An in-vitro animal experiment on metal implants’ thermal effect on radiofrequency ablation

Zhao, Lin; Chu, Hong Wei; He, Fenglan; Wang, Luping; Kong, Jian

doi:10.1186/1477-7819-11-147

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…30 Because the monetary figures are difficult to compare across health systems and economies, the costs of related procedures may be helpful. For example, the average expenditure in Taiwan was US $5500 for coronary bypass surgery, 43 $6400 for radiofrequency catheter ablation for atrial fibrillation, 44 $10 000 for bare metal stent implantation, and $11 700 for drug-eluting stent implantation in the treatment of stable coronary artery disease. 45 Unlike these other elective procedures, ECMO is generally reserved for those with the lowest chances of immediate survival.…”

Section: Survival Of Ecmo Use In Adults 2431mentioning

confidence: 99%

Survival Analysis After Extracorporeal Membrane Oxygenation in Critically Ill Adults

et al. 2016

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As a result of many "miraculous" experiences, intensive care facilities everywhere in Taiwan are adopting ECMO technology. 13,14 The Taiwan National Health Insurance (NHI) initiated reimbursement for the high costs of ECMO therapy in 2002, further supporting its rapidly expanding implementation in the years since. The criteria for instituting ECMO in adult patients included cardiogenic shock of various origins, respiratory failure (defined as Pao 2 <60 mm Hg under 100% Fio 2 , CO 2 retention, or a bridge to lung transplantation) resulting from infectious or noninfectious processes, airway injury, and hypothermia (core temperature ≤30°C).15 ECMO is most used as a last resort for patients with severe refractory shock. The Taiwan NHI Background-Extracorporeal membrane oxygenation (ECMO) provides circulatory and respiratory support for patients with severe acute cardiopulmonary failure. The objective of this study was to examine the survival outcomes for patients who received ECMO. Methods and Results-Adult patients who received ECMO from September 1, 2002, to December 31, 2012 from the Taiwan National Health Insurance Database associated with coronary artery bypass graft surgery, myocardial infarction/cardiogenic shock, injury, and infection/septic shock. A Cox regression model was used to determine hazard ratios and to compare 30-day and 1-year survival rates with the myocardial infarction/cardiogenic shock group used as the reference. The mean±SD age of the 4227-patient cohort was 57±17 years, and 72% were male. The overall mortalities were 59.8% and 76.5% at 1 month and 1 year. Survival statistics deteriorated sharply when ECMO was required for >3 days. Acute (30-day) survival was more favorable in the infection/septic shock (n=1076; hazard ratio, 0.61; 95% confidence interval, 0.55-0.67), coronary artery bypass graft surgery (n=1077; hazard ratio, 0.68; 95% confidence interval, 0.61-0.75), and injury (n=369, hazard ratio, 0.82; 95% confidence interval, 0.70-0.95) groups. The extended survival rapidly approached an asymptote near 20% for the infection/septic shock, myocardial infarction/cardiogenic shock (n=1705), and coronary artery bypass graft surgery groups. The pattern of survival for the injury group was somewhat better, exceeding 30% at year-end. Conclusions-Regardless of initial pathology, patients requiring ECMO were critically ill with similar guarded prognoses.Those in the trauma group had somewhat better outcomes. Determining the efficacy and cost-effectiveness of ECMO should be a critical future goal. Continuing medical education (CME) credit is available for this article. Go to http://cme.ahajournals.org to take the quiz.Received August 22, 2015; accepted April 19, 2016. claims database contains extensive clinical data obtained during the roll out of this therapeutic modality and thus allows the study of the outcomes of patients on ECMO. Despite the efficacy of prompt ECMO support as an acute lifesaving strategy in cardiovascular emergencies, the overall mortality associated with cardiogenic shock...

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Section: Survival Of Ecmo Use In Adults 2431mentioning

confidence: 99%

Survival Analysis After Extracorporeal Membrane Oxygenation in Critically Ill Adults

et al. 2016

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“…However, small metallic implants showed none or lesser thermal effects. Lin et al studied the influences of silver clips and 125-I seeds within the target area of RFA, without significant thermal differences to the control group [15]. Even closer to our study design, Boll et al investigated the effect of titanium surgical clips in an ex vivo porcine liver model.…”

Section: Discussionmentioning

confidence: 87%

Microwave Ablation in the Proximity of Surgical Clips: Is there a Safety Issue?

Liebl

Schulze-Hagen

Zimmermann

et al. 2020

Cardiovasc Intervent Radiol

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Purpose The purpose of this study was to evaluate the heat generation of surgical clips within the target area of MWA and the influences on the ablation volume. Materials and Methods In bovine liver tissue, 42 ex vivo microwave ablations (60 W; 180 s) were performed. During ablation, the temperature was measured continuously at 4 points of interest (POI), in a distance of 7.5 and 15 mm on each side of the microwave antenna, with a titanium surgical placed at one 7.5-mm POI. Ablation volumes containing large vessels (n = 10) were excluded. For every POI, the mean temperature of 32 ablations was calculated. The mean temperatures were compared between the 4 POI and statistically analyzed using the Student's t test.Results The mean maximum temperatures at the side of the clip were 88.76°C/ 195 s and 52.97°C/ 195 s and at the side without clip 78.75°C/ 195 s and 43.16°C/ 195 s, respectively, at POI 7.5 mm and POI 15 mm. The maximum difference of mean temperatures for POI 7.5 mm was 12.91°C at 84 s (p = 0.022) and for POI 15 mm 9.77°C at 195 s (p = 0.009). No significant changes in size and shape of the ablation zone could be determined. Conclusions Our study demonstrated significantly higher temperatures adjacent to surgical clips. Also, the temperatures distal to the titanium clip were higher compared to the control location without clip. These findings suggest an increased risk of thermal damage to surrounding tissues during MWA, especially in case of immediate contact to surgical clips.

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An in-vitro animal experiment on metal implants’ thermal effect on radiofrequency ablation

Cited by 2 publications

References 6 publications

Survival Analysis After Extracorporeal Membrane Oxygenation in Critically Ill Adults

Survival Analysis After Extracorporeal Membrane Oxygenation in Critically Ill Adults

Microwave Ablation in the Proximity of Surgical Clips: Is there a Safety Issue?

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