Percutaneous Image-Guided Cryoablation of Challenging Mediastinal Lesions Using Large-Volume Hydrodissection: Technical Considerations and Outcomes.

Détails

ID Serval
serval:BIB_1F8B38CEA651
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Percutaneous Image-Guided Cryoablation of Challenging Mediastinal Lesions Using Large-Volume Hydrodissection: Technical Considerations and Outcomes.
Périodique
Cardiovascular and interventional radiology
Auteur(s)
Garnon J., Koch G., Caudrelier J., Ramamurthy N., Rao P., Tsoumakidou G., Cazzato R.L., Gangi A.
ISSN
1432-086X (Electronic)
ISSN-L
0174-1551
Statut éditorial
Publié
Date de publication
11/2016
Peer-reviewed
Oui
Volume
39
Numéro
11
Pages
1636-1643
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
This study was designed to describe the technique of percutaneous image-guided cryoablation with large-volume hydrodissection for the treatment of challenging mediastinal lesions.
Between March 2014 and June 2015, three patients (mean age 62.7 years) with four neoplastic anterior mediastinal lesions underwent five cryoablation procedures using large-volume hydrodissection. Procedures were performed under general anaesthesia using CT guidance. Lesion characteristics, hydrodissection and cryoablation data, technical success, complications, and clinical outcomes were assessed using retrospective chart review.
Lesions (mean size 2.7 cm; range 2-4.3 cm) were in contact with great vessels (n = 13), trachea (n = 3), and mediastinal nerves (n = 6). Hydrodissection was performed intercostally (n = 4), suprasternally (n = 2), transsternally (n = 1), or via the sternoclavicular joint (n = 1) using 1-3 spinal needles over 13.4 (range 7-26) minutes; 450 ml of dilute contrast was injected (range 300-600 ml) and increased mean lesion-collateral structure distance from 1.9 to 7.7 mm. Vulnerable mediastinal nerves were identified in four of five procedures. Technical success was 100 %, with one immediate complication (recurrent laryngeal nerve injury). Mean follow-up period was 15 months. One lesion demonstrated residual disease on restaging PET-CT and was retreated to achieve complete ablation. At last follow-up, two patients remained disease-free, and one patient developed distant disease after 1 year without local recurrence.
Cryoablation using large-volume hydrodissection is a feasible technique, enabling safe and effective treatment of challenging mediastinal lesions.
Mots-clé
Aged, Cryosurgery/methods, Follow-Up Studies, Humans, Male, Mediastinal Neoplasms/surgery, Middle Aged, Radiography, Interventional/methods, Retrospective Studies, Tomography, X-Ray Computed/methods, Treatment Outcome, Cryoablation, Hydrodissection, Hydromediastinum, Mediastinal malignancies, Mediastinum
Pubmed
Web of science
Création de la notice
09/10/2018 11:33
Dernière modification de la notice
20/08/2019 12:55
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