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

2016 ◽  
Vol 39 (9) ◽  
pp. 1289-1297 ◽  
Author(s):  
Sandeep Bagla ◽  
Dawood Sayed ◽  
John Smirniotopoulos ◽  
Jayson Brower ◽  
J. Neal Rutledge ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Spine Metastases ◽  
Clinical Series ◽  
Painful Spine

Radiofrequency Ablation of Spine Metastases: A Clinical and Technical Approach

2021 ◽  
Vol 25 (06) ◽  
pp. 795-804
Author(s):  
Steven Yevich ◽  
Stephen Chen ◽  
Zeyad Metwalli ◽  
Joshua Kuban ◽  
Stephen Lee ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Multidisciplinary Treatment ◽  
Treatment Algorithm ◽  
Treatment Strategies ◽  
Clinical Work ◽  
Additional Treatment ◽  
Vertebral Compression Fractures ◽  
Tumor Control ◽  
Technical Approach ◽  
Spine Metastases

AbstractPercutaneous radiofrequency ablation (RFA) is an integral component of the multidisciplinary treatment algorithm for both local tumor control and palliation of painful spine metastases. This minimally invasive therapy complements additional treatment strategies, such as pain medications, systemic chemotherapy, surgical resection, and radiotherapy. The location and size of the metastatic lesion dictate preprocedure planning and the technical approach. For example, ablation of lesions along the spinal canal, within the posterior vertebral elements, or with paraspinal soft tissue extension are associated with a higher risk of injury to adjacent spinal nerves. Additional interventions may be indicated in conjunction with RFA. For example, ablation of vertebral body lesions can precipitate new, or exacerbate existing, pathologic vertebral compression fractures that can be prevented with vertebral augmentation. This article reviews the indications, clinical work-up, and technical approach for RFA of spine metastases.

One-year outcomes of radiofrequency ablation of incompetent perforator veins using the radiofrequency stylet device

2010 ◽  
Vol 25 (2) ◽  
pp. 79-84 ◽  
Author(s):  
P Marsh ◽  
B A Price ◽  
J M Holdstock ◽  
M S Whiteley
Keyword(s):  
Radiofrequency Ablation ◽  
De Novo ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Clinical Score ◽  
Clinical Series ◽  
Specific Device ◽  
Primary Varicose Veins ◽  
One Year

Objectives Early success treating incompetent perforator veins (IPVs) with radiofrequency ablation (RFA) and the trend to move varicose vein surgery into a walk-in walk-out service led to the design of a specific device enabling RFA of IPVs using local anaesthesia (ClosureRFS™ stylet). Our aim was to assess one-year outcomes of a clinical series of patients undergoing treatment with this device. Truncal reflux, where present, was treated initially, and RFA of IPVs was performed as a secondary procedure. Method Duplex ultrasound examinations were performed and the presence of IPVs documented. Results were compared with preoperative scans. IPVs were classified as closed, not closed/reopened or de novo. Results Of the 75 patients invited for follow-up, 53 attended at a median time of 14 months (range 11–25). Sixty-seven limbs were analysed (M:F 1:2.1, median age 62, range 25–81). Of the 124 treated IPVs, 101 were closed (82%). Clinical, aetiological, anatomical and pathological clinical score was improved in 49.3% limbs. IPV closure was reduced in patients with recurrent varicose veins compared with primary varicose veins (72.3% versus 87%, P = 0.056). Conclusion These results demonstrate the radiofrequency stylet device to be an effective treatment for IPVs.

Five-year results of incompetent perforator vein closure using TRans-Luminal Occlusion of Perforator

2009 ◽  
Vol 24 (2) ◽  
pp. 74-78 ◽  
Author(s):  
J L Bacon ◽  
A J Dinneen ◽  
P Marsh ◽  
J M Holdstock ◽  
B A Price ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Learning Curve ◽  
Horizontal Plane ◽  
De Novo ◽  
Duplex Ultrasound ◽  
Participation Rate ◽  
Series Data ◽  
Ultrasound Guided ◽  
Clinical Series ◽  
Subfascial Endoscopic Perforator Surgery

In 2000, we developed a percutaneous method of treating incompetent perforator veins (IPV) using ultrasound-guided radiofrequency ablation (RFA), which we termed TRansluminal Occlusion of Perforator (TRLOP). Objective To audit the five-year outcome of the TRLOP technique as indicated by the rate of IPV closure on duplex ultrasound (DUS). Methods Patients underwent DUS five years post-TRLOP. Experienced vascular technologists documented the presence of IPVs using a two co-ordinate system, blinded to previous results. Results were then compared with preoperative scans. IPVs were classified as: closed; not closed/reopened; or de novo. Closed IPVs were defined as the absence of any IPV at or within 5 cm of a previous IPV in the vertical and horizontal plane. Any IPVs found outside the delineated area were defined as de novo IPVs. Results Of 67 patients invited, 37 attended DUS (55% participation rate; men to women ratio of 14:23, age 40–84; mean 64). Preoperative clinical, aetiological, anatomical and pathological classification: C2, 36.2%; C3, 27.6%; C4, 34.5%; C6, 1.7%. From 125 IPVs analysed, 101 were closed (81%), 24 were not closed/reopened (19%) and 14 de novo IPVs were found. Discussion Despite these results representing our learning curve for the procedure, we found TRLOP to be an effective treatment for IPVs. The closure rates described are comparable with the published clinical series data for subfascial endoscopic perforator surgery.

scholarly journals Combined Ablation and Radiation Therapy of Spinal Metastases: A Novel Multimodality Treatment Approach

2015 ◽  
Vol 6;18 (6;11) ◽  
pp. 573-581
Author(s):  
Taylor J. Greenwood
Keyword(s):  
Radiation Therapy ◽  
Retrospective Study ◽  
Radiofrequency Ablation ◽  
Spinal Metastases ◽  
Percutaneous Ablation ◽  
Vertebral Augmentation ◽  
Single Institution ◽  
Safety And Efficacy ◽  
Spine Metastases ◽  
Radiation Resistant

Background: Radiation therapy (RT) is the current gold standard for palliation of painful vertebral metastases. However, other percutaneous modalities such as radiofrequency ablation (RFA), cryoablation, and vertebral augmentation have also been shown to be effective in alleviating symptoms. Combined RT and ablation may be more effective than either therapy alone in palliating painful metastatic disease to the spine. Objective: To evaluate the safety and efficacy of combined ablation, either RFA or cryoablation, and RT in the treatment of spinal metastases. Study Design: Retrospective study. Setting: This is a retrospective study at a single institution. Methods: Medical records of all patients who underwent ablation of spine lesions at a single institution between March 2012 and June 2014 were reviewed; patients treated with both RT and either RFA or cryoablation concurrently were identified. Pain scores before and after RFA were measured with the numerical rating scale (NRS) (0 – 10 point scale) and compared. Procedural complications, changes in general activity level, and pain medication usage after ablation were also recorded. When available, follow-up imaging was evaluated for evidence of residual or recurrent disease. Results: Twenty-one patients with 36 spine metastases were treated with RT and percutaneous ablation concurrently; either RFA (21/22) or cryoablation (1/22). One patient received 2 separate RFA treatments. Overall, mean worst pain score (8.0, SD = 2.3) significantly decreased at both one week (4.3, SD = 3.1; P < .02) and 4 weeks (2.9, SD = 3.3; P < .0003). Temporary postprocedural radicular pain occurred after one RFA treatment (4.5%; 1/22). Seven patients had radiation resistant tumors (renal cell, melanoma, or sarcoma). Post-procedural imaging (median 6 months; range 2 – 27 months) showed stable treated disease in 12/13 treatments at 3 months and 10/10 at 6 months. Limitations: The therapeutic effect of vertebral augmentation versus percutaneous ablation cannot be separated in this retrospective study. Radiation treatment protocols were variable and included both stereotactic body and conventional RT which may have different safety and efficacy profiles. Conclusion: Percutaneous ablation and concurrent RT is safe and effective in palliating painful spinal metastases and can be effective in those who have radiation resistant tumor histology. Key words: Interventional spine oncology, pain, percuataneous ablation, radiofrequency ablation, cryoablation, radiation therapy, spine metastases, vertebroplasty

scholarly journals Efficacy and Safety of Percutaneous Radiofrequency Thermal Ablation in the Treatment of Lung Cancer Lesions

2015 ◽  
Vol 28 (1) ◽  
pp. 63 ◽  
Author(s):  
Ana Tavares eCastro ◽  
Sara Freitas ◽  
Antónia Portilha ◽  
Fernando Alves ◽  
Filipe Caseiro-Alves
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Radiofrequency Ablation ◽  
Tnm Classification ◽  
Univariate Analysis ◽  
Lung Lesions ◽  
Major Complications ◽  
Clinical Series ◽  
Clinical Records

<p><strong>Introduction:</strong> In this study, we reviewed a clinical series composed by all malignant lung lesions submitted to computed tomographyguided percutaneous thermal radiofrequency ablation, in our hospital, a rather recent technique that has been gaining scientific recognition.<br /><strong>Material and Methods:</strong> For data purposes, all radiofrequency ablation and corresponding clinical records were retrospectively<br />analysed. A computed tomography scan was performed before and after each procedure to evaluate the tumour’s features, and at a second step to assess results and complications. The frequency of local recurrence and disease progression were determined based on imaging follow-up. Kaplan–Meier analysis was used to estimate survival. Univariate analysis recognized clinical and pathological factors affecting survival. These were also tested by multivariate analysis.<br /><strong>Results:</strong> A total of 28 malignant lung lesions, 20 primary and 8 metastatic, from 28 patients (78.6% male; mean age 62 ± 17 years old), were submitted to computed tomography-guided radiofrequency ablation between January 2004 and July 2010. Total necrosis was achieved in 74.1% of the lesions. Immediate radiofrequency ablation-related complications were observed in half of the procedures. Among major complications, death occurred in one patient only. Median overall survival was 43.0 months for a mean 2-years follow-up.<br />Median progression-free survival was 31.6 months. Lesion’s size smaller than 35 mm, stage III disease by the TNM classification and previous treatment attempts were significantly associated with better outcomes. Disease-related mortality was 46.4%.<br /><strong>Discussion: </strong>This procedure proved to be efficient to treat lung cancerous lesions, with a low-rate of major complications.<br /><strong>Conclusions:</strong> Computed tomography-guided percutaneous radiofrequency ablation is a minimally invasive procedure that appears to be valuable in the treatment of lung cancer lesions.<br /><strong>Keywords:</strong> Catheter Ablation; Lung Neoplasms; Tomography, X-Ray Computed.</p>

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