Background: Close proximity of a tumor to heart or large vessels is considered a relative contraindication to percutaneous ablation. We reviewed our experience with the use of various ablation modalities in such conditions. Methods and Materials: A retrospective review of patients treated at our institution with percutaneous ablation for unresctable lung or mediastinal malignancies (LMM) was performed, and patients with tumors located less than 10 mm from large vessels or pericardium were identified. All ablations were performed under conscious sedation and local anesthesia. The therapeutic outcomes were evaluated by contrast-enhanced CT after 1 month. Immediate and short term results are presented. Results: Between June 2008 to January 2011 we treated with CT-guided percutaneous ablation 27 patients (mean age 64 years) with lesions located within 10 mm from heart or large vessels. Overall, 13 metastases, 12 NSCLC, 1 thymoma, and 1 mesothelial sarcoma were treated with CT-guided radiofrequency ablation (RFA, N=14), microwave ablation (MWA, N=7) and cryoablation (CA, N=6). In all cases, the procedure was technically successful. No intra-procedural arrhythmia occurred. In two patients, an electrode penetrated in the pericardium without consequences. Morbidity consisted of pneumothorax (n=7), and pleural effusions (n=3). At 1-month follow-up, CT revealed complete necrosis in 22 cases and partial (from 70 to 90%) necrosis in the 5 cases. Conclusion: In our experience ablation of LMM in close proximity of hearth or large vessels appears effective and associated with acceptable morbidity. Heat-sink effect did not preclude achievement of complete ablation in the majority of those cases.
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|Titolo:||Feasibility and Safety of Percutaneous Radiofrequency, Microwave or Cryoablation for Unresectable Thoracic Malignancies in Close Proximity to Heart and Large Vessels|
|Data di pubblicazione:||2013|
|Appare nelle tipologie:||1.5 Abstract in rivista|