Safety and Efficacy of Percutaneous Microwave Hepatic Ablation Near the Heart. J Vasc Interv Radiol 2017 Apr;28(4):490-497
Date
02/14/2017Pubmed ID
28190707DOI
10.1016/j.jvir.2016.12.1216Scopus ID
2-s2.0-85011957110 (requires institutional sign-in at Scopus site) 23 CitationsAbstract
PURPOSE: To evaluate safety and efficacy of percutaneous hepatic microwave (MW) ablation performed near the heart.
MATERIALS AND METHODS: This study reviewed 118 consecutive peripheral (ablation zone margins within 5 mm of liver capsule) percutaneous MW hepatic ablations performed between June 2010 and August 2015. Ablation zones of 27 tumors (22.8%) extended to ≤ 5 mm from myocardium, and these ablations comprised the study group; the remaining ablations formed the control group. The study cohort included 14 men and 10 women (mean age, 59 y) with 16 hepatocellular carcinomas, 9 metastases, and 2 hemangiomas. Periprocedural imaging was used to evaluate tumor size and distance from the heart, ablation zone size, and complications. Mean tumor size and distance to myocardium were 2.6 cm ± 1.7 and 1.1 cm ± 1.1, respectively. The electronic medical record was used to retrospectively assess local tumor progression (LTP) and electrocardiogram and hemodynamic alterations during and after ablation. Statistical analysis was performed with Fisher exact test and t test.
RESULTS: Median follow-up was 13.6 months (range, 1.2-38.7 months). No arrhythmias occurred during or after ablation in the follow-up period (0/27). There was no difference between groups in frequency of alterations in periprocedural blood pressure (25.9% vs 29.6%, p=0.81) or heart rate (18.5% vs 24.2%, P = .61) or rate of LTP (12.0% vs 10.8%, P = 1.0).
CONCLUSIONS: Percutaneous MW ablation near the heart may be safe and effective, without increased risk of cardiac complications and with similar rates of LTP, compared with a control group of peripheral liver ablations.
Author List
Carberry GA, Smolock AR, Cristescu M, Wells SA, Ziemlewicz TJ, Lubner MG, Hinshaw JL, Brace CL, Lee FT JrAuthor
Mircea M. Cristescu MD, MBA Assistant Professor in the Radiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Ablation TechniquesAged
Carcinoma, Hepatocellular
Electronic Health Records
Female
Heart Injuries
Hemangioma
Humans
Liver Neoplasms
Magnetic Resonance Imaging
Male
Margins of Excision
Microwaves
Middle Aged
Retrospective Studies
Risk Factors
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Tumor Burden