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Focal Ablation

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https://www.readbyqxmd.com/read/28644203/invasive-investigation-of-insular-cortex-epilepsy
#1
Philippe Ryvlin, Fabienne Picard
Invasive long-term EEG investigations of the insula have been performed since the mid-nineties in an expanding range of focal epilepsies suspected to involve the insular cortex. The various clinical forms of insular epilepsies were delineated during the last 2 decades, and include the following presentations: perisylvian epilepsy, temporal plus epilepsy, sleep hypermotor epilepsy, MRI-negative frontal and parietal lobe epilepsies, and insular lesions. In fact, a majority of complex stereoelectroencephalography procedures will include at least one electrode targeting the insula...
July 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28641910/dependence-of-boiling-histotripsy-treatment-efficiency-on-hifu-frequency-and-focal-pressure-levels
#2
Tatiana D Khokhlova, Yasser A Haider, Adam D Maxwell, Wayne Kreider, Michael R Bailey, Vera A Khokhlova
Boiling histotripsy (BH) is a high-intensity focused ultrasound (HIFU)-based method of mechanical tissue fractionation that utilizes millisecond-long bursts of HIFU shock waves to cause boiling at the focus in milliseconds. The subsequent interaction of the incoming shocks with the vapor bubble mechanically lyses surrounding tissue and cells. The acoustic parameter space for BH has been investigated previously and an inverse dependence between the HIFU frequency and the dimensions of a BH lesion has been observed...
June 19, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28641381/supraventricular-tachyarrhythmias-in-patients-with-a-persistent-left-superior-vena-cava
#3
Jongmin Hwang, Hyoung-Seob Park, Jun Kim, Jeong Su Kim, Jong Sung Park, Ki-Hun Kim, Myung Hwan Bae, Sang-Hee Lee, Young Soo Lee, Seongwook Han, Dae-Kyeong Kim, Tae-Joon Cha, Dong Gu Shin, Byung Chun Jung, Yoon-Nyun Kim
Aims: A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. This venous anomaly can impact the evaluation and treatment of supraventricular tachyarrhythmia (SVA). The aim of this study was to assess the proportion and characteristics of PLSVC in adult SVA patients. Methods and results: From July 2002 to July 2012, clinical and procedural data from databases of 10 cardiac electrophysiology laboratories in the Yeungnam region of the Republic of Korea were reviewed...
June 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28639746/acute-changes-in-histopathology-and-intravascular-imaging-after-catheter-based-renal-denervation-in-a-porcine-model
#4
Atsushi Sakaoka, Akiyuki Takami, Yuji Onimura, Hitomi Hagiwara, Hisako Terao, Fumiaki Kumagai, Kiyoshi Matsumura
OBJECTIVES: We first aimed to identify the histopathological changes occurring immediately after renal denervation (RDN) with radiofrequency energy, and then to assess the feasibility of determining procedural success using currently available clinical intravascular imaging techniques. BACKGROUND: Catheter-based RDN has been used as an alternative therapy for hypertension. However, no practical endpoint to determine procedural success during treatment has been established...
June 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28635336/new-advances-in-focal-therapy-for-early-stage-prostate-cancer
#5
Kae Jack Tay, Ariel A Schulman, Christina Sze, Efrat Tsivian, Thomas J Polascik
Prostate focal therapy offers men the opportunity to achieve oncological control while preserving sexual and urinary function. The prerequisites for successful focal therapy are to accurately identify, localize and completely ablate the clinically significant cancer(s) within the prostate. We aim to evaluate the evidence for current and upcoming technologies that could shape the future of prostate cancer focal therapy in the next five years. Areas Covered: Current literature on advances in patient selection using imaging, biopsy and biomarkers, ablation techniques and adjuvant treatments for focal therapy are summarized...
June 21, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28633808/impact-of-mr-guided-boiling-histotripsy-in-distinct-murine-tumor-models
#6
Martijn Hoogenboom, Dylan C Eikelenboom, Renske J E van den Bijgaart, Arend Heerschap, Pieter Wesseling, Martijn H den Brok, Jurgen J Fütterer, Gosse J Adema
Interest in mechanical high intensity focused ultrasound (HIFU) ablation is rapidly growing. Boiling histotripsy (BH) is applied for mechanical fragmentation of soft tissue into submicron fragments with limited temperature increase using the shock wave and cavitation effects of HIFU. Research on BH has been largely limited to ex vivo experiments. As a consequence, the in vivo pathology after BH treatment and the relation to preexistent tissue characteristics are not well understood. This study reports on in vivo MR guided BH treatment, either with 100 or 200 pulses per focal spot, in three different subcutaneous mouse tumor models: a soft-tissue melanoma (B16OVA), a compact growing thymoma (EL4), and a highly vascularized neuroblastoma (9464D)...
September 2017: Ultrasonics Sonochemistry
https://www.readbyqxmd.com/read/28623986/double-prepuncture-as-a-valuable-adjunctive-technique-for-complex-endovenous-ablation
#7
Scarlett Hao, Samantha Cox, Thomas S Monahan, Rajabrata Sarkar
OBJECTIVE: The objective of this study was to characterize the technique and to report the results of double prepuncture used during complex radiofrequency ablation (RFA) in cases of treating multiple incompetent veins or encountering focal obstruction to catheter advancement. METHODS: A double prepuncture technique was applied in patients requiring endovascular ablation of multiple veins and patients with great saphenous vein cannulation failure. We treated 13 limbs in 12 patients during a 24-month period with RFA in which the double prepuncture technique was used...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28621306/targeted-two-photon-chemical-apoptotic-ablation-of-defined-cell-types-in-vivo
#8
Robert A Hill, Eyiyemisi C Damisah, Fuyi Chen, Alex C Kwan, Jaime Grutzendler
A major bottleneck limiting understanding of mechanisms and consequences of cell death in complex organisms is the inability to induce and visualize this process with spatial and temporal precision in living animals. Here we report a technique termed two-photon chemical apoptotic targeted ablation (2Phatal) that uses focal illumination with a femtosecond-pulsed laser to bleach a nucleic acid-binding dye causing dose-dependent apoptosis of individual cells without collateral damage. Using 2Phatal, we achieve precise ablation of distinct populations of neurons, glia and pericytes in the mouse brain and in zebrafish...
June 16, 2017: Nature Communications
https://www.readbyqxmd.com/read/28612019/thermal-ablation-in-the-management-of-colorectal-cancer-patients-with-oligometastatic-liver-disease
#9
REVIEW
Elena Nadia Petre, Constantinos Sofocleous
BACKGROUND: Surgical resection of limited colorectal liver disease improves long-term survival and can be curative in a subset of selected cases. Image-guided percutaneous ablation therapies have emerged as safe and effective alternative options for selected patients with unresectable colorectal liver metastases (CLM) that can be ablated with margins. Ablation causes focal destruction of tissue and has increasingly been shown to provide durable eradication of tumors. METHODS: A selective review of literature was conducted in PubMed, focusing on recent studies reporting on the safety, efficacy, and long-term outcomes of percutaneous ablation modalities in the treatment of CLM...
March 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28605809/retinal-macrophages-synthesize-c3-and-activate-complement-in-amd-and-in-models-of-focal-retinal-degeneration
#10
Riccardo Natoli, Nilisha Fernando, Haihan Jiao, Tanja Racic, Michele Madigan, Nigel L Barnett, Joshua A Chu-Tan, Krisztina Valter, Jan Provis, Matt Rutar
Purpose: Complement system dysregulation is strongly linked to the progression of age-related macular degeneration (AMD). Deposition of complement including C3 within the lesions in atrophic AMD is thought to contribute to lesion growth, although the contribution of local cellular sources remains unclear. We investigated the role of retinal microglia and macrophages in complement activation within atrophic lesions, in AMD and in models of focal retinal degeneration. Methods: Human AMD donor retinas were labeled for C3 expression via in situ hybridization...
June 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28604765/mlk3-regulates-fra-1-and-mmps-to-drive-invasion-and-transendothelial-migration-in-triple-negative-breast-cancer-cells
#11
C Rattanasinchai, B J Llewellyn, S E Conrad, K A Gallo
Mixed-lineage kinase 3 (MLK3), a mitogen-activated protein kinase kinase kinase (MAP3K), has critical roles in metastasis of triple-negative breast cancer (TNBC), in part by regulating paxillin phosphorylation and focal adhesion turnover. However the mechanisms and the distinct step(s) of the metastatic processes through which MLK3 exerts its influence are not fully understood. Here we report that in non-metastatic, estrogen receptor-positive breast cancer (ER+ BC) cells, induced MLK3 expression robustly upregulates the oncogenic transcription factor, FOS-related antigen-1 (FRA-1), which is accompanied by elevation of matrix metalloproteinases (MMPs), MMP-1 and MMP-9...
June 12, 2017: Oncogenesis
https://www.readbyqxmd.com/read/28597737/extension-of-catheter-ablation-and-outcome-for-ventricular-tachycardia-or-premature-ventricular-contractions-from-the-right-ventricular-outflow-tract
#12
Ki-Hun Kim, Hyoung-Seob Park, Yeo-Jung Song, Jeong-Sook Seo, Han-Young Jin, Dae-Kyeong Kim, Dong-Soo Kim, Young-Soo Lee, Ki-Won Hwang, Guang-Won Seo, Dong-Kie Kim, Pil-Sang Song, Sang-Hoon Seol, Doo-Il Kim, Yoon-Nyun Kim
Objective We aimed to determine whether the extension of ablation could influence the ablation outcome for ventricular tachycardia (VT)/premature ventricular contractions (PVCs) from the right ventricular outflow tract (RVOT). Methods and results The radiofrequency catheter ablation results of 33 VT/6 frequent PVCs from the RVOT were analysed. The ablation extension was divided into 3 categories from the final successful ablation point with the earliest activation: (I) focal ablation (15 cases); ablation at 1 or 2 points; (II) focal with extended ablation (12 cases); focal and surrounding area ablation (maximum ≤1 cm) after elimination of clinical VT/PVCs; and (III) broad ablation (12 cases); continued broad ablation (maximum >1 cm) after elimination of clinical VT/PVCs...
February 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28597532/substrate-characterization-and-catheter-ablation-in-patients-with-scar-related-ventricular-tachycardia-using-ultra-high-density-3d-mapping
#13
Jana M Nührich, Lukas Kaiser, Ruken Özge Akbulak, Benjamin N Schäffer, Christian Eickholt, Michael Schwarzl, Pawel Kuklik, Julia Moser, Mario Jularic, Stephan Willems, Christian Meyer
BACKGROUND: Ablation of scar-related ventricular tachycardia (VT), especially in non-inducible VT or hemodynamically unstable patients, can be challenging. Thus, we evaluated feasibility of an ultra high-density 3D-mapping approach to characterize the ventricular substrate and, if possible, to map VT. METHODS AND RESULTS: Twenty-two patients (67±2 years, mean LV-EF 36±3%) with both ischemic and non-ischemic cardiomyopathy and documented VT underwent mapping and catheter ablation using a 64-electrode mini-basket catheter...
June 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28596994/recurrent-post-ablation-paroxysmal-atrial-fibrillation-shares-substrates-with-persistent-atrial-fibrillation-an-11-center-study
#14
Junaid A B Zaman, Tina Baykaner, Paul Clopton, Vijay Swarup, Robert C Kowal, James P Daubert, John D Day, John Hummel, Amir A Schricker, David E Krummen, Moussa Mansour, Gery F Tomassoni, Kevin R Wheelan, Mohan Vishwanathan, Shirley Park, Paul J Wang, Sanjiv M Narayan, John M Miller
INTRODUCTION: The role of atrial fibrillation (AF) substrates is unclear in patients with paroxysmal AF (PAF) that recurs after pulmonary vein isolation (PVI). We hypothesized that patients with recurrent post-ablation (redo) PAF despite PVI have electrical substrates marked by rotors and focal sources, and structural substrates that resemble persistent AF more than patients with (de novo) PAF at first ablation. METHODS: In 175 patients at 11 centers, we compared AF substrates in both atria using 64 pole-basket catheters and phase mapping, and indices of anatomical remodeling between patients with de novo or redo PAF and first ablation for persistent AF...
April 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28594430/substrate-characteristics-and-ablation-outcome-of-left-atrial-tachycardia-in-rheumatic-mitral-valve-disease
#15
Hongwu Chen, Bing Yang, Weizhu Ju, Fengxiang Zhang, Gang Yang, Kai Gu, Mingfang Li, Hailei Liu, Zidun Wang, Kejiang Cao, Minglong Chen
BACKGROUND: Right atrial tachycardia (AT) is common arrhythmia post-surgical valve replacement in patients with rheumatic heart disease (RHD). However, the substrate and the mechanism of left AT in such patients and the ablation efficacy is less known. METHODS AND RESULTS: Twenty-seven RHD patients with AT were enrolled in this study, nine of them (33%) had Left AT. Five and four patients had left AT during the first and second procedure, respectively. A spontaneous scar in the left posterior wall was identified in all patients, and obvious anterior scar in three patients...
June 8, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28585695/the-rhogap-myo9b-promotes-bone-growth-by-mediating-osteoblastic-responsiveness-to-igf-1
#16
Brooke K McMichael, Yong-Hoon Jeong, Justin A Auerbach, Cheol-Min Han, Ryan Sedlar, Vikram Shettigar, Martin Bähler, Sudha Agarwal, Do-Gyoon Kim, Beth S Lee
The RhoA subfamily of Rho GTPases regulates actin-based cellular functions in bone such as differentiation, migration, and mechanotransduction. Polymorphisms or genetic ablation of RHOA and some of its regulatory guanine exchange factors (GEFs) have been linked to poor bone health in humans and mice, but the effects of RhoA-specific GTPase-activating proteins (GAPs) on bone quality have not yet been identified. Therefore, we examined the consequences of RhoGAP Myo9b gene knockout on bone growth, phenotype and cellular activity...
June 6, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28583643/utility-of-t1-weighted-mri-as-a-predictor-of-liver-lesion-visibility-on-ultrasound-a-clinical-tool-to-determine-feasibility-of-ultrasound-guided-percutaneous-interventions
#17
Timothy L Miao, Ania Z Kielar, Rebecca M Hibbert, Nicola Schieda
PURPOSE: To determine the utility of fat-suppressed T1-weighted gradient recalled echo (FS-T1W-GRE) MRI to predict visibility of focal liver lesions (FLL) on abdominal ultrasound (US). MATERIALS AND METHODS: With IRB approval, between 2010 and 2013, 109 patients (28.4% females, age 66.9±10.9years) with 177 FLL (hepatocellular carcinoma=132, metastases=44, other=1) underwent MRI and prospective, radiologist-performed treatment-planning US (to determine eligibility for US-guided ablation)...
May 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28579687/therapeutic-ultrasound-and-prostate-cancer
#18
REVIEW
Karthik M Sundaram, Sam S Chang, David F Penson, Sandeep Arora
Therapeutic ultrasound approaches including high-intensity focused ultrasound (HIFU) are emerging as popular minimally invasive alternative treatments for localized, low-to-intermediate risk prostate cancer. FDA approval was recently granted for two ultrasound-guided HIFU devices. Clinical trials for devices using MRI guidance are ongoing. The current level of evidence for whole-gland ultrasound ablation suggests that its clinical efficacy and adverse event rates including erectile dysfunction and urinary incontinence are similar to current definitive therapies such as radical prostatectomy and external-beam radiotherapy...
June 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28557354/modeling-liver-electrical-conductivity-during-hypertonic-injection
#19
Quim Castellví, Patricia Sánchez-Velázquez, Xavier Moll, Enrique Berjano, Anna Andaluz, Fernando Burdío, Bart Bijnens, Antoni Ivorra
Metastases in the liver frequently grow as scattered tumor nodules which neither can be removed by surgical resection nor focally ablated. Previously, we have proposed a novel technique based on irreversible electroporation which may be able to simultaneously treat all nodules in the liver while sparing healthy tissue. The proposed technique requires increasing the electrical conductivity of healthy liver by injecting a hypersaline solution through the portal vein. Aiming to assess the capability of increasing the global conductivity of the liver by means of hypersaline fluids, here it is presented a mathematical model which estimates the NaCl distribution within the liver and the resulting conductivity change...
May 30, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28551444/effect-of-prior-focal-therapy-on-perioperative-oncologic-and-functional-outcomes-of-salvage-robotic-assisted-radical-prostatectomy
#20
Igor Nunes-Silva, Eric Barret, Victor Srougi, Mohammed Baghdadi, Paolo Capogrosso, Silvia Garcia-Barreras, Solange Kanso, Rafael Tourinho-Barbosa, Ariê Carneiro, Rafael Sanchez-Salas, François Rozet, Marc Galiano, Xavier Cathelineau
PURPOSE: To assess the impact of focal therapy (FT) on perioperative, oncologic, and functional outcomes in men who underwent salvage robotic-assisted radical prostatectomy(S-RARP) compared to primary RARP (P-RARP). MATERIALS AND METHODS: FT was performed in patients presenting Gleason score 3+3 or 3+4, clinical stage ≤cT2a, serum prostate-specific antigen(PSA) ≤15ng/ml, unilateral positive biopsy, maximum length of any positive core <10mm and life expectancy >10 years...
May 24, 2017: Journal of Urology
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