO were referred for the percutaneous closure of PFO. The prevalence of PFO was 41% in patients with CS and 22% in the control group (p = 0.03) and was significantly higher in patients with CHD (59%, p = 0.009). Four patients (14% of those with CHD) were referred for the percutaneous closure of PFO, and 3 patients ultimately underwent PFO closure (using Amplatzer septal occluders). At 6-month follow-up, New York Heart Association class was improved in all patients, as well as arterial blood gas results (p = 0.04) and 6-minute walking distance (p = 0.03), but all patients presented residual right-to-left shunts. In conclusion, this prospective study demonstrates that in patients with CHD, the prevalence of PFO is high and that percutaneous closure of PFO is feasible, with a reduction in symptoms but with residual shunting.

  14. Percutaneous transhepatic cholecystostomy for choledocholithiasis with acute cholangitis in high-risk patients.

    Science.gov (United States)

    Ren, Zuhai; Xu, Yong; Zhu, Shaihong

    2012-01-01

    To evaluate the safety and feasibility of percutaneous transhepatic cholecystostomy for choledocholithiasis with acute cholangitis in high-risk patients. Six high-risk patients of choledocholithiasis complicated with moderate to severe acute cholangitis underwent percutaneous transhepatic cholecystostomy and subsequent interval open surgery from January, 2008 to October 2010. These patients, who were not suitable for both endoscopic and transhepatic biliary drainage, were reviewed retrospectively. Percutaneous transhepatic cholecystostomy was performed uneventfully. One patient developed hemoperitoneum which was successfully controlled by conservative treatment. Biliary peritonitits occurred in two patients, one ceased to leak spontaneously, the other developed a biloma which was cured by repuncture. No procedure-related death occurred. Sepsis was relieved completely 3 to 4 days after procedure. Two patients underwent interval open exploration of the common bile duct. One patient who recovered from sepsis succumbed on day 12 post-cholecystostomy because of an acute cardiac infarct. The other 3 patients were cured of sepsis and discharged without further treatment. The results showed that ultrasound-guided percutaneous transhepatic cholecystostomy is a safe and effective procedure for choledocholithiasis with moderate to severe acute cholangitis in highly selected high-risk surgical patients. It may deserve to become a definitive therapy for subsequent surgical management. Larger controlled studies are needed to further confirm our findings.

  15. Identifying pathogens of spondylodiscitis: percutaneous endoscopy or CT-guided biopsy.

    Science.gov (United States)

    Yang, Shih-Chieh; Fu, Tsai-Sheng; Chen, Lih-Huei; Chen, Wen-Jer; Tu, Yuan-Kun

    2008-12-01

    Identifying offending pathogens is crucial for appropriate antibiotic administration for infectious spondylitis. Although computed tomography (CT)-guided biopsy for bacteriologic diagnosis is a standard procedure, it has a variable success rate. Some reports claim percutaneous endoscopic discectomy and drainage offer a sufficient amount of tissue for microbiologic examination and easy application. We therefore compared the diagnostic value of CT guidance with that of endoscope guidance in 52 patients with suspected infectious spondylitis. Twenty patients underwent percutaneous endoscopic discectomy and drainage by an orthopaedic surgeon and the other 32 patients underwent CT-guided biopsies by a radiologist. Patients were followed a minimum of 12 months after treatment. Culture results of the biopsy specimens were recorded. Causative bacteria were identified more frequently with percutaneous endoscopy than in CT-guided biopsy (18 of 20 [90%] versus 15 of 32 [47%]). We observed no biopsy-related complications or side effects in either group. The data suggest percutaneous endoscopic discectomy and drainage yield higher bacterial recovery rates than CT-guided spinal biopsy. Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

  16. A prospective study of percutaneous vertebroplasty in patients with myeloma and spinal metastases

    International Nuclear Information System (INIS)

    Chew, C.; Ritchie, M.; O’Dwyer, P.J.; Edwards, R.

    2011-01-01

    Aim: To assess patient outcome in a consecutive series of patients with myeloma and spinal metastases who underwent percutaneous vertebroplasty. Materials and methods: Data were gathered prospectively on all patients undergoing percutaneous vertebroplasty between June 2001 and June 2010. Outcome measures included visual analogue pain scores (VAS) and Roland–Morris Questionnaire (RMQ) in patients treated since 2005 as well as complications and long-term outcome in all patients. Results: One hundred and twenty-eight patients underwent percutaneous vertebroplasty for myeloma (n = 41) or spinal metastases (n = 87) over a 9 year period. VAS scores fell from 7.75 ± 1.88 pre-vertebroplasty to 4.77 ± 2.69 post-vertebroplasty (p = 0.001). RDQ scores improved from 18.55 ± 4.79 to 13.5 ± 6.96 (p = 0.001). Complications were recorded in three patients: cement extension to vena cava (n = 1), local haematoma (n = 1), and loss of sensation over T1 dermatome (n = 1). The Kaplan–Meier estimate of 5 year survival post-vertebroplasty was 40% for patients with myeloma and 25% for those with metastases. Conclusion: This large prospective study demonstrates percutaneous vertebroplasty reduces pain and improves disability in patients from intractable pain from myeloma or spinal metastases and now forms an important part of the multimodality treatment for these patients.

  17. Nephrostomy in percutaneous nephrolithotomy (PCNL)

    DEFF Research Database (Denmark)

    Cormio, Luigi; Preminger, Glenn; Saussine, Christian

    2013-01-01

    PURPOSE: To explore the relationships between nephrostomy tube (NT) size and outcome of percutaneous nephrolithotomy (PCNL). METHODS: The Clinical Research Office of the Endourological Society (CROES) prospectively collected data from consecutive patients treated with PCNL over a 1-year period at......; nephrostomy size > 18 Fr) NT. RESULTS: Patients who received a LB NT had a significantly lower rate of hemoglobin reduction (3.0 vs. 4.3 g/dL; P ...

  18. Fraxelated radiofrequency device for acne scars

    Science.gov (United States)

    Rao, Babar K.; Khokher, Sairah

    2012-09-01

    Acne scars can be improved with various treatments such as topical creams, chemical peels, dermal fillers, microdermabrasion, laser, and radiofrequency devices. Some of these treatments especially lasers and deep chemical peels can have significant side effects such as post inflammatory hyperpigmentation in darker skin types. Fraxelated RF Laser devices have been reported to have lower incidence of side effects in all skin phototypes. Nine patients between ages 18 and 35 of various skin phototypes were selected from a private practice and treated with a RF fraxelated device (E-matrix) for acne scars. Outcomes were measured by physician observation, subjective feedback received by patients, and comparison of before and after photographs. In this small group of patients with various skin phototypes, fraxelated radiofrequency device improved acne scars with minimal side effects and downtime.

  19. Temperature-controlled irrigated tip radiofrequency catheter ablation

    DEFF Research Database (Denmark)

    Petersen, H H; Chen, X; Pietersen, Adrian

    1998-01-01

    INTRODUCTION: In patients with ventricular tachycardias due to structural heart disease, catheter ablation cures radiofrequency ablation. Irrigated tip radiofrequency ablation using power control and high infusion rates enlarges lesion......: We conclude that temperature-controlled radiofrequency ablation with irrigated tip catheters using low target temperature and low infusion rate enlarges lesion size without increasing the incidence of cratering and reduces coagulum formation of the tip....

  20. Comparison of the long term efficacy of radiofrequency ablation and surgical turbinoplasty in inferior turbinate hypertrophy: a randomized clinical study.

    Science.gov (United States)

    Bakshi, Satvinder Singh; Shankar Manoharan, Kiruba; Gopalakrishnan, Surianarayanan

    2017-08-01

    To compare the long term effectiveness of radiofrequency thermal ablation with that of surgical turbinoplasty, a prospective, randomized, blinded clinical study was conducted. Eighty six patients suffering from nasal obstruction due to bilateral inferior turbinate hypertrophy were enrolled. Forty four patients were operated by radiofrequency ablation, while 42 underwent surgical turbinoplasty. The outcomes of both techniques were compared in terms of symptoms using visual analogue score (VAS) and endoscopic scores. A statistically significant difference in the VAS scores existed between the two groups by the 3rd month in terms of nasal obstruction (p=.0002) and headache (p=.0001), by the 6th month in terms of nasal secretions (p=.007), by the end of 1 year in terms of sneezing (p=.023) and no statistically significant difference even till the end of year with respect to hyposmia. Radiofrequency thermal ablation is more effective than surgical turbinoplasty in terms of treating nasal obstruction and equally effective in terms of managing sneezing. Radiofrequency ablation has the advantage of being a day care procedure and minimal complications.

  1. Percutaneous transhepatic portacaval shunt (PTPS)

    International Nuclear Information System (INIS)

    Chu Jianguo; Sun Xiaoli; Lv Chunyan; Xu Xiaoming; Huang He; Yang Shuhui; Zhou Hua

    2005-01-01

    Objective: To present a latest procedures for portal hypertension with preliminary results and evaluate the technical feasibility and efficacy of the portacaval shunt creation through percutaneous transhepatic approach with its potential clinical significance. Methods: Nineteen patients with portal hypertension (17 men; mean age 57 years, range 32-73) were referred for PTPS procedure because of bleeding varices (n=16), intractable ascites (n=2), and hepatopulmonary syndrome (n=1). The severity of liver disease was Child's B in 4 and Child's C in 15. The PTPS was created by a percutaneous transhepatic puncture through left portal vein to the IVC and a polytetrafluoroethylene (PTFE) stent-grafts was placed through a transhepatic approach. Results: Technical and functional successes were achieved in all patients-arerage without any procedure-related complications. The postprocedural portal vein-IVC gradients decreased with a mean 13 cmH 2 O and with average 216 days of follow-up showing no recurrent variceal bleeding and refractory ascites. The primary patency ratefor 365 days was 94.8%, obviously higher than classical TIPS. Conclusions: Portacaval shunt creation using the percutaneous transhepatic technique is secure and feasible with favorable primary patency due to the a straight line shunt construction and provide a good alternative to the standard portosystemic shunt in difficult or impossible circumstances. (authors)

  2. Radiofrequency Wire Recanalization of Chronically Thrombosed TIPS

    Energy Technology Data Exchange (ETDEWEB)

    Majdalany, Bill S., E-mail: bmajdala@med.umich.edu [University of Michigan Health System, Division of Interventional Radiology, Department of Radiology (United States); Elliott, Eric D., E-mail: eric.elliott@osumc.edu [The Ohio State University Wexner Medical Center, Division of Interventional Radiology, Department of Radiology (United States); Michaels, Anthony J., E-mail: Anthony.michaels@osumc.edu; Hanje, A. James, E-mail: James.Hanje@osumc.edu [The Ohio State University Wexner Medical Center, Division of Gastroenterology and Hepatology, Department of Medicine (United States); Saad, Wael E. A., E-mail: wsaad@med.umich.edu [University of Michigan Health System, Division of Interventional Radiology, Department of Radiology (United States)

    2016-07-15

    Radiofrequency (RF) guide wires have been applied to cardiac interventions, recanalization of central venous thromboses, and to cross biliary occlusions. Herein, the use of a RF wire technique to revise chronically occluded transjugular intrahepatic portosystemic shunts (TIPS) is described. In both cases, conventional TIPS revision techniques failed to revise the chronically thrombosed TIPS. RF wire recanalization was successfully performed through each of the chronically thrombosed TIPS, demonstrating initial safety and feasibility in this application.

  3. ROLE OF RADIOFREQUENCY ABLATION IN ADENOMA SEBACEUM

    Directory of Open Access Journals (Sweden)

    Ch. Madh

    2016-03-01

    Full Text Available Adenoma sebaceum, pathognomonic of tuberous sclerosis, are tiny angiofibromas which commonly occur over central part of face. Recurrence after treatment is common and hence a need for inexpensive, safe and efficient treatment is required. Radiofrequency ablation is a safe and an economical procedure and has been known to cause less scarring with good aesthetic results compared to other ablative methods such as electrocautery.

  4. Issues in epidemiological studies of radiofrequency workers

    International Nuclear Information System (INIS)

    Hocking, B.

    1985-01-01

    The paper reviews some of the issues in a proposed epidemiological study of radiofrequency workers. First a few other epidemiological studies are discussed to illustrate some of the common problems such as inadequate definition of effects and/or exposure. Then technical problems in determining dosage and responses as well as study design are reviewed, and finally the administrative aspects of ethics, industrial relations and costs are considered

  5. [Analysis of clinical effects of percutaneous vertebroplasty and percutaneous kyphoplasty in treating osteoporotic vertebral compression fracture].

    Science.gov (United States)

    Wu, Yao; Wang, Feng; Zhou, Jian-Qiang; Liu, Cai-Yun; Wu, Rui-Xing

    2014-05-01

    To explore the clinical outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF). From January 2007 to February 2010, the data of 40 patients with osteoporotic vertebral compression fracture underwent treatment were retrospectively analyzed. Of them,20 patients were treated with PVP (PVP group), there were 8 males and 12 females with an average age of (66.37 +/- 2.34) years old (54 to 81); 20 patients were treated with PKP (PKP group), there were 11 males and 9 females with an average of (65.12 +/- 3.21) years old (56 to 79). Postoperative at 1 week, 12 weeks, 1 year, pain and daily life function were respectively assessed by visual analogue scale (VAS) and Barthel index (BI); and anterior height of responsibility vertebra, Cobb angle were measured by X-rays. In PVP group, 1 case complicated with bone cement leakage without clinical symptoms and no operation to treat. No postoperative infection and deep vein thrombosis were found between two groups. All patients were followed up more than 1 year, pain and daily life function has obviously improved than preoperative (P 0.05); there was no significant difference between two groups (P > 0.05). In PVP group, there was no significant difference in anterior height of responsibility vertebra, Cobb angle before and after operation;and in PKP group, postoperative data has obviously improved than preoperative (P 0.05); there was no significant difference between two groups at 1 week, 12 weeks, 1 year after operation. Both the methods can obviously relieve pain and completely or partly recover daily life function in treating OVCF. But PKP has advantages of recovery of anterior height of responsibility vertebra and correction of Cobb angle, especially for serious compression.

  6. Radiofrequency volumetric reduction for masseteric hypertrophy.

    Science.gov (United States)

    Jin Park, Young; Woo Jo, Yong; Bang, Sa Ik; Kim, Hyung Joon; Lim, So Young; Mun, Goo Hyun; Hyon, Won Sok; Oh, Kap Sung

    2007-01-01

    Masseteric hypertrophy occurs frequently among Asians, including Koreans, because of racial characteristics and dietary habits. It is thought to be an unpleasant feature, especially because of its strong and masculine impression. Recently, the authors developed a method for the volumetric reduction of hypertrophied masseter muscles using radiofrequency energy to correct the squared facial appearance caused by the hypertrophy. This study was performed to investigate the effects of radiofrequency applied to reduce hypertrophied masseter muscles of patients who sought an aesthetic alternative for a slim, smooth, and feminine-looking lower facial contour. A total of 340 patients were treated. The patients usually recognized the volume change 3 to 6 weeks after treatment, and an objective volume reduction was observed within 3 months of the operation. The range of the reduction in the masseter thickness, as measured by ultrasonic examination at a 6-month postoperative follow-up visit, was 10% to 60% (mean, 27%). Most of the patients could eat a nearly normal diet after 4 weeks and were satisfied with the improved aesthetic contour lines of their lower face. Radiofrequency-induced coagulation tissue necrosis of the masseter did not cause any infections or limitations of mouth opening, and the clinical improvement was well maintained after the treatment.

  7. 21 CFR 886.4100 - Radiofrequency electrosurgical cautery apparatus.

    Science.gov (United States)

    2010-04-01

    ... bleeding by a high frequency electric current. (b) Classification. Class II. ... electrosurgical cautery apparatus. (a) Identification. A radiofrequency electrosurgical cautery apparatus is an AC...

  8. Incidence and Cause of Hypertension During Adrenal Radiofrequency Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Yamakado, Koichiro, E-mail: yama@clin.medic.mie-u.ac.jp; Takaki, Haruyuki [Mie University School of Medicine, Department of Interventional Radiology (Japan); Yamada, Tomomi [Mie University School of Medicine, Department of Translational Medicine (Japan); Yamanaka, Takashi; Uraki, Junji; Kashima, Masataka; Nakatsuka, Atsuhiro; Takeda, Kan [Mie University School of Medicine, Department of Interventional Radiology (Japan)

    2012-12-15

    Purpose: To evaluate the incidence and cause of hypertension prospectively during adrenal radiofrequency ablation (RFA). Methods: For this study, approved by our institutional review board, written informed consent was obtained from all patients. Patients who received RFA for adrenal tumors (adrenal ablation) and other abdominal tumors (nonadrenal ablation) were included in this prospective study. Blood pressure was monitored during RFA. Serum adrenal hormone levels including epinephrine, norepinephrine, dopamine, and cortisol levels were measured before and during RFA. The respective incidences of procedural hypertension (systolic blood pressure >200 mmHg) of the two patient groups were compared. Factors correlating with procedural systolic blood pressure were evaluated by regression analysis.ResultsNine patients underwent adrenal RFA and another 9 patients liver (n = 5) and renal (n = 4) RFA. Asymptomatic procedural hypertension that returned to the baseline by injecting calcium blocker was found in 7 (38.9%) of 18 patients. The incidence of procedural hypertension was significantly higher in the adrenal ablation group (66.7%, 6/9) than in the nonadrenal ablation group (11.1%, 1/9, P < 0.0498). Procedural systolic blood pressure was significantly correlated with serum epinephrine (R{sup 2} = 0.68, P < 0.0001) and norepinephrine (R{sup 2} = 0.72, P < 0.0001) levels during RFA. The other adrenal hormones did not show correlation with procedural systolic blood pressure. Conclusion: Hypertension occurs frequently during adrenal RFA because of the release of catecholamine.

  9. Radiofrequency turbinoplasty for nonallergic rhinitis in geriatric patients.

    Science.gov (United States)

    Yu, Myeong Sang; Kang, Sung-Ho; Kim, Bo-Hyung; Lim, Dae Jun; Kim, Jong-Yeup

    2015-01-01

    Radiofrequency (RF) turbinoplasty may be effective in treating nonallergic rhinitis in elderly patients. The present study evaluated the efficacy of nasal turbinate surgery with RF for the treatment of nonallergic rhinitis in elderly patients refractory to medical therapy. A total of 35 consecutive patients older than 65 years of age (mean subject age, 75.5 ± 9.6 [standard deviation] years) with nonallergic rhinitis refractory to medical therapy who underwent RF turbinate surgery were enrolled in this study. The efficacy of RF turbinoplasty in treating nonallergic rhinitis in elderly patients was evaluated by using rhinoscopy and a visual analog scale score of nasal symptoms. The response rate of primary RF turbinate surgery for nonallergic rhinitis refractory to medical therapy was 68.6%. Postoperative symptom scores for rhinorrhea and nasal obstruction were significantly improved. Persistent crust formation developed in seven patients (20.0%). No patient experienced major complications (e.g., septal hematoma, abscess, septal perforation), but partial bone necrosis was observed in one patient. RF turbinoplasty appeared to be effective for treating some nonallergic rhinitis symptoms in elderly patients, including rhinorrhea and nasal obstruction. These preliminary results are encouraging and warrant further investigation.

  10. Bilateral Intra-Articular Radiofrequency Ablation for Cervicogenic Headache

    Directory of Open Access Journals (Sweden)

    Charles A. Odonkor

    2017-01-01

    Full Text Available Introduction. Cervicogenic headache is characterized by unilateral neck or face pain referred from various structures such as the cervical joints and intervertebral disks. A recent study of patients with cervical pain showed significant pain relief after cervical medial branch neurotomy but excluded patients with C1-2 joint pain. It remains unclear whether targeting this joint has potential for symptomatic relief. To address this issue, we present a case report of C1-2 joint ablation with positive outcomes. Case Presentation. A 27-year-old female presented with worsening cervicogenic headache. Her pain was 9/10 by visual analog scale (VAS and described as cramping and aching. Pain was localized suboccipitally with radiation to her jaw and posterior neck, worse on the right. Associated symptoms included clicking of her temporomandibular joint, neck stiffness, bilateral headaches with periorbital pain, numbness, and tingling. History, physical exam, and diagnostic studies indicated localization to the C1-2 joint with 80% decrease in pain after C1-2 diagnostic blocks. She underwent bilateral intra-articular radiofrequency ablation of the C1-C2 joint. Follow-up at 2, 4, 8, and 12 weeks showed improved function and pain relief with peak results at 12 weeks. Conclusion. Clinicians may consider C1-C2 joint ablation as a viable long-term treatment option for cervicogenic headaches.

  11. Image-guided percutaneous disc sampling: impact of antecedent antibiotics on yield

    International Nuclear Information System (INIS)

    Agarwal, V.; Wo, S.; Lagemann, G.M.; Tsay, J.; Delfyett, W.T.

    2016-01-01

    Aim: To evaluate the effect of antecedent antimicrobial therapy on diagnostic yield from percutaneous image-guided disc-space sampling. Materials and methods: A retrospective review of the electronic health records of all patients who underwent image-guided percutaneous sampling procedures for suspected discitis/osteomyelitis over a 5-year period was performed. One hundred and twenty-four patients were identified. Demographics, medical history, and culture results were recorded as well as duration of presenting symptoms and whether antecedent antibiotic therapy had been administered. Results: Of the 124 patients identified who underwent image-guided percutaneous disc-space sampling, 73 had received antecedent antibiotic treatment compared with 51 who had not. The overall positive culture rate for the present study population was 24% (n=30). The positive culture rate from patients previously on antibiotics was 21% (n=15) compared with 29% (n=15) for patients who had not received prior antibiotic treatment, which is not statistically significant (p=0.26). Eighty-six percent (n=63) of patients who had antecedent antibiotics received treatment for 4 or more days prior to their procedure, whereas 14% (n=10) received treatment for 1–3 days prior to their procedure. The difference in culture positivity rate between these two groups was not statistically significant (p=0.43). Culture results necessitated a change in antibiotic therapy in a third of the patients who had received antecedent antibiotic therapy. Conclusion: Antecedent antibiotic therapy, regardless of duration, did not result in significantly diminished diagnostic yield from percutaneous sampling for suspected discitis/osteomyelitis. The present results suggest that percutaneous biopsy may nonetheless yield positive diagnostic information despite prior antimicrobial therapy. If the diagnostic information may impact choice of therapeutic regimen, percutaneous biopsy should still be considered in cases where

  12. Safety and feasibility of percutaneous skin closure using purse-string suture compared with compression bandage after pulmonary vein isolation.

    Science.gov (United States)

    Akkaya, Ersan; Berkowitsch, Alexander; Zaltsberg, Sergej; Deubner, Nikolas; Greiss, Harald; Hain, Andreas; Hamm, Christian W; Sperzel, Johannes; Neumann, Thomas; Kuniss, Malte

    2017-09-01

    This observational study was designed to analyze the safety and feasibility of percutaneous skin closure using a purse-string suture and compare it with the use of a compression bandage after pulmonary vein isolation. A total of 407 patients undergoing pulmonary vein isolation (217 with radiofrequency and 190 with cryoballoon ablation) were treated with either purse-string sutures or compression bandages. The purse-string suture was applied after ablation before withdrawal of the sheaths. Patients were on bed rest for 6 hours prior to suture removal, which was accomplished 18-24 h after ablation. The compression bandage was applied after sheath withdrawal and was removed after 12 hours of bed rest. We analyzed the occurrence of any vascular or thromboembolic complication as well as hospital costs and hospital stay length after ablation. The incidence of vascular complications after compression bandage was higher than after purse-string suture in the cryoballoon and radiofrequency group (P string suture. Percutaneous skin closure with a purse-string suture has the clinical impact to reduce vascular complications, hospital costs, and hospital stay length after pulmonary vein isolation. © 2017 Wiley Periodicals, Inc.

  13. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  14. Percutaneous transhepatic recanalization of malignant hilarobstruction: A possible rescue for early failure of endoscopic y-stenting

    International Nuclear Information System (INIS)

    Kwon, Hoon; Kim, Chang Won; Lee, Tae Hong; Kim, Dong Uk; Jeon, Ung Bae; Kang, Dae Hwan

    2013-01-01

    Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting. Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage. Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days. In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.

  15. Percutaneous balloon dilatation for benign hepaticojejunostomy strictures

    NARCIS (Netherlands)

    Vos, P. M.; van Beek, E. J.; Smits, N. J.; Rauws, E. A.; Gouma, D. J.; Reeders, J. W.

    2000-01-01

    BACKGROUND: Percutaneous balloon dilatation of biliary tract strictures is generally accepted as a safe and inexpensive procedure. The effectiveness in selected groups of patients remains under discussion. The purpose of this study was to evaluate the results of percutaneous balloon dilatation in

  16. Atrio-ventricular conduction following radiofrequency ablation for atrio-ventricular node reentry tachycardia in children.

    Science.gov (United States)

    Kantoch, Michal J; Atallah, Joseph; Soni, Reeni N

    2010-07-01

    The study was designed to assess atrio-ventricular (AV) conduction with non-invasive methods at least 1 year after radiofrequency ablation (RFA) of the slow pathway for AV node reentry tachycardia. Medical records of all patients who underwent RFA before their 18th birthday were reviewed. Patients were brought back for clinical evaluation, an electrocardiogram, an exercise stress test, and ambulatory Holter monitoring. Radiofrequency ablation of the slow pathway above the ostium of the coronary sinus was done in 106 children. No procedure resulted in high degree AV block. Follow-up evaluation was possible in 67 patients (63% of the total cohort) who were brought back to the clinic 1-13.7 years, mean 4.7+/-3.0 years after the procedure. Dizzy spells were reported by 36% of examined patients and 2 patients reported syncope. PR intervals were normal in all but two patients when compared with published normal values. One patient presented with persistent, post-procedural first-degree AV block and another developed new onset, symptomatic second degree AV block 2 years after the procedure and required pacemaker implantation. Non-invasive testing showed normal PR intervals in a cohort of patients who underwent RFA of the slow pathway in childhood or adolescence. Late AV block occurred in one child. Clinical evaluation more than a year after the procedure is warranted in symptomatic patients.

  17. Safety Outcomes After Percutaneous Transcatheter Closure of Patent Foramen Ovale.

    Science.gov (United States)

    Merkler, Alexander E; Gialdini, Gino; Yaghi, Shadi; Okin, Peter M; Iadecola, Costantino; Navi, Babak B; Kamel, Hooman

    2017-11-01

    We sought to evaluate the real-world rate of safety outcomes after patent foramen ovale (PFO) closure in patients with ischemic stroke or transient ischemic attack (TIA). We performed a retrospective cohort study using administrative claims data on all hospitalizations from 2005 to 2013 in New York, California, and Florida. Using International Classification of Diseases, Ninth Revision, Clinical Modification codes, we identified patients who underwent percutaneous transcatheter PFO closure within 1 year of ischemic stroke or TIA. Our outcome was an adverse event occurring during the hospitalization for PFO closure, defined as in prior studies as atrial fibrillation or flutter, cardiac tamponade, pneumothorax, hemothorax, a vascular access complication, or death. Crude rates were reported with exact confidence intervals. We identified 1887 patients who underwent PFO closure after ischemic stroke or TIA. The rate of any adverse outcome during the hospitalization for PFO closure was 7.0% (95% confidence interval [CI], 5.9%-8.2%). Rates of adverse outcomes varied by age and type of preceding cerebrovascular event. In patients >60 years of age, the rate of adverse outcomes was 10.9% (95% CI, 8.6%-13.6%) versus 4.9% (95% CI, 3.8%-6.3%) in patients ≤60 years of age. The rate of adverse outcomes was 9.9% (95% CI, 7.3%-12.5%) in patients with preceding ischemic stroke versus 5.9% (95% CI, 4.7%-7.1%) after TIA. Approximately 1 in 14 patients who underwent percutaneous transcatheter PFO closure after ischemic stroke or TIA experienced a serious periprocedural adverse outcome or death. The risk of adverse outcomes was highest in older patients and in those with preceding ischemic stroke. © 2017 American Heart Association, Inc.

  18. Percutaneous vertebroplasty (pv): indications, contraindications, and technique

    International Nuclear Information System (INIS)

    Hoffmann, R.T.; Jakobs, T.F.; Wallnoefer, A.; Reiser, M.F.; Helmberger, T.K.

    2003-01-01

    Percutaneous vertebroplasty (pv) is a worldwide increasingly performed interventional therapeutic procedure. This article addresses indications, patient preparation, technical requirements and approach as well as possible complications of percutaneous vertebroplasty. Percutaneous vertebroplasty is a technique consisting in an injection of bone cement into a vertebral body under imaging guidance. This procedure is performed to relief pain and support the mechanical stability in partially collapsed vertebral bodies. In the management of spinal compression fractures secondary to osteoporosis, myeloma, osteolytic metastases and aggressive hemangiomas, percutaneous vertebroplasty yields analgesic effect, and provides additional fortification in weakened segments of the vertebral column. Contraindications include major bleeding disorders, radicular pain and pain caused by compression of the myelon. Percutaneous vertebroplasty results in prompt pain relief and rapid rehabilitation. In experienced hands, using correct technique, pv is a safe and effective procedure for treating pain, caused either by osteoporotic or malignant vertebral compression fractures. (orig.) [de

  19. Study of DSA-guided percutaneous puncture location of foramen oval

    International Nuclear Information System (INIS)

    Zhao Xiaojun; He Jiawei; Bai Guanghui; Shi Jianjing; Xu Chongyong; Zhan Gonghao

    2008-01-01

    Objective: To study the technique of digital substraction angiography (DSA)-guided percutaneous puncture location of foramen oval. Methods: 39 cases of trigeminal neuralgia were included in the study from Feb. 2004 to Oct. 2006. The patients were punctured by the amending anterior position. The f0ramen oval was displayed by moving the tube tilted 20-28 degree to the caudal and 16-23 degree to the healthy side. The direction and depth of the needles was determined on the lateral view. Then, radio-frequency thermocoagulation therapy was performed. Results: The needles were located in oval foramen in all the patients. Pain disappeared in 36 cases, alleviated in other cases, and no serious complication occurred during therapy. Conclusions: Oval foramen locations by DSA can improve the successful rate of operation. The foramen oval can be clearly displayed by DSA-guided in amending position, with comfortable position for patients. (authors)

  20. Surgical resection versus radiofrequency ablation in treatment of small hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    HE Xiuting

    2013-08-01

    Full Text Available ObjectiveTo compare clinical efficacy and recurrence between surgical resection and radiofrequency ablation (RFA in the treatment of small hepatocellular carcinoma (HCC. MethodsThe clinical data of 97 patients with small HCC, who underwent surgical resection or RFA as the initial treatment in The First Hospital of Jilin University from January 2002 to December 2008, were collected. Sixty-three cases, who survived 2 years after treatment, were followed up; of the 63 cases, 34 underwent surgical resection, and 29 underwent RFA. The recurrence of these patients was analyzed retrospectively. The measurement data were analyzed by chi-square test. The Cox regression analysis was used for determining the risk factors for recurrence. The log-rank test was used for disease-free survival (DFS difference analysis. ResultsThe 3-month, 1-year, and 2-year intrahepatic recurrence rates for the patients who underwent surgical resection were 15%, 38%, and 64%, respectively, versus 21%, 35%, and 45% for those who underwent RFA, without significant differences between the two groups of patients. The intrahepatic recurrence after initial treatment was not significantly associated with treatment method, sex, age, Child-Pugh grade, tumor size, number of nodules, presence of cirrhosis, and alpha-fetoprotein level. There was no significant difference in DFS between the two groups of patients. ConclusionRFA produces a comparable outcome to that by surgical resection in the treatment of small HCC. RFA holds promise as a substitute for surgical resection.

  1. [The percutaneous absorption of diclofenac].

    Science.gov (United States)

    Riess, W; Schmid, K; Botta, L; Kobayashi, K; Moppert, J; Schneider, W; Sioufi, A; Strusberg, A; Tomasi, M

    1986-07-01

    The percutaneous absorption of diclofenac diethylammonium 1.16% (w/w) in a combination of emulsion cream and gel (Voltaren Emulgel) and of diclofenac sodium 1% (w/w) in a cream formulation (Voltaren cream) was investigated in guinea-pig, rabbit and man. The percutaneous absorption of diclofenac sodium in guinea-pig was 3 to 6% of the dose when the cream formulation in doses of 320, 100 or 40 mg was applied on 10 cm2 of occluded skin and left in place for 6 h. The transdermal delivery of 14C-labelled diclofenac yielded plateau plasma concentrations of radiotracer from 1.5 h after application until removal of the residual cream. Subsequently the steady state drug depots in the skin and muscle tissue were depleted promptly. During daily administration the steady state levels in the muscle tissue in proximity to the application site were about 3 times higher than in distant muscle tissue. By topical application on knee joints of rabbits diclofenac penetrated into the patellar ligament, the adipose corpus and the synovial fluid. In man the percutaneous absorption was 6% of the dose when the Emulgel formulation was spread by 5 mg/cm2 and left for 12 h on non-occluded skin. The pattern of metabolites of diclofenac in human urine was the same after topical and oral administration. In man, upon daily topical administration of 3 times 2.5 g cream formulation (10 mg/cm2) the diclofenac steady state plasma levels were 20 to 40 nmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Severe equinus deformity after radiofrequency-induced calf muscle reduction.

    Science.gov (United States)

    Lim, Kyung Sup; Shim, Jong Sup; Sung, Ki Sun; Koh, Kyung Hwan; Kim, Jung Hwan

    2013-08-01

    Radiofrequency-induced calf muscle volume reduction is a commonly used method for cosmetic shaping of the lower leg contour. Functional disabilities associated with the use of the radiofrequency (RF) technique, with this procedure targeting the normal gastrocnemius muscle, still have not been reported. However, the authors have experienced several severe ankle equinus cases after RF-induced calf muscle volume reduction. This study retrospectively reviewed 19 calves of 12 patients who showed more than 20° of fixed equinus even though they underwent physical therapy for more than 6 months. All were women with a mean age of 32 years (range, 23-41 years). Of the 12 patients, 7 were bilateral. All the patients received surgical Achilles lengthening for deformity correction. To evaluate the clinical outcome, serial ankle dorsiflexion was measured, and the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the latest follow-up visit. The presence of soleus muscle involvement and an ongoing lesion that might affect the postoperative results of preoperative magnetic resonance imaging (MRI) were investigated. Statistical analysis was conducted to analyze preoperative factors strongly associated with patient clinical outcomes. The mean follow-up period after surgery was 18.6 months (range, 12-28 months). At the latest follow-up visit, the mean ankle dorsiflexion was 9° (range, 0-20°), and the mean AOFAS score was 87.7 (range, 80-98). On preoperative MRI, 13 calves showed soleus muscle involvement. Seven calves had ongoing lesions. Five of the ongoing lesions were muscle edema, and the remaining two lesions were cystic mass lesions resulting from muscle necrosis. Ankle dorsiflexion and AOFAS scores at the latest follow-up evaluation were insufficient in the ongoing lesions group. Although RF-induced calf muscle reduction is believed to be a safer method than conventional procedures, careful handling is needed because of the side effects that may

  3. Level of Radiofrequency (RF) Radiations from GSM Base Stations ...

    African Journals Online (AJOL)

    Levels of radiofrequency radiations around two global systems for mobile communication (GSM) base stations located in the vicinity of a residential quarter and workplace complex were measured. The effects of the radiofrequency radiations on albino mice placed in exposure cages and located around the base stations ...

  4. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Cosedis Nielsen, Jens; Johannessen, Arne; Raatikainen, Pekka

    2012-01-01

    There are limited data comparing radiofrequency catheter ablation with antiarrhythmic drug therapy as first-line treatment in patients with paroxysmal atrial fibrillation.......There are limited data comparing radiofrequency catheter ablation with antiarrhythmic drug therapy as first-line treatment in patients with paroxysmal atrial fibrillation....

  5. Endoscopic ultrasound-guided radiofrequency ablation of the pancreas

    DEFF Research Database (Denmark)

    Silviu, Ungureanu Bogdan; Daniel, Pirici; Claudiu, Mărgăritescu

    2015-01-01

    ultrasound (EUS)-guided radiofrequency ablation (RFA) probe through a 19G needle in order to achieve a desirable necrosis area in the pancreas. Radiofrequency ablation of the head of the pancreas was performed on 10 Yorkshire pigs with a weight between 25 kg and 35 kg and a length of 40-70 cm. Using an EUS...

  6. 77 FR 43535 - Grantee Codes for Certified Radiofrequency Equipment

    Science.gov (United States)

    2012-07-25

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 2 Grantee Codes for Certified Radiofrequency Equipment AGENCY: Federal Communications... radiofrequency (RF) devices under part 2 of its rules. This program is one of the primary means that the...

  7. 21 CFR 882.4400 - Radiofrequency lesion generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiofrequency lesion generator. 882.4400 Section 882.4400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... lesion generator. (a) Identification. A radiofrequency lesion generator is a device used to produce...

  8. Clinical review: Percutaneous dilatational tracheostomy

    Science.gov (United States)

    Al-Ansari, Mariam A; Hijazi, Mohammed H

    2006-01-01

    As the number of critically ill patients requiring tracheotomy for prolonged ventilation has increased, the demand for a procedural alternative to the surgical tracheostomy (ST) has also emerged. Since its introduction, percutaneous dilatational tracheostomies (PDT) have gained increasing popularity. The most commonly cited advantages are the ease of the familiar technique and the ability to perform the procedure at the bedside. It is now considered a viable alternative to (ST) in the intensive care unit. Evaluation of PDT procedural modifications will require evaluation in randomized clinical trials. Regardless of the PDT technique, meticulous preoperative and postoperative management are necessary to maintain the excellent safety record of PDT. PMID:16356203

  9. Recent Advances in Percutaneous Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Erem Kaan Basok

    2014-05-01

    Full Text Available The continuous innovations in technology, instrumentations, and techniques allow urologists to perform percutaneous nephrolithotomy (PCNL with increasing efficacy. Although recent advances have facilitated the procedure, some steps are still challenging. A thorough review of the recent urologic literature was performed to identify these improvements in PCNL technique. The newer developments mainly focused on multimodal imaging techniques, miniaturisation of instruments, tracking and navigation systems during access to the stone, and robotic systems. Further studies are necessary to better define the benefits of these new fruitful developments which remain an active research field.

  10. Percutaneous drainage of lung abscesses

    International Nuclear Information System (INIS)

    van Sonnenberg, E.; D'Agostino, H.; Casola, G.; Vatney, R.R.; Wittich, G.R.; Harker, C.

    1989-01-01

    The authors performed percutaneous drainage of lung abscesses in 12 patients. Indications for drainage were septicemia and persistence or worsening of radiographic findings. These lung abscesses were refractory to intravenous antibiotics and to bronchial toilet. Etiology of the abscesses included pneumonia (most frequently), trauma, postoperative development, infected necrotic neoplasm, and infected sequestration. Guidelines for drainage included passage of the catheter through contiguously abnormal lung and pleura, inability of the patient to cough, and/or bronchial obstruction precluding bronchial drainage. Cure was achieved in 11 of 12 patients. Catheters were removed on an average of 16 days after insertion. Antibiotics were administered an average of 18 days before drainage. No major complications occurred

  11. Realtime ultrasound guided percutaneous tracheostomy in emergency setting: the glass ceiling has been broken.

    Science.gov (United States)

    Ravi, Parli Raghavan; Vijai, M N; Shouche, Sachin

    2017-01-01

    In recent years ultrasound guided percutaneous tracheostomy (USPCT) has become a routine practice in critical care units. Its safety and superiority over conventional percutaneous tracheostomy and bronchoscopic guided PCT is proven to be non-inferior in elective cases. However its role in emergency percutaneous tracheostomy has never been studied, since percutaneous tracheostomy itself remains an enigma in accessing emergency airway. There is no report of use of ultrasound guided percutaneous tracheostomy in emergency setting so far in the literature. We report our early experience with USPCT in emergency setting. Sixteen adult patients who required access to an emergency surgical airway after failure to accomplish emergency oro-tracheal intubation were the study population. Their airway was accessed by USPCT. Recorded data included clinical and demographic data including time taken to perform the procedure and complications. Short term and long term follow ups for a period of 2 years were done for the survivors. Twelve male and four female patients underwent the procedure and the average time of the procedure was 3.6 min with no failures nor conversions to surgical tracheostomy and no complications. The average oxygen saturation was 86% and average Glasgow coma scale was 8.4. This time period included the oxygen insufflation time. 10 patients were decannulated while six patients died due to the pathology of the disease itself. There were no complications in either short term or long term follow up. USPCT has a definitive role in emergency both in trauma and non-trauma setting. It is safe, feasible and faster in experienced hands. Use of USPCT in emergency setting has further narrowed the list of contraindications of percutaneous tracheostomy.

  12. Role of percutaneous abscess drainage in the management of young patients with Crohn disease

    Energy Technology Data Exchange (ETDEWEB)

    Pugmire, Brian S. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Gee, Michael S. [Massachusetts General Hospital for Children, Department of Radiology, Boston, MA (United States); Massachusetts General Hospital, Division of Abdominal Imaging, Boston, MA (United States); Kaplan, Jess L.; Winter, Harland S. [Massachusetts General Hospital for Children, Department of Pediatrics, Boston, MA (United States); Hahn, Peter F.; Gervais, Debra A. [Massachusetts General Hospital, Division of Abdominal Imaging, Boston, MA (United States); Doody, Daniel P. [Massachusetts General Hospital for Children, Department of Surgery, Boston, MA (United States)

    2016-05-15

    Intra-abdominal abscess is a common complication of Crohn disease in children. Prior studies, primarily in adults, have shown that percutaneous abscess drainage is a safe and effective treatment for this condition; however, the data regarding this procedure and indications in pediatric patients is limited. Our aim was to determine the success rate of percutaneous abscess drainage for abscesses related to Crohn disease in pediatric patients with a focus on treatment endpoints that are relevant in the era of biological medical therapy. We retrospectively reviewed 25 cases of patients ages ≤20 years with Crohn disease who underwent percutaneous abscess drainage. Technical success was defined as catheter placement within the abscess with reduction in abscess size on post-treatment imaging. Clinical success was defined as (1) no surgery within 1 year of drainage or (2) surgical resection following drainage with no residual abscess at surgery or on preoperative imaging. Multiple clinical parameters were analyzed for association with treatment success or failure. All cases were classified as technical successes. Nineteen cases were classified as clinical successes (76%), including 7 patients (28%) who required no surgery within 1 year of percutaneous drainage and 12 patients (48%) who had elective bowel resection within 1 year. There was a statistically significant association between resumption of immunosuppressive therapy within 8 weeks of drainage and both clinical success (P < 0.01) and avoidance of surgery after 1 year (P < 0.01). Percutaneous abscess drainage is an effective treatment for Crohn disease-related abscesses in pediatric patients. Early resumption of immunosuppressive therapy is statistically associated with both clinical success and avoidance of bowel resection, suggesting a role for percutaneous drainage in facilitating prompt initiation of medical therapy and preventing surgical bowel resection. (orig.)

  13. Direct percutaneous radiologic jejunostomy (PR)and duodenostomy: a retrospective analysis

    International Nuclear Information System (INIS)

    Rieker, O.; Pitton, M.; Herber, S.; Vomweg, T.; Teifke, A.; Dueber, C.

    2005-01-01

    Purpose: To present our experience with direct percutaneous radiologic duodenostomy and jejunostomy (PRJ) for alimentation. Materials and Methods: A retrospective study identified 24 patients who had undergone percutaneous jejunostomy or duodenostomy guided by CT and fluoroscopy over a period of 9 years. Whenever possible, the jejunum was inflated with a 5 French diagnostic catheter and jejunopexy was performed using Cope anchors (T-fasteners). A 12 to 14 French locking pigtail drain was inserted for alimentation. In 8 patients, percutaneous direct jejunostomy was performed using only fluoroscopy. In 9 patients, both CT and fluoroscopy were used to guide the jejunostomy. In all 7 patients who underwent duodenostomy, a combination of CT and fluoroscopy was used. The reports were reviewed for complications and the technical success rate. The technical success rate was determined. Results: Percutaneous radiologic jejunostomy was attempted in 17 patients and failed in 5 patients. PRJ was successful in all 8 procedures guided by fluoroscopy and in 4 of 9 procedures guided by CT and fluoroscopy. Direct percutaneous duodenostomy guided by CT and fluoroscopy was successful in all 7 cases. There were no procedure-related laparotomies and no mortality related to the jejunostomy. Minor complications were infection of the abdominal wall (n=1), lingering pain requiring a new jejunostomy (n=1) and aspiration because of persistent reflux (n=1). Conclusion: PRJ is a safe procedure even in critically ill patients. It is technically difficult and may fail if the jejunum cannot be distended. Percutaneous radiologic duodenostomy and jejunostomy are recommended for prolonged alimentation of malnourished patients following esophageal or gastric surgery. (orig.)

  14. Role of percutaneous abscess drainage in the management of young patients with Crohn disease

    International Nuclear Information System (INIS)

    Pugmire, Brian S.; Gee, Michael S.; Kaplan, Jess L.; Winter, Harland S.; Hahn, Peter F.; Gervais, Debra A.; Doody, Daniel P.

    2016-01-01

    Intra-abdominal abscess is a common complication of Crohn disease in children. Prior studies, primarily in adults, have shown that percutaneous abscess drainage is a safe and effective treatment for this condition; however, the data regarding this procedure and indications in pediatric patients is limited. Our aim was to determine the success rate of percutaneous abscess drainage for abscesses related to Crohn disease in pediatric patients with a focus on treatment endpoints that are relevant in the era of biological medical therapy. We retrospectively reviewed 25 cases of patients ages ≤20 years with Crohn disease who underwent percutaneous abscess drainage. Technical success was defined as catheter placement within the abscess with reduction in abscess size on post-treatment imaging. Clinical success was defined as (1) no surgery within 1 year of drainage or (2) surgical resection following drainage with no residual abscess at surgery or on preoperative imaging. Multiple clinical parameters were analyzed for association with treatment success or failure. All cases were classified as technical successes. Nineteen cases were classified as clinical successes (76%), including 7 patients (28%) who required no surgery within 1 year of percutaneous drainage and 12 patients (48%) who had elective bowel resection within 1 year. There was a statistically significant association between resumption of immunosuppressive therapy within 8 weeks of drainage and both clinical success (P < 0.01) and avoidance of surgery after 1 year (P < 0.01). Percutaneous abscess drainage is an effective treatment for Crohn disease-related abscesses in pediatric patients. Early resumption of immunosuppressive therapy is statistically associated with both clinical success and avoidance of bowel resection, suggesting a role for percutaneous drainage in facilitating prompt initiation of medical therapy and preventing surgical bowel resection. (orig.)

  15. Ultrasound-guided radiofrequency thermal ablation of normal kidney in a rabbit model: correlation with CT and histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Won; Lee, Jeong Min; Kin, Chong Soo; Lee, Sang Hun [College of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2002-01-01

    To assess the feasibility and safety of using a cooled-tip electrode to perform percutaneous radiofrequency ablation of kidney tissue in rabbits, and to evaluate the ability of CT to reveal the appearance and extent of tissue necrosis during follow-up after ablation. Using ultrasound guidance, a 17-G cooled-tip electrode was inserted into the right lower portion of the kidney in 26 New Zealand White rabbits. Radiofrequency was applied for 2 mins, and biphasic helical CT scanning was used to assess tissue destruction and the presence or absence of complications immediately after the procedure and at 24 hrs, 2 and 3 days, and 1,2,3,4,5,6 and 7 weeks. The study had three phases: acute (immediately killed : N=10); subacute (killed at 24 hrs (n=3), 2 days (n=3), 3 days (n=1) : N=7); chronic (killed at 1 week (n=4), 2 weeks (n=2), 4 weeks (n=1), 7 weeks (n=1): N=8). After the animals were killed, their kidneys were histopathologically examined and the radiologic and pathologic findings of lesion size and configuration were correlated. In each instance, ultrasound-guided radiofrequency ablations of the lower pole of the kidney were technically successful. Contrast-enhanced biphasic helical CT revealed regions of hypoattenuation devoid of parenchymal enhancement, and these correlated closely with true pathologic lesion size (r=0.884; p>0.05). In subacute and chronic models, CT scanning revealed gradual spontaneous resorption of the ablated lesion and the presence of perilesional calcification. Histopathologically, in the acute phase the ablated lesion showed coagulative necrosis and infiltration of inflammatory cells, and in the chronic phase there was clear cut necrosis of glomeruli, tubules and renal interstitium, with diminishing inflammatory response and peripheral fibrotic tissue formation. Ultrasound-guided renal radiofrequency ablation is technically feasible and safe. In addition, the avascular lesion measured at contrast-enhanced helical CT closely correlated with

  16. Ultrasound-guided radiofrequency thermal ablation of normal kidney in a rabbit model: correlation with CT and histopathology

    International Nuclear Information System (INIS)

    Kim, Sang Won; Lee, Jeong Min; Kin, Chong Soo; Lee, Sang Hun

    2002-01-01

    To assess the feasibility and safety of using a cooled-tip electrode to perform percutaneous radiofrequency ablation of kidney tissue in rabbits, and to evaluate the ability of CT to reveal the appearance and extent of tissue necrosis during follow-up after ablation. Using ultrasound guidance, a 17-G cooled-tip electrode was inserted into the right lower portion of the kidney in 26 New Zealand White rabbits. Radiofrequency was applied for 2 mins, and biphasic helical CT scanning was used to assess tissue destruction and the presence or absence of complications immediately after the procedure and at 24 hrs, 2 and 3 days, and 1,2,3,4,5,6 and 7 weeks. The study had three phases: acute (immediately killed : N=10); subacute (killed at 24 hrs (n=3), 2 days (n=3), 3 days (n=1) : N=7); chronic (killed at 1 week (n=4), 2 weeks (n=2), 4 weeks (n=1), 7 weeks (n=1): N=8). After the animals were killed, their kidneys were histopathologically examined and the radiologic and pathologic findings of lesion size and configuration were correlated. In each instance, ultrasound-guided radiofrequency ablations of the lower pole of the kidney were technically successful. Contrast-enhanced biphasic helical CT revealed regions of hypoattenuation devoid of parenchymal enhancement, and these correlated closely with true pathologic lesion size (r=0.884; p>0.05). In subacute and chronic models, CT scanning revealed gradual spontaneous resorption of the ablated lesion and the presence of perilesional calcification. Histopathologically, in the acute phase the ablated lesion showed coagulative necrosis and infiltration of inflammatory cells, and in the chronic phase there was clear cut necrosis of glomeruli, tubules and renal interstitium, with diminishing inflammatory response and peripheral fibrotic tissue formation. Ultrasound-guided renal radiofrequency ablation is technically feasible and safe. In addition, the avascular lesion measured at contrast-enhanced helical CT closely correlated with

  17. 65. Impact of focused echocardiography in clinical decision of patients presented with STMI, underwent primary percutenouse angioplasty

    Directory of Open Access Journals (Sweden)

    M. Qasem

    2016-07-01

    Full Text Available Echocardiography in coronary artery diseases is an essential, routine echocardiography prior to primary percutaneous angioplasty is not clear. In our clinical practice in primary angioplasty we faced lots of complications either before or during or after the procedure. Moreover, lots of incidental findings that discovered after the procedure which if known will affect the plan of management. One-hundred-nineteen consecutive underwent primary angioplasty. All patients underwent FE prior to the procedure in catheterization lab while the patient was preparing for the procedure. FE with 2DE of LV at base, mid and apex, and apical stander views. Diastology grading, E/E′ and color doppler of mitral and aortic valve were performed. (N = 119 case of STMI were enrolled, mean age 51 ± 12 year. Eleven cases (9.2% had normal coronary and normal LV function. Twenty cases (17% of MI complication detected before the procedures: RV infarction 8.4% (5.1% asymptomatic and 3.3% symptomatic, ischemic MR (8.4%, LV apical aneurysm (0.8%, significant pericardial effusion (0.80%. Acute pulmonary edema in 17 cases (14.3%: six cases (5.1% developed acute pulmonary edema on the cath lab with grade 3 diastolic dysfunction and E/E ′  >20, 9 cases (7.6% develop acute pulmonary edema in CCU with grade 2–3 diastolic dysfunction and E/E′ 15–20. 2 cases (2.7% develop acute pulmonary in CCU with grade 1–2 diastolic dysfunction and E/E′ 9–14. One case (0.8% presented cardiac tamponade 2 h post PCI. Incidental finding not related to STMI were as follow: 2 cases (1.7% with severe fibro degenerative MR, 2 cases (1.7% with mild to moderate AR and 2 cases (1.7% with mild to moderate AS. Isoled CABG 5/4.2% and CABG and MVR 2/1.7%. FE play an important role in guiding the management, early detection the incidental findings and complication post PCI.

  18. Percutaneous Closure of 2 Paravalvular Leaks and a Gerbode Defect after Mitral Valve Replacement for Infective Endocarditis.

    Science.gov (United States)

    Peñalver, Jorge; Shatila, Wassim; Silva, Guilherme V

    2017-04-01

    Surgical valve replacement after infective endocarditis can result in local destructive paravalvular lesions. A 30-year-old woman with infective endocarditis underwent mitral valve replacement that was complicated postoperatively by 2 paravalvular leaks. During percutaneous closure of the leaks, a Gerbode defect was also found and closed. We discuss our patient's case and its relation to others in the relevant medical literature. To our knowledge, we are the first to describe the use of a percutaneous approach to close concomitant paravalvular leaks and a Gerbode defect.

  19. Subclavian steal syndrome: treatment by percutaneous transluminal angioplasty; Sindrome do roubo da subclavia: tratamento por angioplastia transluminar percutanea

    Energy Technology Data Exchange (ETDEWEB)

    Abath, Carlos Gustavo Coutinho [Instituto de Medicina e Cirurgia, Recife, PE (Brazil)]|[Hospital Memorial Sao Jose, Recife, PE (Brazil); Silva, Marcos Antonio Barbosa da [Instituto de Medicina e Cirurgia, Recife, PE (Brazil); Brito, Norma Maria Tenorio [Hospital Memorial Sao Jose, Recife, PE (Brazil); Marques, Silvio Romero; Santa Cruz, Rodolfo [Pernambuco Univ., Recife, PE (Brazil). Hospital das Clinicas; Henrique, Darcy [Real Hospital Portugues, Recife, PE (Brazil)

    1995-09-01

    The subclavian steal syndrome is a rare vascular disease that can be managed by interventional radiology. It is presented the experience with three cases of this syndrome that underwent percutaneous transluminal angioplasty, and a brief literature review is done. Two patients remained asymptomatic 23 and 30 months, respectively, after the procedure. One patient presented with recurrent symptoms 12 months after the dilatation. Considering the low morbidity and good clinical and technical results, percutaneous transluminal angioplasty is the first choice in the subclavian steal syndrome treatment. (author). 9 refs., 3 figs.

  20. Predicting Infected Bile Among Patients Undergoing Percutaneous Cholecystostomy

    International Nuclear Information System (INIS)

    Beardsley, Shannon L.; Shlansky-Goldberg, Richard D.; Patel, Aalpen; Freiman, David B.; Soulen, Michael C.; Stavropoulos, S. William; Clark, Timothy W.I.

    2005-01-01

    Purpose. Patients may not achieve a clinical benefit after percutaneous cholecystostomy due to the inherent difficulty in identifying patients who truly have infected gallbladders. We attempted to identify imaging and biochemical parameters which would help to predict which patients have infected gallbladders. Methods. A retrospective review was performed of 52 patients undergoing percutaneous cholecystostomy for clinical suspicion of acute cholecystitis in whom bile culture results were available. Multiple imaging and biochemical variables were examined alone and in combination as predictors of infected bile, using logistic regression. Results. Of the 52 patients, 25 (48%) had infected bile. Organisms cultured included Enterococcus, Enterobacter, Klebsiella, Pseudomonas, E. coli, Citrobacter and Candida. No biochemical parameters were significantly predictive of infected bile; white blood cell count >15,000 was weakly associated with greater odds of infected bile (odds ratio 2.0, p = NS). The presence of gallstones, sludge, gallbladder wall thickening and pericholecystic fluid by ultrasound or CT were not predictive of infected bile, alone or in combination, although a trend was observed among patients with CT findings of acute cholecystitis toward a higher 30-day mortality. Radionuclide scans were performed in 31% of patients; all were positive and 66% of these patients had infected bile. Since no patient who underwent a radionuclide scan had a negative study, this variable could not be entered into the regression model due to collinearity. Conclusion. No single CT or ultrasound imaging variable was predictive of infected bile, and only a weak association of white blood cell count with infected bile was seen. No other biochemical parameters had any association with infected bile. The ability of radionuclide scanning to predict infected bile was higher than that of ultrasound or CT. This study illustrates the continued challenge to identify bacterial cholecystitis

  1. Radiofrequency: an update on latest innovations.

    Science.gov (United States)

    Sadick, Neil S; Malerich, Sarah A; Nassar, Amer H; Dorizas, Andrew S

    2014-11-01

    As the aging population in our society continues to grow, new technologies and procedures promising a more youthful appearance are continuously sought. The utilization of radiofrequency technology remains a novel method for the treatment of many aesthetic and medical dermatological indications. Innovative applications are constantly identified, expanding treatment options for various patient concerns including aging of the hands, cellulite, non-invasive lipolysis, and postpartum skin laxity. Non-invasive treatments are ideal for busy patients seeking minimal recovery time and so called lunch-time procedures. Furthermore, new developments in treatment devices enhance efficacy while decreasing patient discomfort.

  2. Radiofrequency Energy and Electrode Proximity Influences Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation Lesion Size: An In Vitro Study with Clinical Correlation.

    Science.gov (United States)

    Staudt, Michael D; Maturu, Sarita; Miller, Jonathan P

    2018-02-16

    Radiofrequency thermocoagulation of epileptogenic foci via stereoelectroencephalography (SEEG) electrodes has been suggested as a treatment for medically intractable epilepsy, but reported outcomes have been suboptimal, possibly because lesions generated using conventional high-energy radiofrequency parameters are relatively small. To describe a technique of delivering low energy across separate SEEG electrodes in order to create large confluent radiofrequency lesions. The size and configuration of radiofrequency lesions using different radiofrequency intensity and interelectrode distance was assessed in egg whites. Magnetic resonance images (MRI) from 3 patients who had undergone radiofrequency lesion creation were evaluated to determine the contribution of lesion intensity and electrode separation on lesion size. Electroencephalography, MRI, and clinical data were assessed before and after lesion creation. Both in Vitro and in Vivo analysis revealed that less energy paradoxically produced larger lesions, with the largest possible lesions produced when radiofrequency power was applied for long duration at less than 3 W. Linear separation of electrodes also contributed to lesion size, with largest lesions produced when electrodes were separated by a linear distance of between 5 and 12 mm. Clinical lesions produced using these parameters were large and resulted in improvement in interictal and ictal activity. Radiofrequency lesions produced using low-energy delivery between SEEG electrodes in close proximity can produce a large lesion. These findings might have advantages for treatment of focal epilepsy.

  3. Percutaneous Nephrolithotomy under Spinal Anesthesia with Marcaine

    Directory of Open Access Journals (Sweden)

    S.M.R. Rabani

    2010-01-01

    Full Text Available Introduction & Objective: The efficacy of Percutaneous Nephrolithotomy (PCNL in the treatment of renal stones has been proven in its indications. The main method of anesthesia in this procedure is general anesthesia. We used spinal anesthesia (SA as an alternative method of anesthesia with many benefits. This study was intended to show the possibility of SA as a more comfortable method of anesthesia for the surgeon , the anesthesiologist and the patient via more cooperation of the patient during changing the position and prevention of some complications mostly in upper extremities and neck. Materials & Methods: In a prospective clinical trial study, a total of 112 patients underwent PCNL under SA with marcaine , from Nov 2004 till Feb 2009. Their mean age was 36 years (22-48, at first the syringe was stained by epinephrine and then 2 -3.5 ml marcaine was used for SA and addition of analgesics , sedatives or both., if needed. The rest of the procedure was done as routine.Results: Stone clearance was achieved in 82% of the patients and the rest were managed by ESWL. The mean operation time was 126 minutes (90-220, 36% of the patients needed sedation, analgesia, or both, specially those with bigger stones. 6% of the patients had upper pole stones .Blood transfusion was needed only in one patient. No significant complication was observed in this study.Conclusion: PCNL under SA afforded the surgeon and the anesthesiologist the opportunity of more patient cooperation during position changes and precludes some morbidities that may happen under general anesthesia because the patient is awake and able to portend.

  4. Percutaneous laser ablation of unresectable primary and metastatic adrenocortical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Pacella, Claudio M. [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)], E-mail: claudiomaurizio.pacella@fastwebnet.it; Stasi, Roberto; Bizzarri, Giancarlo; Pacella, Sara; Graziano, Filomena Maria; Guglielmi, Rinaldo; Papini, Enrico [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)

    2008-04-15

    Purpose: To evaluate the feasibility, safety, and clinical benefits of percutaneous laser ablation (PLA) in patients with unresectable primary and metastatic adrenocortical carcinoma (ACC). Patients and methods: Four patients with hepatic metastases from ACC and a Cushing's syndrome underwent ultrasound-guided PLA. In one case the procedure was performed also on the primary tumor. Results: After three sessions of PLA, the primary tumor of 15 cm was ablated by 75%. After 1-4 (median 1) sessions of PLA, five liver metastases ranging from 2 to 5 cm were completely ablated, while the sixth tumor of 12 cm was ablated by 75%. There were no major complications. Treatment resulted in an improvement of performance status and a reduction of the daily dosage of mitotane in all patients. The three patients with liver metastases presented a marked decrease of 24-h urine cortisol levels, an improved control of hypertension and a mean weight loss of 2.8 kg. After a median follow-up after PLA of 27.0 months (range, 9-48 months), two patients have died of tumor progression, while two other patients remain alive and free of disease. Conclusions: Percutaneous laser ablation is a feasible, safe and well tolerated procedure for the palliative treatment of unresectable primary and metastatic ACC. Further study is required to evaluate the impact of PLA on survival.

  5. Effectiveness of percutaneous closure of patent foramen ovale for hypoxemia.

    Science.gov (United States)

    Fenster, Brett E; Nguyen, Bryant H; Buckner, J Kern; Freeman, Andrew M; Carroll, John D

    2013-10-15

    The aim of this study was to evaluate the ability of percutaneous patent foramen ovale (PFO) closure to improve systemic hypoxemia. Although PFO-mediated right-to-left shunt (RTLS) is associated with hypoxemia, the ability of percutaneous closure to ameliorate hypoxemia is unknown. Between 2004 and 2009, 97 patients who underwent PFO closure for systemic hypoxemia and dyspnea that was disproportionate to underlying lung disease were included for evaluation. All patients exhibited PFO-mediated RTLS as determined by agitated saline echocardiography. Procedural success was defined as implantation of a device without major complications and mild or no residual shunt at 6 months. Clinical success was defined as a composite of an improvement in New York Heart Association (NYHA) functional class, reduction of dyspnea symptoms, or decreased oxygen requirement. Procedural success was achieved in 96 of 97 (99%), and clinical success was achieved in 68 of 97 (70%). The presence of any moderate or severe interatrial shunt by agitated saline study (odds ratio [OR] = 4.7; p gender (OR = 0.30; p <0.017) decreased the likelihood of success. In conclusion, based on the largest single-center experience of patients referred for PFO closure for systemic hypoxemia, PFO closure was a mechanically effective procedure with an associated improvement in echocardiographic evidence of RTLS, NYHA functional class, and oxygen requirement. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Pediatric Percutaneous Osteoid Osteoma Ablation: Cone-Beam CT with Fluoroscopic Overlay Versus Conventional CT Guidance.

    Science.gov (United States)

    Perry, Brandon C; Monroe, Eric J; McKay, Tyler; Kanal, Kalpana M; Shivaram, Giridhar

    2017-10-01

    To compare technical success, clinical success, complications, radiation dose, and total room utilization time for osteoid osteoma thermal (radiofrequency or microwave) ablation using cone-beam computed tomography (CBCT) with two-axis fluoroscopic navigational overlay versus conventional computed tomography (CT) guidance. A retrospective review was performed to identify all osteoid osteoma ablations performed over a 5.5-year period at a single tertiary care pediatric hospital. Twenty-five ablations (15 radiofrequency and 10 microwave) in 23 patients undergoing fluoroscopic CBCT-guided osteoid osteoma ablation were compared to 35 ablations (35 radiofrequency) in 32 patients undergoing ablation via conventional CT guidance. Dose area product and dose length product were recorded for CBCT and conventional CT, respectively, and converted to effective doses. Technical success, clinical success (cessation of pain and medication use 1 month after ablation), complications, radiation dose, and total room utilization time were compared. All procedures were technically successful. Twenty-two of 25 (88.0%) CBCT and 31 of 35 (88.6%) conventional CT-guided ablations achieved immediate clinical success. There were two minor complications in each group and no major complications. Mean effective radiation dose was significantly lower for CBCT compared to CT guidance (0.12 vs. 0.39 mSv, p = 0.02). Mean total room utilization time for CBCT was longer (133.5 vs. 97.5 min, p = 0.0001). Fluoroscopic CBCT guidance for percutaneous osteoid osteoma ablation yields similar technical and clinical success, reduced radiation dose, and increased total room utilization time compared to conventional CT guidance.

  7. Long-term outcomes of percutaneous lumbar facet synovial cyst rupture

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ambrose J.; Bos, Stijn A.; Torriani, Martin; Simeone, F.J.; Chang, Connie Y.; Pomerantz, Stuart R.; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2017-01-15

    To evaluate the therapeutic value, safety, and long-term clinical outcomes of percutaneous lumbar facet synovial cyst (LFSC) rupture. Our study was institutional review board (IRB)-approved and Health Insurance Portability and Accountability Act (HIPAA)-compliant. The study group comprised 71 patients (44 women, mean age: 65 ± 17 years) who underwent CT- or fluoroscopy-guided percutaneous LFSC rupture. The technical success of LFSC rupture, the long-term clinical outcome, including repeat procedures or surgery, and imaging findings on MRI and CT were recorded. Seventy-nine LFSC ruptures were performed in 71 patients. CT guidance was used in 57 cases and fluoroscopy guidance in 22 cases. LFSC rupture was technically successful in 58 out of 79 cases (73 %). Mean injection volume for cyst rupture was 3.6 ± 2.2 mL and a combination of steroid and anesthetic was injected in all cases. Over a mean follow-up time of 44 months, 12 % of patients underwent repeat cyst rupture, and 46 % eventually underwent surgery, whereas the majority of patients (55 %) experienced symptomatic relief and did not undergo surgery. There was no significant association between a successful outcome and age, sex, level, or size of LFSC (p > 0.1). LFSCs with T2 hypointensity were more likely to require surgery (p = 0.02). There was one complication, a bacterial skin infection that completely resolved following antibiotic therapy. Percutaneous LFSC rupture is an effective and safe nonsurgical treatment option for LFSC. More than half of treated patients were able to avoid subsequent surgery. Therefore, percutaneous LFSC rupture should be considered before surgical intervention. (orig.)

  8. The novel echo-guided ProGlide technique during percutaneous transfemoral transcatheter aortic valve implantation.

    Science.gov (United States)

    Honda, Yohsuke; Araki, Motoharu; Yamawaki, Masahiro; Tokuda, Takahiro; Tsutumi, Masakazu; Mori, Shinsuke; Sakamoto, Yasunari; Kobayashi, Norihiro; Hirano, Keisuke; Ito, Yoshiaki

    2018-04-01

    The aim of this study was to assess clinical benefit of the Echo-guided ProGlide technique in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI). The efficacy of the Echo-guided ProGlide technique during percutaneous TF-TAVI was not previously clarified. A total of 121 consecutive patients who underwent percutaneous TF-TAVI at our institution between February 2014 and July 2017 were enrolled in this study. According to the introduction of this novel technique in March 2016, patients were divided into two groups (echo-guided group who underwent TAVI from March 2016 to July 2017, n = 63; not echo-guided group who underwent TAVI from February 2014 to February 2016, n = 58). The incidence of major vascular complications, defined per the Valve Academic Research Consortium-2 criteria, and ProGlide complications including acute femoral artery stenosis or occlusion and bleeding requiring any intervention. The incidence of major vascular complication and ProGlide complication were significantly lower in the echo-guided group than in not echo-guided group (1.6% vs 17.2%, P guided ProGlide technique was independently associated with prevention of ProGlide complications (odds ratio, 0.11; 95% confidential interval, 0.01-0.76; P = 0.03). This novel Echo-guided ProGlide technique was associated with a lower rate of major vascular complications, particularly ProGlide complications during percutaneous TF-TAVI. © 2017, Wiley Periodicals, Inc.

  9. A sheath model for arbitrary radiofrequency waveforms

    Science.gov (United States)

    Turner, M. M.; Chabert, Pascal

    2012-10-01

    The sheath is often the most important region of a rf plasma, because discharge impedance, power absorption and ion acceleration are critically affected by the behaviour of the sheath. Consequently, models of the sheath are central to any understanding of the physics of rf plasmas. Lieberman has supplied an analytical model for a radio-frequency sheath driven by a single frequency, but in recent years interest has been increasing in radio-frequency discharges excited by increasingly complex wave forms. There has been limited success in generalizing the Lieberman model in this direction, because of mathematical complexities. So there is essentially no sheath model available to describe many modern experiments. In this paper we present a new analytical sheath model, based on a simpler mathematical framework than that of Lieberman. For the single frequency case, this model yields scaling laws that are identical in form to those of Lieberman, differing only by numerical coefficients close to one. However, the new model may be straightforwardly solved for arbitrary current waveforms, and may be used to derive scaling laws for such complex waveforms. In this paper, we will describe the model and present some illustrative examples.

  10. Radiofrequency Thermotherapy for Treating Axillary Hyperhidrosis.

    Science.gov (United States)

    Schick, Christoph H; Grallath, Tanja; Schick, Kerstin S; Hashmonai, Moshe

    2016-05-01

    Thermotherapy has been established between conservative and surgical options as a minimally invasive method for the treatment of axillary hyperhidrosis. The objective of this study was to present radiofrequency thermotherapy (RFTT) as a safe and effective new treatment method. Thirty adult patients with pronounced axillary hyperhidrosis were treated with RFTT with noninsulated microneedles 3 times at intervals of 6 weeks. Subjective improvement was rated using the Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI). Satisfaction and estimated reduction of sweating were monitored. Objective measurements were made using gravimetry. Adverse effects were recorded in follow-up. At the 6-month follow-up, improvement in sweating was seen in 27 patients. The HDSS dropped from 3.4 to 2.1, the DLQI improved significantly from 16 to 7. The gravimetric measurements of sweat were reduced from 221 to 33 mg/min. The average reduction of sweating was reported to be 72%. Adverse effects were generally mild and improved rapidly. Radiofrequency thermotherapy was shown to be an effective and minimally invasive treatment option for axillary hyperhidrosis. Patients described their sweating as normal. The method clearly has the potential to normalize axillary sweating.

  11. Radiofrequency spark chambers and delay line resonators

    International Nuclear Information System (INIS)

    Sayag, Jacques

    1971-01-01

    According to a suggestion of A. Kastler, a spark chamber was excited by an undamped radiofrequency pulse and tracks about 1 mm wide obtained; the result was interpreted by computation of the coefficients of electronic amplification and partial ambipolar diffusion. This work led us to the construction of a new fast triggering undamped wave-train generator of very high tension (patent taken out by the C.E.A. under the no.: EN 7 134 650 the 27.9.1971). Since this apparatus uses a resonant storage line, its design implied a precise knowledge of high impedance delay lines. The experimental radiofrequency spectra of the input impedance of opened or short-circuited lines were plotted completely and analysed by the circuits theory, new measuring methods were established, dispersion relations accurately checked and the equivalence of the formulas, within the third order, with theses of Debye's Dipolar Absorption demonstrated. General properties of Hilbert's transform were also investigated. From the experimental point of view, the electromagnetic energy storage process was extended to the case of a liquid nitrogen-immersed resonant delay line. The good behavior of the cryogenic experiment, where the main difficulty of icing was overcame by the construction of special electrodes, offers great promise for extrapolation to superconductivity. (author) [fr

  12. Percutaneous transcatheter sclerotherapy of oophoritic cysts

    International Nuclear Information System (INIS)

    Huang Youhua; Xu Qiang; Sun Jun; Shen Tao; Shi Hongjian; Tang Qingfang; Chen Qiying; Zhou Mingxia; Li Hongyao

    2005-01-01

    Objective: To evaluate the clinical value of percutaneous transcatheter sclerotherapy in oophoritic cysts. Methods: Seventy six oophoritic cysts incluoling 48 simple and 28 chocolate cysts of 64 patients were treated with percutaneous transcatheter sclerotherapy under CT guidance. 4F multisideholes pigtail catheter was introduced into cyst using absolute alcohol as sclerosing agents. Results: The successful rate of percutaneous oophoritc cyst puncture was 100% in all 64 patients. Among them 58 were cured (90.6%), 6 improved significantly (9.4%). The total effective rate reached 100% with no serious complications. Conclusions: Catheterization sclerotherapy for oophoritic cyst is a simple, complete, safe and effective method. (authors)

  13. Analysis of Recurrence Management in Patients Who Underwent Nonsurgical Treatment for Acute Appendicitis

    Science.gov (United States)

    Liang, Tsung-Jung; Liu, Shiuh-Inn; Tsai, Chung-Yu; Kang, Chi-Hsiang; Huang, Wei-Chun; Chang, Hong-Tai; Chen, I-Shu

    2016-01-01

    Abstract The recurrence rate for acute appendicitis treated nonoperatively varies between studies. Few studies have adequately evaluated the management of these patients when appendicitis recurs. We aimed to explore the recurrence rate and management of patients with acute appendicitis that were first treated nonoperatively. We identified patients in the Taiwan National Health Insurance Research Database who were hospitalized due to acute appendicitis for the first time between 2000 and 2010 and received nonsurgical treatment. The recurrence and its management were recorded. Data were analyzed to access the risk factors for recurrence and factors that influenced the management of recurrent appendicitis. Among the 239,821 patients hospitalized with acute appendicitis for the first time, 12,235 (5.1%) patients were managed nonoperatively. Of these, 864 (7.1%) had a recurrence during a median follow-up of 6.5 years. Appendectomy was performed by an open and laparoscopic approach in 483 (55.9%) and 258 (29.9%) patients, respectively. The remaining 123 (14.2%) patients were again treated nonsurgically. Recurrence was independently associated with young age, male sex, percutaneous abscess drainage, and medical center admission by multivariable analysis. In addition, age appendicitis, percutaneous abscess drainage, nor length of first time hospital stay had an influence on the selection of surgical approach. In conclusion, a laparoscopic appendectomy can be performed in recurrent appendicitis cases, and its application may not be related to previous appendicitis severity. PMID:27015200

  14. Percutaneous Biopsy of Retrobulbar Masses: Anatomical Considerations and MRI Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Edalat, Faramarz, E-mail: faramarz.edalat@gmail.com; Cazzato, Roberto Luigi; Garnon, Julien; Tsoumakidou, Georgia [Nouvel Hôpital Civil (Hôpitaux Universitaires de Strasbourg, HUS), Department of Interventional Radiology (France); Avérous, Gerlinde [CHU Strasbourg Hautepierre, Department of Pathology (France); Caudrelier, Jean; Koch, Guillaume; Gangi, Afshin [Nouvel Hôpital Civil (Hôpitaux Universitaires de Strasbourg, HUS), Department of Interventional Radiology (France)

    2017-04-15

    PurposeObtaining adequate tissue from retrobulbar masses remains a challenge. To this end, a new method of retrobulbar mass biopsy using MRI guidance is presented.Materials and MethodsTwo patients (7- and 71-year-old male) with indeterminate retrobulbar masses underwent bioptic and cytological samplings using MR-compatible 18G and 20–22G needles, and multi-planar MR fluoroscopy. An inferior approach was taken to avoid injury to the optic nerve and ophthalmic arteries.ResultsThe two biopsies were completed without complication. The core biopsy resulted in a final diagnosis, whereas the cytological sampling was non-diagnostic.ConclusionPercutaneous MR-guided retrobulbar mass biopsy proved to be feasible and safe in the two cases described in this report.

  15. ANTERIOR PERCUTANEOUS CERVICAL DISCECTOMY. TWO-YEAR FOLLOW-UP OF A BLUNT TECHNIQUE PROCEDURE

    Directory of Open Access Journals (Sweden)

    Jorge Felipe Ramírez León

    Full Text Available ABSTRACT Objective: To report the outcomes of non-endoscopic percutaneous cervical discectomy by anterior blunt approach for the treatment of degenerative disc disease. Methods: A review of the medical records of patients with axial cervical pain resulting from degenerative disc disease and treated with discectomy and percutaneous nucleoplasty by anterior blunt approach with radiofrequency source was carried out. The data were evaluated according to modified MacNab and pre- and postoperative VAS criteria at 3, 12 and 24 months. Results: Sixty-two procedures were performed in 48 patients between 2008 and 2014. The mean age of the population was 52.4 years. MacNab results were 84.6%, 92.3%, and 89.2% improvement (excellent and good results at 3, 12 and 24 months, respectively. The VAS changed from 7.4 to 2.3 two years after the procedure, showing a statistically significant difference (p=0.000. There were no major complications or re-interventions related to the technique. Conclusions: Anterior non-endoscopic discectomy and nucleoplasty for the treatment of discogenic axial cervical pain may be an effective alternative to open surgery. In the two-year follow-up, our blunt technique proved to be a safe procedure with no approach-related complications, and provided outcomes comparable to those reported using the original needle technique.

  16. Gallbladder Cryoablation: Proof of Concept in a Swine Model for a Percutaneous Alternative to Cholecystectomy

    Energy Technology Data Exchange (ETDEWEB)

    McGregor, Hugh C. J., E-mail: hugh.mcgregor@ucsf.edu; Saeed, Maythem, E-mail: maythem.saeed@ucsf.edu; Surman, Andrew, E-mail: andrew.surman@ucsf.edu; Ehman, Eric C., E-mail: eric.ehman@ucsf.edu; Hetts, Steven W., E-mail: steven.hetts@ucsf.edu; Wilson, Mark W., E-mail: mark.wilson@ucsf.edu; Conrad, Miles B., E-mail: miles.conrad@ucsf.edu [University of California San Francisco, Department of Radiology and Biomedical Imaging (United States)

    2016-07-15

    PurposeTo investigate the feasibility of percutaneous gallbladder cryoablation (GBC) under CT guidance in a swine model with histopathologic correlation.Materials and MethodsInstitutional Animal Care and Use Committee approval was obtained for this study protocol. Five pigs underwent GBC. Under CT guidance, 3–4 cryoprobes were positioned percutaneously at the gallbladder margins. Thermocouple probes were placed percutaneously at the gallbladder fundus, neck, free wall, and gallbladder fossa. Two freeze–thaw cycles ranging from 10 to 26 min were performed. The subjects were sacrificed 5 h after cryoablation. The gallbladder and bile ducts were resected, stained, and examined microscopically.ResultsGBC was completed in all subjects. A 10-mm ablation margin was achieved beyond all gallbladder walls. Thermocouple probes reached at least −20 °C. Intra-procedural body temperature decreased to a minimum of 35 °C but recovered after the procedure. Intra- and post-procedural vital signs otherwise remained within physiologic parameters. Non-target ablation occurred in the stomach and colon of the first two subjects. Histology demonstrated complete denudation of the gallbladder epithelium, hemorrhage, and edema within the muscularis layer, and preservation of the microscopic architecture of the common bile duct in all cases.ConclusionPercutaneous gallbladder cryoablation is feasible, with adequate ablation margins obtained and histologic changes demonstrating transmural necrosis. Adjacent structures included in the ablation may require conservative ablation zones, hydrodissection, or continuous saline lavage.

  17. EMG-Guided Percutaneous Placement of Cement-Augmented Pedicle Screws for Osteoporotic Thoracolumbar Burst Fractures.

    Science.gov (United States)

    Iacopino, Domenico Gerardo; Certo, Francesco; Graziano, Francesca; Basile, Luigi; Gulì, Carlo; Visocchi, Massimiliano; Conti, Alfredo; Maugeri, Rosario

    2017-01-01

    Percutaneous techniques have increasingly gained popularity in recent years. The application of technological innovation, including neuromonitoring techniques, has the potential to increase the safety and efficacy of these procedures. Thirty patients suffering from osteoporotic dorsolumbar burst fracture were prospectively enrolled in this study. The patients underwent percutaneous fenestrated pedicle screw fixation augmented with polymethylmethacrylate (PMMA) injection. A novel surgeon-dedicated neuromonitoring device was used in order to increase the safety and the accuracy of the screw insertion. A second group of 30 patients who did not undergo neuromonitoring during percutaneous pedicle screw placement, matched for demographic characteristics, constituted the control group. A total of 296 screws were inserted. All treated patients had a good outcome, documented by an improvement in visual analogue scale (VAS) scores. Excellent trajectories were achieved in all patients. Cobb's angle and anterior vertebral height were satisfactorily restored in all study group patients. Three misplaced screws in three patients and a case of PMMA leakage without neurological deficits were observed in the control group, whereas no complication was recorded in the study group (p = 0.03). Neuromonitoring in cement-augmented percutaneous pedicle screw placement appears to improve surgeon confidence during surgery, reducing the risk of screw misplacement or cement leakage.

  18. Delayed rupture of the extensor hallucis longus and extensor digitorum communis tendons after breaching the anterior capsule with a radiofrequency probe during ankle arthroscopy: a case report.

    Science.gov (United States)

    Tuncer, Serdar; Aksu, Neslihan; Isiklar, Ugur

    2010-01-01

    A 40-year-old man with early arthritis, loose bodies, and anterolateral joint impingement symptoms in his left ankle, which was refractory to noninvasive therapeutic modalities for 1 year, underwent ankle arthroscopy and radiofrequency thermal ablation. The anterior capsule of the ankle joint was breached by the radiofrequency probe while the loose bodies were removed from the anterior recess, exposing the extensor tendons and resulting in a delayed spontaneous rupture of the extensor hallucis longus tendon and extensor tendons to the second and third toes. The extensor hallucis longus tendon was repaired with a semitendinosus tendon graft, and extensor digitorum tendons underwent primary repair. The patient regained full function and was symptom free 1 year after surgery. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Contribution of computed tomography guided percutaneous drainage of tuberculous cold abscesses adjunctive to pharmaceutical anti-tubercular treatment

    International Nuclear Information System (INIS)

    Tsagouli, Paraskevi; Sotiropoulou, Evagelia; Filippousis, Petros; Sidiropoulou, Nektaria; Georgiadi, Vithleem; Thanos, Loukas

    2012-01-01

    Purpose: To determine the efficiency and safety of the percutaneous aspiration and drainage of rare touberculous cold abscesses under CT guidance. Materials and methods: We retrospectively studied 63 cases of 44 patients, treated in our hospital during the last two years. They suffered from tuberculous infection complicated with tuberculous cold abscesses variously located. All these patients underwent percutaneous aspiration and drainage under CT imaging, following the trocar puncture technique. The catheter remained in place for about a week. A follow up CT scan was performed in all cases before the catheter removal. Some of the patients were under anti tuberculosis medication. Results: All the patients had a successful recovery from the abscesses. There were no major or minor complications observed. No recurrence occurred until today. Conclusion: CT guided percutaneous aspiration and drainage of tuberculous cold abscesses is a safe, minimal invasive and effective method of treatment. Drainage and specific antituberculosis therapy leads to a satisfactory conclusion.

  20. Glyburide increases risk in patients with diabetes mellitus after emergent percutaneous intervention for myocardial infarction - A nationwide study

    DEFF Research Database (Denmark)

    Jorgensen, C. H.; Gislason, G. H.; Bretler, D.

    2011-01-01

    Danish patients receiving glucose-lowering drugs admitted with myocardial infarction between 1997 and 2006 who underwent emergent percutaneous coronary intervention were identified from national registers. Multivariable Cox proportional hazards models were used to analyze the risk of cardiovascular......BACKGROUND: Sulfonylureas have been linked to an increased cardiovascular risk by inhibition of myocardial preconditioning. Whether individual sulfonylureas affect outcomes in diabetic patients after emergent percutaneous coronary intervention for myocardial infarction is unknown. METHODS: All...... mellitus undergoing emergent percutaneous coronary intervention after myocardial infarction. Early reperfusion therapy is the mainstay in modern treatment of myocardial infarction and the time may have come to discard glyburide in favour of sulfonylureas that do not appear to confer increased...

  1. Percutaneous penetration studies for risk assessment

    DEFF Research Database (Denmark)

    Sartorelli, Vittorio; Andersen, Helle Raun; Angerer, Jürgen

    2000-01-01

    . In order to predict the systemic risk of dermally absorbed chemicals and to enable agencies to set safety standards, data is needed on the rates of percutaneous penetration of important chemicals. Standardization of in vitro tests and comparison of their results with the in vivo data could produce...... internationally accepted penetration rates and/or absorption percentages very useful for regulatory toxicology. The work of the Percutaneous Penetration Subgroup of EC Dermal Exposure Network has been focussed on the standardization and validation of in vitro experiments, necessary to obtain internationally...... accepted penetration rates for regulatory purposes. The members of the Subgroup analyzed the guidelines on percutaneous penetration in vitro studies presented by various organizations and suggested a standardization of in vitro models for percutaneous penetration taking into account their individual...

  2. Percutaneous treatment of liver hydatid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan; Oezmen, Mustafa N

    1999-10-01

    Hydatic disease caused by Echinococcus granulosus is an endemic disease and an important public health problem in some countries of the world. The results of surgical treatment are associated with a high rate of mortality, morbidity, postoperative recurrence and a long period of hospital stay and the medical treatment results are still controversial. Although the percutaneous aspiration and treatment of liver hydatid cysts were considered to be contraindicated due to risks of anaphylactic shock and dissemination of clear-crystal fluid into the abdomen, several reports of successful percutaneous treatment of liver hydatid cysts have been published in the literature. Today, percutaneous treatment of liver hydatid cysts is the most effective and reliable treatment procedure in the selected cases. In this review, indications, contraindications, method and techniques, healing criteria, complications, results and importance of the percutaneous treatment of liver hydatid cysts are discussed.

  3. Percutaneous ablation of the gallbladder

    International Nuclear Information System (INIS)

    Saini, S.; Mueller, P.R.; Girard, M.; Lee, M.J.; Goldberg, M.; Brink, J.A.; Flotte, T.J.; Ribiero, R.; Ferrucci, J.T.

    1990-01-01

    This paper examines the feasibility of using Holmium: yttrium-aluminum-garnet (YAG) laser to permanently obliterate the cystic duct and then using chemical sclerosants to ablate the gallbladder mucosa. Percutaneous cholecystostomy was performed in 30 domestic pigs. The cystic duct was cannulated and while the laser fiber was withdrawn at a rate of 0.5 cm/sec, pulsed laser energy (10 Hz) was delivered. Animals were sacrificed immediately (n = 7), at 72 hours (n = 4), and 6 weeks (n = 19). In the 6-week group, gallbladder sclerosis (95% alcohol plus sodium tetradecyl sulfate) was performed in 13 animals immediately after occluding the cystic duct. Control animals were included in each group

  4. Left main percutaneous coronary intervention.

    Science.gov (United States)

    Teirstein, Paul S; Price, Matthew J

    2012-10-23

    The introduction of drug-eluting stents and advances in catheter techniques have led to increasing acceptance of percutaneous coronary intervention (PCI) as a viable alternative to coronary artery bypass graft (CABG) for unprotected left main disease. Current guidelines state that it is reasonable to consider unprotected left main PCI in patients with low to intermediate anatomic complexity who are at increased surgical risk. Data from randomized trials involving patients who are candidates for either treatment strategy provide novel insight into the relative safety and efficacy of PCI for this lesion subset. Herein, we review the current data comparing PCI with CABG for left main disease, summarize recent guideline recommendations, and provide an update on technical considerations that may optimize clinical outcomes in left main PCI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Percutaneous drainage of tuberculous abscesses

    International Nuclear Information System (INIS)

    Puri, S.K.; Panicker, H.; Narang, P.; Kumar, N.; Dhall, A.; Gupta, S.B.

    2001-01-01

    To assess the role of percutaneous catheter drainage (PCD) in the management of tuberculous ilio-psoas abscesses, twenty-two patients with 26 tuberculous ilio-psoas abscesses were subjected to PCD under real time US guidance taking help of a pre-procedure CT for planning the route of catheter insertion. Complete cure of the ilio-psoas abscesses could be achieved in 22 of 26 abscesses (84.6%). Average duration of drainage was 10 days. US/ CT follow-up ranged from 3-24 months. PCD was a failure in four abscesses (15.4%). Two patients, one with bilateral abscesses, had recurrent abscesses while one patient had an abscess associated with extensive spondylo-discitis. No significant complication was encountered in the study. PCD is a simple, safe and very effective (success rate 84.6%) alternative to surgical drainage in the management of tuberculous ilio-psoas abscesses. (author)

  6. [Percutanous dilation tracheotomy: our experience].

    Science.gov (United States)

    Domènech, I; Mateu, T; Cisa, E; Juan, A; Gil, E; Palau, M; Dicenta, M

    2004-01-01

    Percutaneous dilation Tracheotomy (PDT) is becoming a popular alternative to surgical tracheotomy. In our hospital, we recently adopted the use of the PDT in intensive care unit patients. The objective [corrected] of this investigation is to characterize and quantify the rate of complications for PDT. A prospective study of 60 PDT performed at different intesive care units, betweem September 2002 to July 2003. The intraoperative time for PDT was 8 minutes. Complications included 6 cases of mild intraoperative hemorrhage, 1 case of moderate intraoperative hemorrhage, 4 cases of mild postoperative hemorrhage and 1 case of subcutaneous emphysema. PDT is a good alternative to surgical tracheotomy and should be added to the otolaryngologists armamentarium of surgical airway procedures.

  7. Percutaneous transluminal angioplasty in arteriosclerosis

    International Nuclear Information System (INIS)

    Chung, Soo Young; Cha, In Ho

    1984-01-01

    Percutaneous transluminal angioplasty (PTA) is a non-operative therapeutic procedure to the dilation of stenosis or to the recanalization of occlusion in atherosclerotic arteries using of dilatation catheters. PTA was performed 37 times in 34 patients with arteriosclerotic for 1 year and 4 months from March, 1982 to June, 1983 at department of radiology, Klinikum Barmen/west Germany. The results were as follows; 1. The male to female ratio was 2 : 1 and peak age range was from 61 to 70. 2. The most common indication was clinical stage II b with 19 cases (51.3%). 3. PTA was performed most commonly in superficial femora artery in 25 cases (67.5%). 4. Acute major complication occurred in 2 cases (5.4%). PTA is a alternative or complementary therapeutic procedure to vascular surgery.

  8. Bivalirudin in percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Sam J Lehman

    2006-12-01

    Full Text Available Sam J Lehman, Derek P ChewDepartment of Medicine, Flinders University, South Australia, AustraliaAbstract: Bivalirudin is a member of the direct thrombin inhibitor group of anticoagulants. It has been evaluated as an alternative to unfractionated and low-molecular-weight heparins in the settings of percutaneous coronary intervention (PCI and acute coronary syndrome (ACS. Results of clinical trials to date suggest bivalirudin is a viable alternative to the use of a heparin combined with a glycoprotein (GP IIb/IIIa inhibitor in these settings. Thrombin has a central role in coagulation and platelet activation in ACS and during PCI. Its direct inhibition is an attractive target for therapy in these settings. Bivalirudin is a 20 amino acid polypeptide hirudin analog. It displays bivalent and reversible binding to the thrombin molecule, inhibiting its action. Direct inhibition of thrombin with bivalirudin has theoretical pharmacokinetic and pharmacodynamic advantages over the indirect anticoagulants. A reduction in rates of bleeding without loss of anti-thrombotic efficacy has been a consistent finding across multiple clinical trials. There may be economic benefits to the use of bivalirudin if it permits a lower rate of use of the GP IIb/IIIa inhibitors. This article reviews the pharmacology of bivalirudin and clinical trial evidence to date. There are now data from multiple clinical trials and meta-analyses in the setting of ACS and PCI. Early results from the acute catheterization and urgent intervention strategy (ACUITY trial are discussed. Keywords: bivalirudin, direct thrombin inhibitor, acute coronary syndrome, percutaneous coronary intervention

  9. Treatment of wrinkles and elastosis using vacuum-assisted bipolar radiofrequency heating of the dermis.

    Science.gov (United States)

    Gold, Michael H; Goldman, Mitchel P; Rao, Jaggi; Carcamo, Alex S; Ehrlich, Michelle

    2007-03-01

    Reduction of wrinkles is increasingly becoming one of the most sought after aesthetic procedures. A variety of treatment modalities are available for this application, including radiofrequency energy in various modes of action. The goal of the reported study was to evaluate the safety and efficacy of a new device, which implements an innovative combination of bipolar radiofrequency and vacuum. Forty-six healthy adults at two clinics underwent eight facial treatments every 1 to 2 weeks. For 6 months after treatment, patients were assessed directly by two evaluators at each clinic (the treating physician and an additional reviewer) using standard evaluation tools-the Fitzpatrick-Goldman Classification of Wrinkling and Degree of Elastosis and a visual analog scale. Significant improvement in the skin's appearance and texture was observed during the treatment course and continued to increase during the follow-up period. The mean elastosis score on the wrinkling and elastosis scale before treatment was 4.5 and was reduced to less than 2.5 by 6 months after treatment, representing a drop of an entire wrinkle class (from II to I) on this scale. The reported pain levels were low, and the subjects expressed their satisfaction with the treatment and its outcome. The adverse responses consisted mainly of transient erythema and burn/blistering; there were also a few occurrences of edema, purpura, and crusting and one transient hyperpigmentation. No permanent complications had occurred. Our results demonstrate the safety and efficacy associated with use of this radiofrequency and vacuum device, employing Functional Aspiration Controlled Electrothermal Stimulation (FACES) technology, for reduction of facial wrinkles and elastosis.

  10. CT-guided radiofrequency ablation of osteoid osteoma using a novel battery-powered drill

    Energy Technology Data Exchange (ETDEWEB)

    Schnapauff, Dirk; Streitparth, Florian; Wieners, Gero; Collettini, Federico; Hamm, Bernd; Gebauer, Bernhard [Charite Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Joehrens, Korinna [Charite Universitaetsmedizin Berlin, Department of Pathology, Berlin (Germany)

    2015-05-01

    To evaluate the use of a novel battery-powered drill, enabling specimen requirement while drilling, in radiofrequency ablation of osteoid osteoma as an alternative to conventional orthopedic drills. Between 2009 and 2013, altogether 33 patients underwent CT-guided radiofrequency ablation of an osteoid osteoma at our institution. To access the nidus of the clinically and radiologically suspected osteoid osteoma, a channel was drilled using the OnControl Bone Marrow Biopsy System (OBM, Arrow OnControl, Teleflex, Shavano Park, TX, USA) and a biopsy was taken. Procedure time (i.e., drilling including local anesthesia), amount of scans (i.e., single-shot fluoroscopy), radiation exposure, and the results of biopsy were investigated and compared retrospectively to a classical approach using either a manual bone biopsy system or a conventional orthopedic drill (n = 10) after ethical review board approval. Drilling the tract into the nidus was performed without problems in 22 of the 23 OBM cases. Median procedure time was 7 min compared to 13 min using the classical approach (p < 0.001). Median amount CT scans, performed to control correct positioning of the drill was comparable with 26 compared to 24.5 (p = NS) scans. Histologically, the diagnosis of osteoid osteomas could be determined in all 17 cases where a biopsy was taken. Radiofrequency ablation could be performed without problems in any case. The use of the battery-powered drill was feasible and facilitated the access to the osteoid osteoma's nidus offering the possibility to extract a specimen in the same step. (orig.)

  11. Infective endocarditis following percutaneous pulmonary valve replacement

    DEFF Research Database (Denmark)

    Cheung, Gary; Vejlstrup, Niels; Ihlemann, Nikolaj

    2013-01-01

    Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult.......Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult....

  12. Percutaneous Transabdominal Approach for the Treatment of Endoleaks after Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sun Young; Lee, Do Yun; Lee, Kwang Hun [Severance Hospital, University of Yonsei, Seoul (Korea, Republic of); Won, Jong Yun [Gangnam Severance Hospital, University of Yonsei, Seoul (Korea, Republic of); Choi, Dong Hoon; Shim, Won Heum [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    The purpose of this study was to evaluate the technical feasibility and clinical efficacy of percutaneous transabdominal treatment of endoleaks after endovascular aneurysm repair. Between 2000 and 2007, six patients with type I (n = 4) or II (n = 2) endoleaks were treated by the percutaneous transabdominal approach using embolization with N-butyl cyanoacrylate with or without coils. Five patients underwent a single session and one patient had two sessions of embolization. The median time between aneurysm repair and endoleak treatment was 25.5 months (range: 0-84 months). Follow-up CT images were evaluated for changes in the size and shape of the aneurysm sac and presence or resolution of endoleaks. The median follow-up after endoleak treatment was 16.4 months (range: 0-37 months). Technical success was achieved in all six patients. Clinical success was achieved in four patients with complete resolution of the endoleak confirmed by follow-up CT. Clinical failure was observed in two patients. One eventually underwent surgical conversion, and the other was lost to follow-up. There were no procedure-related complications. The percutaneous transabdominal approach for the treatment of type I or II endoleaks, after endovascular aneurysm repair, is an alternative method when conventional endovascular methods have failed.

  13. Potential of Radiofrequency Ablation in Combination with Immunotherapy in the Treatment of Hepatocellular Carcinoma

    Science.gov (United States)

    Li, Guangfu; Staveley-O’Carroll, Kevin F; Kimchi, Eric T

    2016-01-01

    Radiofrequency ablation (RFA) is an important treatment option for patients with early hepatocellular carcinoma (HCC). RFA offers a reliable, reproducible modality to effectively treat hepatic lesions with minimal collateral damage to the surrounding hepatic parenchyma. In addition to traditional open operative techniques, RFA can be performed percutaneously or laparoscopically to minimize the physiologic insult to the patient. Due to the concomitant hepatic damage and dysfunction that often is present in patients with HCC these factors make RFA a frequently utilized therapeutic option. However, RFA is most efficacious in treating smaller tumors (≤ 2 cm), particularly when an ablation margin of ≥ 4–5 mm can be obtained. RFA has diminishing utility in larger tumors, resulting in reduced three and five year overall survival rates when compared to surgical resection. Multimodal approaches to include RFA with other standard and investigational approaches have become a subject of recent interest. RFA capably produces cellular destruction causing liberation of a substantial amount of antigens, many of which are tumor-specific providing a favorable environment for immune recognition. We propose that utilizing an immunotherapeutic approach in conjunction with RFA is the next logical step in the treatment of HCC. In this review, we summarize how RFA modulates antitumor immunity and works in concert with immunotherapy in the treatment of HCC. The information provided is expected to help the future design of novel RFA-integrated immunotherapies which are able to generate durable and powerful antitumor immune response to achieve optimal tumor control. PMID:28042519

  14. Radiofrequency ablation in the treatment of osteoid osteoma: results and complications

    Energy Technology Data Exchange (ETDEWEB)

    Earhart, Jeffrey [Case Western Reserve University, Department of Orthopaedic Surgery, MetroHealth Medical Center, Cleveland, OH (United States); Wellman, David [Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, NY (United States); Donaldson, James [Feinberg School of Medicine at Northwestern University, Department of Medical Imaging, Ann and Robert H. Lurie Children' s Hospital of Chicago, Chicago, IL (United States); Chesterton, Julie [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States); King, Erik [Northwestern University Feinberg School of Medicine, Department of Orthopaedic Surgery, Ann and Robert H. Lurie Children' s Hospital of Chicago, Chicago, IL (United States); Janicki, Joseph A. [Northwestern University Feinberg School of Medicine, Department of Orthopaedic Surgery, Children' s Hospital of Chicago, Chicago, IL (United States); Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Orthopaedic Surgery, Chicago, IL (United States)

    2013-07-15

    Percutaneous radiofrequency ablation (RFA) for treatment of osteoid osteoma is effective and avoids the potential complications of open surgical resection. This study evaluates the efficacy of RFA at a single tertiary-care pediatric hospital and highlights an important complication. The medical records of 21 cases of RFA in 21 children between 2004 and 2010 were reviewed retrospectively for demographic data, lesion site, access point and technique for ablation, clinical outcome and complications. Clinical follow-up was available for 17/21 children (81%) at an average of 17.0 months (range 0.5-86.1 months). No persistence or recurrence of pre-procedural pain was noted. Two children (9.5%) had a complication, including a burn to the local skin and muscle requiring local wound care, and a late subtrochanteric femur fracture treated successfully with open reduction internal fixation. RFA is a safe and effective alternative to surgical resection of the osteoid osteoma nidus. When accessing the proximal femur, the risk of late post-procedural fracture must be considered and discussed with the family. An understanding of biomechanical principles in the proximal femur might provide an effective strategy for limiting this risk. (orig.)

  15. Analysis by MRI of residual tumor after radiofrequency ablation for early stage breast cancer.

    Science.gov (United States)

    Vilar, Vanessa Sales; Goldman, Suzan Menasce; Ricci, Marcos Desidério; Pincerato, Katia; Oliveira, Helio; Abud, Thiago Giansante; Ajzen, Sergio; Baracat, Edmund Chada; Szejnfeld, Jacob

    2012-03-01

    The objective of our study was to evaluate the effectiveness of MRI in the detection of possible residual lesions after radiofrequency ablation (RFA) in the treatment of breast cancer. We prospectively evaluated 14 patients who had undergone ultrasound-guided core biopsies diagnostic of invasive ductal carcinoma (IDC; range of diameters, 1.0-3.0 cm) and then ultrasound-guided percutaneous RFA with sentinel node biopsy as the primary treatment. Breast MRI was performed 1 week before RFA to evaluate tumor extension and again 3 weeks after RFA to verify the presence of possible residual lesions. Conventional surgical resection of the tumors was performed 1 week after RFA. The MRI findings were compared with histopathologic analyses to confirm the presence or absence of residual tumor. There was no residual enhancement in seven lesions on the postablation breast MRI scans. These findings were confirmed by negative histopathologic findings in the surgical specimens. The MRI scans of five patients showed small areas of irregular enhancement that corresponded to residual lesions. In the two remaining patients, we observed enhancement of almost the entire lesion, indicating that RFA had failed. Breast MRI is effective in detecting residual lesions after RFA in patients with IDC.

  16. Autofluorescence hyperspectral imaging of radiofrequency ablation lesions in porcine cardiac tissue.

    Science.gov (United States)

    Gil, Daniel A; Swift, Luther M; Asfour, Huda; Muselimyan, Narine; Mercader, Marco A; Sarvazyan, Narine A

    2017-08-01

    Radiofrequency ablation (RFA) is a widely used treatment for atrial fibrillation, the most common cardiac arrhythmia. Here, we explore autofluorescence hyperspectral imaging (aHSI) as a method to visualize RFA lesions and interlesional gaps in the highly collagenous left atrium. RFA lesions made on the endocardial surface of freshly excised porcine left atrial tissue were illuminated by UV light (365 nm), and hyperspectral datacubes were acquired over the visible range (420-720 nm). Linear unmixing was used to delineate RFA lesions from surrounding tissue, and lesion diameters derived from unmixed component images were quantitatively compared to gross pathology. RFA caused two consistent changes in the autofluorescence emission profile: a decrease at wavelengths below 490 nm (ascribed to a loss of endogenous NADH) and an increase at wavelengths above 490 nm (ascribed to increased scattering). These spectral changes enabled high resolution, in situ delineation of RFA lesion boundaries without the need for additional staining or exogenous markers. Our results confirm the feasibility of using aHSI to visualize RFA lesions at clinically relevant locations. If integrated into a percutaneous visualization catheter, aHSI would enable widefield optical surgical guidance during RFA procedures and could improve patient outcome by reducing atrial fibrillation recurrence. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. LAPAROSCOPIC NEPHRECTOMY USING RADIOFREQUENCY THERMAL ABLATION

    Directory of Open Access Journals (Sweden)

    B. Ya. Alekseev

    2012-01-01

    Full Text Available The wide use of current diagnostic techniques, such as ultrasound study, computed tomography, and magnetic resonance imaging, has led to significantly increased detection rates for disease in its early stages. This gave rise to a change in the standards for the treatment of locally advanced renal cell carcinoma (RCC. Laparoscopic nephrectomy (LN has recently become the standard treatment of locally advanced RCC in the clinics having much experience with laparoscopic surgery. The chief drawback of LN is difficulties in maintaining intraoperative hemostasis and a need for creating renal tissue ischemia. The paper gives the intermediate results of application of the new procedure of LN using radiofrequency thermal ablation in patients with non-ischemic early-stage RCC.

  18. Radiofrequency encoded angular-resolved light scattering

    DEFF Research Database (Denmark)

    Buckley, Brandon W.; Akbari, Najva; Diebold, Eric D.

    2015-01-01

    The sensitive, specific, and label-free classification of microscopic cells and organisms is one of the outstanding problems in biology. Today, instruments such as the flow cytometer use a combination of light scatter measurements at two distinct angles to infer the size and internal complexity...... of cells at rates of more than 10,000 per second. However, by examining the entire angular light scattering spectrum it is possible to classify cells with higher resolution and specificity. Current approaches to performing these angular spectrum measurements all have significant throughput limitations...... Encoded Angular-resolved Light Scattering (REALS), this technique multiplexes angular light scattering in the radiofrequency domain, such that a single photodetector captures the entire scattering spectrum from a particle over approximately 100 discrete incident angles on a single shot basis. As a proof...

  19. Emerging indications of endoscopic radiofrequency ablation

    Science.gov (United States)

    Becq, Aymeric; Camus, Marine; Rahmi, Gabriel; de Parades, Vincent; Marteau, Philippe

    2015-01-01

    Introduction Radiofrequency ablation (RFA) is a well-validated treatment of dysplastic Barrett's esophagus. Other indications of endoscopic RFA are under evaluation. Results Four prospective studies (total 69 patients) have shown that RFA achieved complete remission of early esophageal squamous intra-epithelial neoplasia at a rate of 80%, but with a substantial risk of stricture. In the setting of gastric antral vascular ectasia, two prospective monocenter studies, and a retrospective multicenter study, (total 51 patients), suggest that RFA is efficacious in terms of reducing transfusion dependency. In the setting of chronic hemorrhagic radiation proctopathy, a prospective monocenter study and a retrospective multicenter study (total 56 patients) suggest that RFA is an efficient treatment. A retrospective comparative study (64 patients) suggests that RFA improves stents patency in malignant biliary strictures. Conclusions Endoscopic RFA is an upcoming treatment modality in early esophageal squamous intra-epithelial neoplasia, as well as in gastric, rectal, and biliary diseases. PMID:26279839

  20. Optical generation of radio-frequency power

    Energy Technology Data Exchange (ETDEWEB)

    Hietala, V.M.; Vawter, G.A.; Brennan, T.M.; Hammons, B.E.; Meyer, W.J.

    1994-11-01

    An optical technique for high-power radio-frequency (RF) signal generation is described. The technique uses a unique photodetector based on a traveling-wave design driven by an appropriately modulated light source. The traveling-wave photodetector (TWPD) exhibits simultaneously a theoretical quantum efficiency approaching 100 % and a very large electrical bandwidth. Additionally, it is capable of dissipating the high-power levels required for the RF generation technique. The modulated light source is formed by either the beating together of two lasers or by the direct modulation of a light source. A system example is given which predicts RF power levels of 100`s of mW`s at millimeter wave frequencies with a theoretical ``wall-plug`` efficiency approaching 34%.

  1. Radiofrequency identification for inventory in neurointerventional practice.

    Science.gov (United States)

    Byers, Ernest; Gomez, Max A; Sheridan, Robert M; Orr, Nelson W; Hirsch, Joshua A

    2011-03-01

    Implementations of radiofrequency identification (RFID) systems within hospital settings are not unique or without controversy. To date, little consideration has been given to use of this technology in clinical interventional radiologic practice. The potential financial advantages coupled with benefits to quality and safety and increases in staff satisfaction are considerable. The authors outline these advantages by enabling readers to broadly consider the systemic perspective of implementing RFID technology with an associated vision toward downstream growth. Furthermore, the authors demonstrate the benefits of RFID technology integration in reducing cost and increasing quality assurance and the on-time delivery of services. Implementing RFID requires commitment from frontline technologist staff members to work collaboratively with management and external vendors. Ultimately, the authors believe this technology can positively influence patient care. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  2. Radio-frequency quadrupole linear accelerator

    International Nuclear Information System (INIS)

    Wangler, T.P.; Stokes, R.H.

    1980-01-01

    The radio-frequency quadrupole (RFQ) is a new linear accelerator concept in which rf electric fields are used to focus, bunch, and accelerate the beam. Because the RFQ can provide strong focusing at low velocities, it can capture a high-current dc ion beam from a low-voltage source and accelerate it to an energy of 1 MeV/nucleon within a distance of a few meters. A recent experimental test at the Los Alamos Scientific Laboratory (LASL) has confirmed the expected performance of this structure and has stimulated interest in a wide variety of applications. The general properties of the RFQ are reviewed and examples of applications of this new accelerator are presented

  3. Freescale Sdn Bhd: Monitoring Radiofrequency Assessment

    International Nuclear Information System (INIS)

    Wan Saffiey Wan Abdullah; Noor Ezati Shuib; Rozaimah Abdul Rahim; Pasupathy, E.; Muhammad Yusri Yahaya

    2015-01-01

    Freescale Semiconductor (M) Sdn Bhd, requested the assistance of Malaysian Nuclear Agency (Nuclear Malaysia) to conduct an electromagnetic radiation (Radiofrequency Radiation) measurements around its facilities at Freescale Semiconductor (M) Sdn Bhd, 2, Jalan SS8/2, Sungai Wai Free Industrial Zone, 47300 Petaling Jaya, Selangor. Nuclear Agency Non-Ionising Radiation (NIR) Group carried out the measurement on 30th July 2012. In carrying out the work, the Group was assisted by Mr Daniel. The main objectives of the measurement were to assess the presence of electromagnetic radiation (RF field) in an accessible work places within and around the facilities and to advise the company on outcomes of the assessment and measurement based on international recommendations of standard guidelines issued by Malaysian Communication and Multimedia Commission (MCMC) and International Commission on Non-Ionising Radiation Protection (ICNIRP). (author)

  4. Fluoroscopy-Guided Percutaneous Gallstone Removal Using a 12-Fr Sheath in High-Risk Surgical Patients with Acute Cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan [Keimyung University, College of Medicine, Daegu (Korea, Republic of); Kim, Yong Joo [Andong General Hospital, Andong (Korea, Republic of); Shin, Tae Beom [Gyeonsang National University, College of Medicine, Jinju (Korea, Republic of)

    2011-04-15

    To evaluate the technical feasibility and clinical efficacy of percutaneous transhepatic cholecystolithotomy under fluoroscopic guidance in high-risk surgical patients with acute cholecystitis. Sixty-three consecutive patients of high surgical risk with acute calculous cholecystitis underwent percutaneous transhepatic gallstone removal under conscious sedation. The stones were extracted through the 12-Fr sheath using a Wittich nitinol stone basket under fluoroscopic guidance on three days after performing a percutaneous cholecystostomy. Large or hard stones were fragmented using either the snare guide wire technique or the metallic cannula technique. Gallstones were successfully removed from 59 of the 63 patients (94%). Reasons for stone removal failure included the inability to grasp a large stone in two patients, and the loss of tract during the procedure in two patients with a contracted gallbladder. The mean hospitalization duration was 7.3 days for acute cholecystitis patients and 9.4 days for gallbladder empyema patients. Bile peritonitis requiring percutaneous drainage developed in two patients. No symptomatic recurrence occurred during follow-up (mean, 608.3 days). Fluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath is technically feasible and clinically effective in high-risk surgical patients with acute cholecystitis

  5. Genetic effects of radiofrequency radiation (RFR)

    International Nuclear Information System (INIS)

    Verschaeve, L.

    2005-01-01

    The possible effects of radiofrequency (RF) exposure on the genetic material of cells are considered very important since damage to the DNA of somatic cells can be linked to cancer development or cell death whereas damage to germ cells can lead to genetic damage in next and subsequent generations. This is why the scientific literature reports many investigations on the subject. According to a number of review papers, the conclusion so far is that there is little evidence that RFR is directly mutagenic and that adverse effects that were reported in some of the papers are predominantly the result of hyperthermia. Yet, some subtle indirect effects on DNA replication and/or transcription of genes under relatively restricted exposure conditions cannot be ruled out. Furthermore, the possibility of combined effects of RFR with environmental carcinogens/mutagens merits further attention. The present paper takes into account more recent investigations but the conclusion remains the same. A majority of studies report no increased (cyto)genetic damage but yet, a considerable number of investigations do. However, many studies were not sufficiently characterized, are therefore difficult to replicate and cannot be compared to others. Experimental protocols were very different from one study to another and investigations from a single laboratory were very often limited in the sample size or number of cells investigated, preventing a robust statistical analysis. Subtle, but significant differences between RFR-exposed and sham-exposed cells cannot be found in such conditions. For the above reasons, it was concluded at a workshop in Loewenstein (November 2002) that further investigations by individual laboratories most probably will not add much to the discussion of radiofrequency radiation (RFR) genotoxicity. Large, well coordinated, international collaborative studies involving participation of several experienced scientists are considered an alternative of uttermost importance

  6. Genetic effects of radiofrequency radiation (RFR).

    Science.gov (United States)

    Verschaeve, L

    2005-09-01

    The possible effects of radiofrequency (RF) exposure on the genetic material of cells are considered very important since damage to the DNA of somatic cells can be linked to cancer development or cell death whereas damage to germ cells can lead to genetic damage in next and subsequent generations. This is why the scientific literature reports many investigations on the subject. According to a number of review papers, the conclusion so far is that there is little evidence that RFR is directly mutagenic and that adverse effects that were reported in some of the papers are predominantly the result of hyperthermia. Yet, some subtle indirect effects on DNA replication and/or transcription of genes under relatively restricted exposure conditions cannot be ruled out. Furthermore, the possibility of combined effects of RFR with environmental carcinogens/mutagens merits further attention. The present paper takes into account more recent investigations but the conclusion remains the same. A majority of studies report no increased (cyto)genetic damage but yet, a considerable number of investigations do. However, many studies were not sufficiently characterized, are therefore difficult to replicate and cannot be compared to others. Experimental protocols were very different from one study to another and investigations from a single laboratory were very often limited in the sample size or number of cells investigated, preventing a robust statistical analysis. Subtle, but significant differences between RFR-exposed and sham-exposed cells cannot be found in such conditions. For the above reasons, it was concluded at a workshop in Löwenstein (November 2002) that further investigations by individual laboratories most probably will not add much to the discussion of radiofrequency radiation (RFR) genotoxicity. Large, well coordinated, international collaborative studies involving participation of several experienced scientists are considered an alternative of uttermost importance

  7. POTENTIAL OF ULTRASOUND-GUIDED LUMBAR FACET RADIOFREQUENCY DENERVATION

    Directory of Open Access Journals (Sweden)

    I. V. Volkov

    2017-01-01

    Full Text Available The aim of the study was to evaluate the possibility of US navigation for Radiofrequency denervation (RFD of the lumbar facets.Material and methods. The authors performed a prospective controlled cohort study which included 50 patients with chronic pain syndrome who underwent RFD LIII-SI facets on both sides. The main group (US included 25 patients, who underwent US guided navigation with FScontrol of the correct placement of the cannula prior to ablation. In the control group (FS the RFD was performed only under FS control. Patients were selected after preliminary test block of medial branch with 50% pain reduction from the baseline. Patients with overweight, spinal deformity, pronounced degenerative changes, spinal stenosis and developmental anomalies were not included in the study. For the evaluation of outcomes, the numeric pain scale NRS-11 and the Oswestry index (ODI were used, the accuracy of the cannula position was assessed and factors determining the accuracy were searched.Results. As a result of the intervention, there was a significant decrease of NRS-11 and ODI criteria in both groups (p<0.001, a positive outcome was achieved in 18 (72% of US patients and 16 (64% of FS patients, p = 0.564. Of the 200 attempts to position the cannula under the ultrasound control, 169 (84.5% were successful, in most cases (187 out of 200, 93.5% at least 3 attempts were required to reposition the cannula. The average time for performing the procedure under the ultrasound control was 47.3±1.13 minutes. The facet angle and procedure level were defined as predictors of the cannula positioning accuracy, odds ratio 0.93 (95% CI 0.894–0.963 and 0.51 (95% CI 0.32–0.805, respectively.Conclusion. RFD of lumbar facet under ultrasound navigation allows to achieve a relatively high accuracy of the cannula position into the zone of passage of the articular branch. The navigation capabilities are reduced at the level of LV and SI vertebrae due to structural

  8. Laser Initiation and Radiofrequency Sustainment of Seeded Air Plasmas

    National Research Council Canada - National Science Library

    Scharer, J. E

    2006-01-01

    .... The low ionization energy organic gas (TMAE) laser-initiated see plasmas create an initial condition that is used for plasma sustainment at much lower radiofrequency (RF) power levels (0.4 - 3 W/cc...

  9. Management of mild to moderate rhinophyma with a radiofrequency.

    Science.gov (United States)

    Erisir, Ferhat; Isildak, Huseyin; Haciyev, Yusuf

    2009-03-01

    Rhinophyma is characterized by an enlarged, bulbous, and red nose resulting from the enlargement of the sebaceous glands beneath the surface of the skin on the nose. Its etiology remains unclear. Treatment of the disease is controversial. In this study, we discussed the treatment of rhinophyma by radiofrequency in 5 patients. We presented 5 patients with rhinophyma. The patients' median age was 57.4 years. A radiofrequency unit was used in cut/coagulate mode at 10 U. A 0.38-in loop electrode was placed ensuring symmetry until the nose's shape was re-created. All patients achieved a good cosmetic result, which was defined as a near-to-normal nasal contour without clinical scarring or minimal scarring. Rhinophyma is a disease that can badly deform the nose and can be treated by radiofrequency. We described radiofrequency treatment of large rhinophymas with good aesthetic outcomes.

  10. Efficacy evaluation of laparoscopy assisted ultrasound guided radiofrequency ablation in the treatment of hepatocellular carcinoma beneath the diaphragm

    Directory of Open Access Journals (Sweden)

    Song WANG

    2017-06-01

    Full Text Available Objective To explore the feasibility, safety and efficacy of laparoscopy assisted ultrasound guided radiofrequency ablation (RFA in the treatment of hepatocellular carcinoma (HCC beneath the diaphragm. Methods Twenty- three consecutive patients with solitary HCC beneath the diaphragm were treated by laparoscopy assisted ultrasound guided RFA in the Chinese PLA General Hospital from January 2013 to March 2016. We observed the perioperative complications and followed- up long-term effect. Results All the 23 patients successfully underwent laparoscopy assisted ultrasound guided radiofrequency ablation. No serious complications such as massive hemorrhage, biliary fistula and severe pleural effusion, hemopneumothorax occurred in the patients during perioperative period. CT examination 2-3 days after the operation revealed that the tumor was completely covered by the ablation area. Besides, the survival condition was satisfactory during follow-up period of 9-38 months. Conclusion Laparoscopy-assisted ultrasound-guided radiofrequency ablation is effective and safe for HCC beneath the diaphragm. DOI: 10.11855/j.issn.0577-7402.2017.05.16

  11. Long-term Nasal and Peri-oral Tightening by a Single Fractional Noninsulated Microneedle Radiofrequency Treatment.

    Science.gov (United States)

    Tanaka, Yohei

    2017-02-01

    Background: The skin tightening effects induced by non-insulated microneedle radiofrequency have proved long-lasting. Our previous three-dimensional volumetric assessment showed significant facial tightening for up to six months. However, nasal and peri-oral tightening effects lasted longer. The objective of this study was to investigate the distribution of the long-term volumetric reduction in facial area induced by a single fractional non-insulated microneedle radiofrequency treatment. Methods: Fifteen Asian patients underwent full facial skin tightening using a sharply tapered non-insulated microneedle radiofrequency applicator with a novel fractionated pulse mode. Three-dimensional volumetric assessments were performed at six and 12 months post-treatment. Patients rated their satisfaction using a 5-point scale at each follow up. Results: Objective assessments with superimposed three-dimensional color images showed significant volumetric reduction in the nasal and peri-oral areas at 12 months post-treatment in all patients. Median volumetric reductions at six and 12 months post-treatment were 13.1 and 12.3ml, respectively. All of the patients were satisfied with their results 12 months post-treatment. Side effects were not observed. Conclusions: This single fractional NIMNRF treatment provided long-lasting nasal and peri-oral tightening as shown via 3D volumetric assessment. Moreover, NIMNRF produced minimal complications, downtime, and few side effects. This approach provides safe and effective treatment of skin tightening.

  12. Lymphangioma Circumscriptum (Microcystic Lymphatic Malformation): Palliative Coagulation Using Radiofrequency Current

    OpenAIRE

    Omprakash HM,; Rajendran SC,

    2008-01-01

    Lymphangioma circumscriptum (LC, microcystic lymphatic malformation), a hamartomatous lymphatic malformation, is a difficult condition to treat. Different treatments such as surgical excision, lasers, sclerotherapy etc have all been tried with varying success. We report here the efficacy of a radiofrequency current in two patients with lymphangioma circumscriptum. The radiofrequency technique is a safe, economical, and commonly available technique for the treatment of LC; the surgical safety ...

  13. Neuraxial anesthesia after local anesthesia for management of percutaneous vertebroplasty complication during vertebroplasty

    Directory of Open Access Journals (Sweden)

    Hüseyin Balkarlı

    Full Text Available Abstract Percutaneous vertebroplasty is a relatively safe, simple and commonly performed interventional procedure for the management of vertebral compression fractures. However, serious complications are rarely reported in the procedure. Those are pulmonary embolism, severe infection, paraplegia and an occurrence of a new fracture in an adjacent vertebra after vertebroplasty. Acute complications are generally associated with the procedure. We present the case of neuraxial anesthesia, developed after local anesthesia with 8 mL of 2% prilocaine, in a 68-year-old woman who underwent percutaneous vertebroplasty after an osteoporotic collapsed fracture in the L1 vertebra due to trauma. To our knowledge, this is the first case in the literature.

  14. Nerve and tendon injury with percutaneous fibular pinning: a cadaveric study.

    Science.gov (United States)

    Iorio, Justin; Criner, Katharine; Rehman, Saqib; Meizinger, Casey; Haydel, Christopher

    2014-12-01

    The purposes of this study were to measure the average distance from a percutaneous pin in each quadrant of the distal fibula to the sural nerve and nearest peroneal tendon, and define the safe zone for percutaneous pin placement as would be used during surgery. Ten fresh-frozen cadavers underwent percutaneous pin fixation into four quadrants of the distal fibula. The sural nerve and peroneal tendon were identified as they coursed around the lateral ankle. Distances from the K-wire in each quadrant to the anatomic structure of interest were measured. Average distances (mm) from the K-wire to the sural nerve in the anterolateral, anteromedial, posterolateral, and posteromedial quadrants were 19.1±8.9 (range, 5.1-35.5), 12.8±8.2 (range, 0.3-27.8), 12.6±6.8 (range, 3.0-27.8), and 5.9±5.5 (range, 0.1-19.9), respectively. Average distances from the K-wire to the nearest peroneal tendon in the anterolateral, anteromedial, posterolateral, and posteromedial quadrants were 15.7±4.4 (range, 9.5-23.1), 11.9±5.2 (range, 3.2-21.7), 6.3±3.9 (range, 0.1-14.4), and 1.0±1.6 (range, 0-5.6), respectively. Percutaneous pinning of distal fibula fractures is a successful treatment option with minimal complications. Our anatomical study found the safe zone of percutaneous pin placement to be in the anterolateral quadrant. The sural nerve can be as close as 5.1mm and the peroneal tendons as near as 15.7mm. In contrast, the posteromedial quadrant was associated with the greatest risk of injury to both the sural nerve and peroneal tendons. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy.

    Science.gov (United States)

    Lucas y Hernandez, J; Golanó, P; Roshan-Zamir, S; Darcel, V; Chauveaux, D; Laffenêtre, O

    2016-03-01

    The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a percutaneous extra-articular reverse-L chevron (PERC) osteotomy. A total of 38 patients underwent 45 procedures. There were 35 women and three men. The mean age of the patients was 48 years (17 to 69). An additional percutaneous Akin osteotomy was performed in 37 feet and percutaneous lateral capsular release was performed in 22 feet. Clinical and radiological assessments included the type of forefoot, range of movement, the American Orthopedic Foot and Ankle (AOFAS) score, a subjective rating and radiological parameters. The mean follow-up was 59.1 months (45.9 to 75.2). No patients were lost to follow-up. The mean AOFAS score increased from 62.5 (30 to 80) pre-operatively to 97.1 (75 to 100) post-operatively. A total of 37 patients (97%) were satisfied. At the last follow up there was a statistically significant decrease in the hallux valgus angle, the intermetatarsal angle and the proximal articular set angle. The range of movement of the first metatarsophalangeal joint improved significantly.. There was more improvement in the range of movement in patients who had fixation of the osteotomy of the proximal phalanx. Preliminary results of this percutaneous approach are promising. This technique is reliable and reproducible. Its main asset is that it maintains an excellent range of movement. The PERC osteotomy procedure is an effective approach for surgical management of moderate hallux valgus which combines the benefits of percutaneous surgery with the versatility of the chevron osteotomy whilst maintaining excellent first MTPJ range of motion. ©2016 The British Editorial Society of Bone & Joint Surgery.

  16. Stroke from Delayed Embolization of Polymerized Glue Following Percutaneous Direct Injection of a Carotid Body Tumor

    Energy Technology Data Exchange (ETDEWEB)

    Krishnamoorthy, Thamburaj; Gupta, Arun Kumar; Rajan, Jayadevan E; Thomas, Bejoy [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, (India)

    2007-06-15

    Direct percutaneous embolization of hypervascular tumors results in more effective preoperative devascularization. Migration of glue is a well known complication of direct glue injection and it may lead to stroke or cranial nerve deficits. We report here on a case of carotid body tumor in a 52-year-old man; the tumor was mainly embolized by percutaneous injection of 50% glue and this was supported with balloon protection of the internal carotid artery. Thirteen hours later, he developed hemiparesis from delayed migration of glue. The possible mechanisms of this migration are discussed and preventive measures are suggested. Preoperative embolization of hypervascular tumors of the head and neck, including carotid body tumor, is often performed to decrease the amount of blood loss during surgery. Devascularization is mainly performed with particulate agents and by employing the transarterial route. More effective embolization may be achieved by performing percutaneous direct embolization of hypervascular tumors with liquid embolic agents. Even though there are few reports available on direct embolization, complications from glue migration have been reported, and this mainly happens during the procedure when the glue is in a liquid state. We report here on a case of delayed migration of polymerized glue (n-butyl-2-cyanoacrylate [NBCA]), many hours after the procedure, into the intracranial circulation and the final result was stroke. A 52-year-old male with right carotid body tumor underwent direct percutaneous glue (n-butylcyanoacrylate [NBCA]) embolization. Several hours later, he developed left hemiparesis from embolization of the polymerized glue cast. Migration of glue during percutaneous tumor embolization is presumed to occur only in the liquid state, which may lead to stroke or cranial nerve deficits. To the best of our knowledge, this is the first report of delayed glue embolization from a treated hypervascular tumor of the head and neck.

  17. Multiphasic helical Computed Tomography of hepatocellular carcinoma. Evaluation after various percutaneous ablation procedures; Tomografia Computerizzata spirale multifasica dell'epatocarcinoma. Valutazione dopo differenti procedure ablative percutanee

    Energy Technology Data Exchange (ETDEWEB)

    Catalano, O.; Esposito, M.; Lobianco, R.; Cusati, B.; Altei, F.; Siani, A. [Ospedale S. Maria delle Grazie, Pozzuoli, NA (Italy). Servizio di Radiologia

    1999-12-01

    The purpose of this paper is to report the personal experience with helical CT evaluation of hepatocellular carcinoma treated with various percutaneous interventional procedures. From December 1996 to September 1998 it were examined with helical CT 41 patients (73 nodules in all) with hepatocellular carcinoma treated with percutaneous ablation therapies: conventional ethanol injection in 18 subjects (31 nodules), one-shot ethanol injection 3 (8 nodules), radiofrequency thermal ablation in 16 (25 nodules), and combined chemo embolization and ethanol injection in 4 (9 nodules). CT performed was 4-27 days after the last session, acquiring biphasic volumetric images in 14 patients and triphasic volumetric images in 27. A second treatment with subsequent CT study was performed for 28 lesions; 15 underwent 3 serial studies and 6 underwent 4 studies. Compared with pretreatment findings, the diameter was unchanged in 62% of the nodules and increased in 38%. Morphology was unchanged in 63% of the lesions while in 37% a mild deformation toward the needle path or a more regular and round shape was evident. Borders were unchanged in 37% of the cases and modified in 63%, appearing well-defined in 73% and ill-defined in 27%. The necrotic portion had a low attenuation with a nodule-to-parenchyma gradient more evident on delayed than on venous and finally arterial acquisitions; 8% of the lesions were not recognizable on unenhanced scans. During the arterial phase the residual tumor appeared hyperdense in 97% of the nodules and isodense in 3%, while during the portal phase it was hyperdense in 22%, isodense in 28% and hypodense in 50%, and during the delayed phase hypodense in 100%. Residual viable tissue was identified in 44% of the nodules and quantified as 100% in 1% of all lesions, > 75% in 3%, > 50% in 4%, > 25% in 23%. In conclusion, multiple-phase helical CT allows optimal depiction of primitive liver nodules treated with percutaneous interventional procedures and has a

  18. Pulmonary vein stenosis after catheter ablation: electroporation versus radiofrequency.

    Science.gov (United States)

    van Driel, Vincent J H M; Neven, Kars G E J; van Wessel, Harry; du Pré, Bastiaan C; Vink, Aryan; Doevendans, Pieter A F M; Wittkampf, Fred H M

    2014-08-01

    Radiofrequency ablation inside pulmonary vein (PV) ostia can cause PV stenosis. A novel alternative method of ablation is irreversible electroporation, but the long-term response of PVs to electroporation ablation is unknown. In ten 6-month-old pigs (60-75 kg), the response of PVs to circular electroporation and radiofrequency ablation was compared. Ten consecutive, nonarcing, electroporation applications of 200 J were delivered 5 to 10 mm inside 1 of the 2 main PVs, using a custom-deflectable, 18-mm circular decapolar catheter. Inside the other PV, circular radiofrequency ablation was performed using 30 W radiofrequency applications via an irrigated 4-mm ablation catheter. PV angiograms were made before ablation, immediately after ablation, and after 3-month survival. PV diameters and heart size were measured. With electroporation ablation, PV ostial diameter decreased 11±10% directly after ablation, but had increased 19±11% after 3 months. With radiofrequency ablation, PV ostial diameter decreased 23±15% directly after ablation and remained 7±17% smaller after 3 months compared with preablation diameter despite a 21±7% increase in heart size during aging from 6 to 9 months. In this porcine model, multiple circumferential 200-J electroporation applications inside the PV ostia do not affect PV diameter at 3-month follow-up. Radiofrequency ablation inside PV ostia causes considerable PV stenosis directly after ablation, which persists after 3 months. © 2014 American Heart Association, Inc.

  19. Percutaneous Cryoablation of Small Hepatocellular Carcinoma with US Guidance and CT Monitoring: Initial Experience

    International Nuclear Information System (INIS)

    Orlacchio, Antonio; Bazzocchi, Gabriele; Pastorelli, Daniela; Bolacchi, Francesca; Angelico, Mario; Almerighi, Cristiana; Masala, Salvatore; Simonetti, Giovanni

    2008-01-01

    The purpose of this study was to retrospectively determine the safety and effectiveness of percutaneous cryoablation, monitored with computed tomography (CT) and ultrasonographic (US) guidance, for the treatment of hepatocellular carcinoma (HCC). Four patients with small HCCs underwent one percutaneous cryoablation treatment session monitored with CT and US guidance. All patients underwent pretreatment blood chemistry testing and imaging evaluation. We treated lesions with simultaneous insertion of multiple 17-G cryoprobes (two or three) and defined technical success when the extension of a visible iceball was beyond 5 mm from the tumor margin. Intralesional enhancement or tumoral size increase was defined as local progression compared with that on images obtained immediately after ablation. We evaluated complications and follow-up (at 1, 3, and 6 months). All patients survived without short- or long-term complications. Cryoablation was technically successful in all patients at the end of the procedure. During follow-up two patients developed disease recurrence. One patient developed local tumor progression on the margin of the lesion; the other, a new HCC. In the case of local tumor progression a new elevation of α-fetoprotein (αFP) levels occurred at first follow-up control. In the other case levels of αFP remained stable during the first 3 months after the procedure, then demonstrated a progressive increase in αFP levels beginning at the fourth month, without tumor evidence during CT control at 3 months. We conclude that percutaneous cryotherapy with US guidance and CT monitoring is a feasible, safe, and effective for treatment of HCC. If local ablative procedures of hepatic lesions are to be performed, percutaneous cryoablation, not laparotomic, should be discussed as an alternative therapeutic measure. Longer follow-up should provide proof of the effectiveness of this technique

  20. Percutaneous microwave ablation with artificial ascites for symptomatic uterine adenomyosis: initial experience.

    Science.gov (United States)

    Hai, Ning; Zhang, Jing; Xu, Ruifang; Han, Zhi-Yu; Liu, Fang Yi

    2017-09-01

    To evaluate the feasibility, safety and technical efficacy of ultrasound-guided percutaneous microwave ablation with artificial ascites for adenomyosis. Between May 2015 and May 2016, a total of 25 patients with symptomatic adenomyosis who underwent ultrasound-guided percutaneous microwave ablation with artificial ascites were included in this retrospective study. A matching cohort of 50 patients underwent ultrasound-guided percutaneous microwave ablation without artificial ascites as controls. The technical efficacy, complications and short-term treatment effectiveness were assessed and compared with the controls. Artificial ascites was successfully achieved in all of the 25 patients with the administration of a median of 550 mL (range, 250-1200 mL) of solution. There was substantial improvement in achieving a better antenna path in 100% (20/20) of the cases with a poor antenna path. The complete separation was achieved in 23 of 25 patients. The mean ablation time was 26.5 ± 7.3 min and the median non-perfusion volume ratio was 76% which was similar to the control group (p > .05). No serious complications were observed. Patient pain scores for dysmenorrhoea showed a statistically significant decline from the baseline of 6.71 ± 0.96 to 2.92 ± 0.79 and the symptom severity score declined statistically significantly from 21.8 ± 5.5 to 16.4 ± 4.8 at 3 months follow-up. Percutaneous microwave ablation with artificial ascites is feasible, safe and can be effective in improving access for treatment of adenomyosis.

  1. Conventional Radiofrequency Thermocoagulation vs Pulsed Radiofrequency Neuromodulation of Ganglion Impar in Chronic Perineal Pain of Nononcological Origin.

    Science.gov (United States)

    Usmani, Hammad; Dureja, G P; Andleeb, Roshan; Tauheed, Nazia; Asif, Naiyer

    2018-01-10

    Chronic nononcological perineal pain has been effectively managed by ganglion Impar block. Chemical neurolysis, cryoablation, and radiofrequency ablation have been the accepted methods of blockade. Recently, pulsed radiofrequency, a novel variant of conventional radiofrequency, has been used for this purpose. This was a prospective, randomized, double-blind study. Two different interventional pain management centers in India. To compare the efficacy of conventional radiofrequency and pulsed radiofrequency for gangliom Impar block. The patients were randomly allocated to one of two groups. In the conventional radiofrequency (CRF) group (N = 34), conventional radiofrequency ablation was done, and in the PRF pulsed radiofrequency (PRF) group (N = 31), pulsed radiofrequency ablation was done. After informed and written consent, fluoroscopy-guided ganglion Impar block was performed through the first intracoccygeal approach. The extent of pain relief was assessed by visual analog scale (VAS) at 24 hours, and at the first, third, and sixth weeks following the intervention. A questionnaire to evaluate subjective patient satisfaction was also used at each follow-up visit. In the CRF group, the mean VAS score decreased significantly from the baseline value at each follow-up visit. But in the PRF group, this decrease was insignificant except at 24-hour follow-up. Intergroup comparison also showed significantly better pain relief in the CRF group as compared with the PRF group. At the end of follow-up, 28 patients (82%) in the CRF group and four patients (13%) in the PRF group had excellent results, as assessed by the subjective patient satisfaction questionnaire. There was no complication in any patient of either study group, except for short-lived infection at the site of skin puncture in a few. Ganglion Impar block by conventional radiofrequency provided a significantly better quality of pain relief with no major side effects in patients with chronic

  2. Percutaneous reduction and fixation of intraarticular calcaneal fractures

    NARCIS (Netherlands)

    Schepers, Tim; Vogels, Lucas M. M.; Schipper, Inger B.; Patka, Peter

    2008-01-01

    Percutaneous reduction by distraction and subsequent percutaneous screw fixation to restore calcaneal and posterior talocalcaneal facet anatomy. The aim of this technique is to improve functional outcome and to diminish the rate of secondary posttraumatic arthrosis compared to conservative treatment

  3. Hemodynamic Change in Pulmonary Vein Stenosis after Radiofrequency Ablation: Assessment with Magnetic Resonance Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Doyoung; Jung, Jung Im; Oh, Yong Seog; Youn, Ho Joong [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2012-11-15

    We present a case of pulmonary vein (PV) stenosis after radio-frequency (RF) ablation, in which a hemodynamic change in the pulmonary artery was similar to that of congenital PV atresia on time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA). A 48-year-old man underwent RF ablation due to atrial fibrillation. The patient subsequently complained of hemoptysis, dyspnea on exertion, and right chest pain. Right PV stenosis after catheter ablation was diagnosed through chest computed tomography and lung perfusion scan. Pulmonary TR-MRA revealed the pulmonary artery via systemic arterial collaterals and draining systemic collateral veins. On a velocity-encoded cine image, the flow direction of the right pulmonary artery was reversed in the diastolic phase and the left pulmonary artery demonstrated continuous forward flow throughout the cardiac cycle. These hemodynamic changes were similar to those seen in congenital unilateral PV atresia.

  4. A bipolar radiofrequency, infrared, vacuum and mechanical massage device for treatment of cellulite: a pilot study.

    Science.gov (United States)

    Hexsel, Doris M; Siega, Carolina; Schilling-Souza, Juliana; Porto, Manoela D; Rodrigues, Ticiana C

    2011-12-01

    Cellulite has a complex and multifactorial etiology. Synergistic action on treating cellulite has gained support in the treatment of cellulite. This study evaluated safety and efficacy of a bipolar radiofrequency, infrared, vacuum and mechanical massage device for cellulite treatment and reduction of body measures. This was a pilot study, which assessed 9 subjects who presented body mass index from 18 to 25 Kg/Kg and at least grade 6 in the Cellulite Severity Scale (CSS). All subjects underwent a 12-session treatment of posterior thighs and buttocks. There was a significant reduction of the hip circumference (p = 0.001), however, no changes in thigh circumferences were observed (p = 0.4). CSS has improved specifically on both buttocks [p = 0.002 (left side) and p = 0.038 (right side)], and no changes were observed on thighs. The studied device demonstrated efficacy in the reduction of cellulite severity and body circumference measures in the buttocks.

  5. Infective complication following percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Bannakij Lojanapiwat

    2016-03-01

    Full Text Available Percutaneous nephrolithotomy (PCNL is a minimally invasive procedure for patients with large renal and upper ureteric stones. Although it is less invasive than open surgery, infection is still the most common complication arising from this procedure and some patients develop septicemia and septic shock, resulting in increase in mortality and morbidity. The incidence of septic shock following PCNL is 1%; however, its mortality rate is as high as 66–80%. Endourologists who perform this procedure need to know how to prevent and manage this common complication. Large calculi, staghorn calculi, positive pelvic urine and stone culture, prolonged operative time, and diabetes are factors that increase the incidence of postoperative infection. Recently, several studies suggested the importance of intraoperative microbiologic evaluation of factors such as intraoperative pelvic urine and stone cultures for selection of suitable postoperative antibiotics. The selection of prophylactic antibiotics, postoperative antibiotics, and specific PCNL techniques play an important role in preventing infection following PCNL. We reviewed the general background, the factors, and role of intraoperative microbiologic evaluation in the management of post-PCNL infection.

  6. Imaging in percutaneous musculoskeletal interventions

    International Nuclear Information System (INIS)

    Gangi, Afshin; Guth, Stephane; Guermazi, Ali

    2009-01-01

    This is one of the first books to deal specifically with imaging in percutaneous musculoskeletal interventions. The use of different imaging modalities during these procedures is well described. In the first chapter, the basic procedures and different guidance techniques are presented and discussed. The ensuing chapters describe in exhaustive detail the abilities and uses of imaging in guiding procedures ranging from biopsy and joint injection to management of pain and tumors. These procedures are extensively documented in adults as well as in the pediatric population. The third part of the book describes the different indications for vascular interventions in musculoskeletal lesions. The final chapter focuses on ultrasound-guided interventions, as they are more common and tend to be fashionable. The book is well illustrated with carefully chosen and technically excellent images. Each of the 18 chapters is written by an expert of international repute, making this book the most current and complete treatment of the subject available. It should be of great interest to interventional radiologists and also musculoskeletal and general radiologists. (orig.)

  7. Hysterosalpingography After Radiofrequency Endometrial Ablation and Hysteroscopic Sterilization as a Concomitant Procedure.

    Science.gov (United States)

    Hopkins, Matthew R; Laughlin-Tommaso, Shannon K; Wall, Darci J; Breitkopf, Daniel M; Creedon, Douglas J; El-Nashar, Sherif A; Famuyide, Abimbola O

    2015-09-01

    To evaluate the accuracy of hysterosalpingography (HSG) in patients who underwent concomitant radiofrequency endometrial ablation and hysteroscopic sterilization. This historical cohort study was conducted at a midwestern academic medical center. A total of 186 women (94 with combined procedure and 92 with sterilization alone) were identified as having undergone intervention between January 1, 2003, and June 30, 2011. Two reviewers blinded to the surgical procedure interpreted the standard clinically indicated HSGs in each group. The primary outcome assessed was the inability to rely on the microinserts for contraception based on HSG interpretation using manufacturers' guidelines (unsatisfactory HSG). Position of the devices and occlusion of tubes were assessed on all 3-month and, when available, all 6-month repeat HSGs. At the 3-month HSG, 5 of 76 (6.6%, 95% confidence interval [CI] 2.2-14.7%) in the sterilization-only group had unsatisfactory HSG compared with 13 of 71 (18.3%, 95% CI 10.1-29.3%) in the combined group (P=.03). After accounting for the seven patients who underwent repeat HSG at 6 months, 3 of 76 (3.95%, 95% CI 0.8-11.1%) in the sterilization-only group had unsatisfactory HSG compared with 13 of 71 (18.31%, 95% CI 10.1-29.3%) i