Erschienen in:
27.04.2020 | Technical Note
Performance of a New Blunt-Tip Needle for the Displacement of Critical Structure in Thermal Ablation
verfasst von:
Pierre Auloge, Roberto L. Cazzato, Jeanie Betsy Chiang, Jean Caudrelier, Julia Weiss, Pierre De Marini, Guillaume Koch, Julien Garnon, Afshin Gangi
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 6/2020
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Abstract
Purpose
To ascertain the performance of a new blunt-tip needle (HydroGuard®), which allows injection of fluids during needle advancement in order to safely approach, displace and insulate nearby critical structures during thermal ablation (TA).
Materials and Methods
This study included 27 consecutive patients treated by TA [cryoablation (CA), radiofrequency (RFA), and microwave MWA)] between April 2018 and January 2019. During TA, hydro- or gas dissection was performed with HydroGuard® needle to displace and protect critical structures close to the tumor (< 10 mm). Technical and clinical success, distance between critical structure and tumor before and after hydro/gas dissection and complications were recorded.
Results
Eighteen patients were treated by CA (66.7%), 7 by MWA (25.9%) and 2 by RFA (7.4%). Majority of patients were treated with a curative intent (24/27; 88.8%). Adjacent critical structures include vessels (n = 3), nerves (n = 10), ureter/renal pelvis (n = 3), bowel/rectum (n = 10), stomach: (n = 3), diaphragm (n = 2), and pleura (n = 1). Technical success was 100%. Clinical success was 88% (24/27). Median minimum distance to adjacent critical structures before hydro/gas dissection was 1 mm (range 0–9 mm; IQR: 0–3 mm) versus 10.5 mm (range 4–47 mm; IQR: 9.7–18 mm) after displacement. Of the 27 patients treated, four developed complications (14.8%; 95% CI: 1.4–28.2): 1 major (3.7%; 95% CI: 0–10.8) and 3 minors (11.1%; 95% CI: 0–23). Only one minor complication was related to inadequate hydro-dissection, resulting in close proximity of the critical structure to the ablation zone.
Conclusion
HydroGuard® is a safe and effective needle when used to approach, displace and insulate nearby critical structures during TA.