Safety of radiofrequency ablation of myocardium and lung adjacent to the heart: an animal study 1 1This study was partially supported by RITA Medical Systems, Inc., Mountain View, California, the Swiss Academy of Medical Sciences (SAMS; Dr. Steinke’s scholarship), and to the St. George Private and Public Hospitals.

Steinke, Karin; Arnold, C C; Wulf, Sue; Morris, David L.

doi:10.1016/s0022-4804(03)00164-1

Cited by 19 publications

(2 citation statements)

References 15 publications

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“…First, the ex vivo tissue is exsanguinated. Blood perfusion in living human lung tissue has been observed to transport heat away after being submitted to thermal ablation [16, 17]. This effect is absent in the ex vivo model.…”

Section: Discussionmentioning

confidence: 99%

“…For these parameters only one and two of the 71 treatments respectively created a thermal effect larger than the 0.53 injury threshold. Considering the rapid development in thermal ablation of lung tissue technology from laser [15] to lung perfusion [23] to radio frequency [17, 24, 25] to vapour, a characterisation of the frequency factor and activation energy for thermal injury of pulmonary tissue is needed. Characterisation of thermal injury parameters for pulmonary tissue would allow for more precise analysis.…”

Section: Discussionmentioning

confidence: 99%

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Thermal effect of endoscopic thermal vapour ablation on the lung surface in human ex vivo tissue

Henne¹,

Anderson²,

Barry³

et al. 2012

International Journal of Hyperthermia

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Purpose: An investigation of the thermal effect and the potential for injury at the lung surface following thermal vapour ablation (InterVapor), an energy-based method of achieving endoscopic lung volume reduction.Methods: Heated water vapour was delivered to fifteen ex vivo human lungs using standard clinical procedure, and the thermal effect at the visceral pleura was monitored with an infrared camera. The time–temperature response was analysed mathematically to determine a cumulative injury quotient, which was compared to published thresholds.Results: The cumulative injury quotients for all 71 treatments of ex vivo tissue were found to be below the threshold for first degree burn and no other markers of tissue injury at the lung surface were observed.Conclusion: The safety profile for thermal vapour ablation is further supported by the demonstration that the thermal effect in a worst-case model is not expected to cause injury at the lung surface.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Thermal effect of endoscopic thermal vapour ablation on the lung surface in human ex vivo tissue

Henne¹,

Anderson²,

Barry³

et al. 2012

International Journal of Hyperthermia

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Radiofrequency Ablation of Liver Colorectal Metastases

Tracey

Dimarakis

Zacharoulis

et al.

Liver and Biliary Tract Surgery

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Lung Tumor Radiofrequency Ablation: Where Do We Stand?

Baère

2010

Cardiovasc Intervent Radiol

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Today, radiofrequency ablation (RFA) of primary and metastatic lung tumor is increasingly used. Because RFA is most often used with curative intent, preablation workup must be a preoperative workup. General anesthesia provides higher feasibility than conscious sedation. The electrode positioning must be performed under computed tomography for sake of accuracy. The delivery of RFA must be adapted to tumor location, with different impedances used when treating tumors with or without pleural contact. The estimated rate of incomplete local treatment at 18 months was 7% (95% confidence interval, 3-14) per tumor, with incomplete treatment depicted at 4 months (n = 1), 6 months (n = 2), 9 months (n = 2), and 12 months (n = 2). Overall survival and lung disease-free survival at 18 months were, respectively, 71 and 34%. Size is a key point for tumor selection because large size is predictive of incomplete local treatment and poor survival. The ratio of ablation volume relative to tumor volume is predictive of complete ablation. Follow-up computed tomography that relies on the size of the ablation zone demonstrates the presence of incomplete ablation. Positron emission tomography might be an interesting option. Chest tube placement for pneumothorax is reported in 8 to 12%. Alveolar hemorrhage and postprocedure hemoptysis occurred in approximately 10% of procedures and rarely required specific treatment. Death was mostly related to single-lung patients and hilar tumors. No modification of forced expiratory volume in the first second between pre- and post-RFA at 2 months was found. RFA in the lung provides a high local efficacy rate. The use of RFA as a palliative tool in combination with chemotherapy remains to be explored.

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Cited by 19 publications

References 15 publications

Thermal effect of endoscopic thermal vapour ablation on the lung surface in human ex vivo tissue

Thermal effect of endoscopic thermal vapour ablation on the lung surface in human ex vivo tissue

Radiofrequency Ablation of Liver Colorectal Metastases

Lung Tumor Radiofrequency Ablation: Where Do We Stand?

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