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Focal Ablation

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https://www.readbyqxmd.com/read/28095774/multiple-focal-and-macroreentrant-left-atrial-tachycardias-originating-from-a-spontaneous-scar-at-the-contiguous-aorta-left-atrium-area-in-a-patient-with-hypertrophic-cardiomyopathy-a-case-report
#1
Kyoichiro Yazaki, Yoichi Ajiro, Fumiaki Mori, Masahiro Watanabe, Kei Tsukamoto, Takashi Saito, Keiko Mizobuchi, Kazunori Iwade
BACKGROUND: Spontaneous scar-related left atrial tachycardia (AT) is a rare arrhythmia. We describe a patient with hypertrophic cardiomyopathy (HCM) who developed multiple, both focal and macroreentrant left ATs associated with a spontaneous scar located at the aorta-left atrium (LA) contiguous area. CASE PRESENTATION: A 65-year-old man with HCM complained of palpitations. Twelve-lead electrocardiogram showed narrow QRS tachycardia with 2:1 atrioventricular conduction...
January 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28090656/real-time-monitoring-of-tissue-displacement-and-temperature-changes-during-mr-guided-high-intensity-focused-ultrasound
#2
Pierre Bour, Fabrice Marquet, Valéry Ozenne, Solenn Toupin, Erik Dumont, Jean-François Aubry, Matthieu Lepetit-Coiffe, Bruno Quesson
PURPOSE: The therapy endpoint most commonly used in MR-guided high intensity focused ultrasound is the thermal dose. Although namely correlated with nonviable tissue, it does not account for changes in mechanical properties of tissue during ablation. This study presents a new acquisition sequence for multislice, subsecond and simultaneous imaging of tissue temperature and displacement during ablation. METHODS: A single-shot echo planar imaging sequence was implemented using a pair of motion-encoding gradients, with alternated polarities...
January 16, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28069193/safety-of-ultrasound-guided-high-intensity-focused-ultrasound-ablation-for-diffuse-adenomyosis-a-retrospective-cohort-study
#3
Yujie Feng, Liang Hu, Wenzhi Chen, Rong Zhang, Xi Wang, Jinyun Chen
OBJECTIVES: To evaluate the safety of ultrasound-guided high-intensity focused ultrasound (HIFU) ablation for patients with diffuse adenomyosis. METHODS: This was a retrospective cohort study. The data was collected from 417 symptomatic adenomyosis patients who underwent ultrasound-guided HIFU between January 2012 and December 2015 at 1st Affiliated Hospital of Chongqing Medical University, Chongqing, China. Among them were 260 patients with diffuse adenomyosis (Group D) and 157 patients with focal adenomyosis (Group F)...
May 2017: Ultrasonics Sonochemistry
https://www.readbyqxmd.com/read/28063269/novel-mapping-technique-for-localization-of-focal-and-reentrant-activation-during-atrial-fibrillation
#4
Yoshihide Takahashi, Shinsuke Iwai, Syu Yamashita, Mayumi Masumura, Masahito Suzuki, Kento Yabe, Yasuhiro Sato, Kenzo Hirao, Mitsuaki Isobe
INTRODUCTION: Identification of wavefront propagation pattern during AF remains challenging in ablation procedures. We sought to test a novel combination of a new mapping technology called Ripple Map and high density mapping to distinguish focal and reentrant activation during atrial fibrillation (AF). METHODS AND RESULTS: Subjects were patients undergoing ablation for persistent AF. If AF remained after isolation of the pulmonary veins, the left atrium (LA) was mapped by a high-density mapping catheter for later analysis, after which ablation was continued using a conventional stepwise approach...
January 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28058731/improved-intercostal-hifu-ablation-using-a-phased-array-transducer-based-on-fermat-s-spiral-and-voronoi-tessellation-a-numerical-evaluation
#5
Pascal Ramaekers, Mario Ries, Chrit T W Moonen, Martijn de Greef
PURPOSE: A major complication for abdominal High Intensity Focused Ultrasound (HIFU) applications is the obstruction of the acoustic beam path by the thoracic cage, which absorbs and reflects the ultrasonic energy leading to undesired overheating of healthy tissues in the pre-focal area. Prior work has investigated the determination of optimized transducer apodization laws, which allow for a reduced rib exposure whilst (partially) restoring focal point intensity through power compensation...
January 6, 2017: Medical Physics
https://www.readbyqxmd.com/read/28045693/kelch-like-ech-associated-protein-1-dependent-nuclear-factor-e2-related-factor-2-activation-in-relation-to-antioxidation-induced-by-sevoflurane-preconditioning
#6
Min Cai, Li Tong, Beibei Dong, Wugang Hou, Likai Shi, Hailong Dong
BACKGROUND: The authors have reported that antioxidative effects play a crucial role in the volatile anesthetic-induced neuroprotection. Accumulated evidence shows that endogenous antioxidation could be up-regulated by nuclear factor-E2-related factor 2 through multiple pathways. However, whether nuclear factor-E2-related factor 2 activation is modulated by sevoflurane preconditioning and, if so, what is the signaling cascade underlying upstream of this activation are still unknown. METHODS: Sevoflurane preconditioning in mice was performed with sevoflurane (2...
December 30, 2016: Anesthesiology
https://www.readbyqxmd.com/read/28039924/focal-impulse-and-rotor-modulation-for-the-treatment-of-atrial-fibrillation-locations-and-one-year-outcomes-of-human-rotors-identified-using-a-64-electrode-basket-catheter
#7
Roland Richard Tilz, Tina Lin, Andreas Rillig, Christian-H Heeger, Leonie Scholz, Peter Wohlmuth, Tudor Bucur, Andreas Metzner, Shibu Mathew, Erik Wissner, Feifan Ouyang, Karl-Heinz Kuck
INTRODUCTION: Pulmonary vein isolation (PVI) is currently the gold standard for catheter ablation of atrial fibrillation (AF). The mechanism for AF-maintenance is still controversial. The concept of rapidly-activating spiral rotors perpetuating AF has led to the development of several rotor-mapping systems. We present our experience with focal impulse and rotor modulation (FIRM) using a 64-electrode basket catheter and computational system and evaluate its feasibility in conjunction with PVI to treat AF...
December 31, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28033149/partial-gland-ablation-in-the-management-of-prostate-cancer-a-review
#8
Timothy D McClure, Daniel J A Margolis, Jim C Hu
PURPOSE OF REVIEW: The index lesion theory has created a strong interest in partial gland ablation for men with prostate cancer. By only treating the focus of clinically significant disease and avoidance of surrounding periprostatic tissue, one may provide adequate oncologic control with minimal side effects. Accurate identification of the index lesion and effective ablation are critical for satisfactory oncologic outcomes. Herein, we review key ablative techniques used in partial gland ablation...
December 28, 2016: Current Opinion in Urology
https://www.readbyqxmd.com/read/28012849/patients-with-barrett-s-esophagus-and-confirmed-persistent-low-grade-dysplasia-at-increased-risk-for-progression-to-neoplasia
#9
Lucas C Duits, M J van der Wel, Cary C Cotton, K Nadine Phoa, Fiebo J W Ten Kate, Cees A Seldenrijk, G Johan A Offerhaus, Mike Visser, Sybren L Meijer, Rosalie C Mallant-Hent, Kausilia K Krishnadath, Roos E Pouw, Jan G P Tijssen, Nicholas J Shaheen, Jacques J G H M Bergman
BACKGROUND & AIMS: For patients with Barrett's esophagus (BE), the diagnosis of low-grade dysplasia (LGD) is subjective and reported outcomes vary. We analyzed data from a multicenter study of endoscopic therapy to identify factors associated progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in patients with LGD of the esophagus. METHODS: We performed a retrospective analysis of data from 255 patients with a primary diagnosis of LGD (78% men; mean age, 63 years) who participated in a randomized controlled trial of surveillance vs radiofrequency ablation in Europe...
December 21, 2016: Gastroenterology
https://www.readbyqxmd.com/read/28000627/the-role-of-contrast-enhanced-endoscopic-ultrasound-in-pancreatic-adenocarcinoma
#10
REVIEW
Adrian Saftoiu, Peter Vilmann, Manoop S Bhutani
Contrast-enhanced endoscopic ultrasound (CE-EUS) allows characterization, differentiation, and staging of focal pancreatic masses. The method has a high sensitivity and specificity for the diagnosis of pancreatic adenocarcinoma which is visualized as hypo-enhanced as compared to the rest of the parenchyma while chronic pancreatitis and neuroendocrine tumors are generally either iso-enhanced or hyper-enhanced. The development of contrast-enhanced low mechanical index harmonic imaging techniques used in real time during endoscopic ultrasound (EUS) allowed perfusion imaging and the quantification of intensity of the contrast signal through time-intensity curve analysis...
November 2016: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/27999692/polypoid-dysplasia-in-barrett-s-esophagus-diagnosis-management-and-very-different-outcomes-in-two-consecutive-cases
#11
Megan Murphy, Christina Tofani, Kunjal Gandhi, Anthony Infantolino
Background. Barrett's esophagus is associated with an increased risk of adenocarcinoma. Dysplasia in Barrett's esophagus is a precursor to adenocarcinoma. Rarely, dysplastic polypoid lesions are superimposed on Barrett's esophagus. Most reported cases of polypoid dysplasia in Barrett's esophagus have been advanced on presentation and treated with esophagectomy. We describe two cases of polypoid changes in Barrett's esophagus and treatment with polypectomy followed by radiofrequency ablation. Cases. A 75 yo male presented with esophageal polyps, which on biopsy showed gastric cardia/foveolar mucosa with focal intestinal metaplasia without dysplasia...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27997963/efficacy-of-the-cryoballoon-focal-ablation-system-for-the-eradication-of-dysplastic-barrett-s-esophagus-islands
#12
Hannah T Künzli, Dirk W Schölvinck, Sybren L Meijer, Kees A Seldenrijk, Jacques G H M Bergman, Bas L A M Weusten
Background and study aim Cryoablation can be used for the treatment of Barrett's esophagus (BE). A recent dosimetry study, using the CryoBalloon Focal Ablation System (CryoBalloon), demonstrated that 10-second ablations result in complete eradication of BE. However, the efficacy of 10-second ablation in a larger cohort of patients has not been investigated, nor has the potential of precise targeting of specific areas. The aim of the study was to assess the efficacy and performance (i. e. targeting of BE islands) of a 10-second cryoablation using the CryoBalloon...
December 20, 2016: Endoscopy
https://www.readbyqxmd.com/read/27997415/high-intensity-focused-ultrasound-for-focal-therapy-reality-or-pitfall
#13
Ariel A Schulman, Kae J Tay, Cary N Robertson, Thomas J Polascik
PURPOSE OF REVIEW: Progress in imaging, fusion software, and ablative modalities has fostered growth of the latest image-guided generation of high-intensity focused ultrasound (HIFU) for focal treatment of prostate cancer. Although early reports are encouraging, important questions remain regarding candidate selection, treatment, and outcomes. We review contemporary considerations for the use of HIFU for focal treatment of primary and radio-recurrent prostate cancer. RECENT FINDINGS: HIFU has been used to treat prostate cancer for over two decades...
December 16, 2016: Current Opinion in Urology
https://www.readbyqxmd.com/read/27995752/ultrasound-image-based-visual-servoing-for-moving-target-ablation-by-high-intensity-focused-ultrasound
#14
Joonho Seo, Norihiro Koizumi, Mamoru Mitsuishi, Naohiko Sugita
BACKGROUND: Although high intensity focused ultrasound (HIFU) is a promising technology for tumor treatment, a moving abdominal target is still a challenge in current HIFU systems. In particular, respiratory-induced organ motion can reduce the treatment efficiency and negatively influence the treatment result. In this research, we present: (1) a methodology for integration of ultrasound (US) image based visual servoing in a HIFU system; and (2) the experimental results obtained using the developed system...
December 20, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/27965318/mapping-and-ablation-of-anteroseptal-atrial-tachycardia-in-patients-with-congenitally-corrected-transposition-of-the-great-arteries-implication-of-pulmonary-sinus-cusps
#15
Xiao-Gang Guo, Zili Liao, Qi Sun, Xu Liu, Gong-Bu Zhou, Jian-du Yang, Bin Luo, Feifan Ouyang, Jian Ma, Shu Zhang
AIMS: We sought to investigate focal atrial tachycardias (ATs) in patients with congenitally corrected transposition of the great arteries (ccTGA). METHODS AND RESULTS: We identified three cases of focal ATs with ccTGA from 2007 to 2015. The clinical findings, electrocardiography, electrophysiological features, and ablation were reported. All three cases had {S,L,L}-type ccTGA. The AT P waves shared the following features: narrow in width, positive in leads I and aVL, and negative/positive in lead V1...
December 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27959970/magnetic-resonance-thermometry-guided-stereotactic-laser-ablation-of-cavernous-malformations-in-drug-resistant-epilepsy-imaging-and-clinical-results
#16
D Jay McCracken, Jon T Willie, Brad Fernald, Amit M Saindane, Daniel L Drane, Daniel L Barrow, Robert E Gross
BACKGROUND: Surgery is indicated for cerebral cavernous malformations (CCM) that cause medically refractory epilepsy. Real-time magnetic resonance thermography (MRT)-guided stereotactic laser ablation (SLA) is a minimally invasive approach to treating focal brain lesions. SLA of CCM has not previously been described. OBJECTIVE: To describe MRT-guided SLA, a novel approach to treating CCM-related epilepsy, with respect to feasibility, safety, imaging, and seizure control in 5 consecutive patients...
March 2016: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/27955940/magnetic-resonance-imaging-transrectal-ultrasound-fusion-focal-cryotherapy-of-the-prostate-a-prospective-development-study
#17
Massimo Valerio, Taimur Tariq Shah, Paras Shah, Neil Mccartan, Mark Emberton, Manit Arya, Hashim Uddin Ahmed
OBJECTIVES: The use of software-based magnetic resonance-transrectal ultrasound fusion to deliver focal therapy may increase the precision of treatment. This is a prospective development study assessing the feasibility of Magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion focal cryotherapy. METHODS AND MATERIALS: Consecutive patients undergoing focal cryotherapy were included in an academic registry (December 2013-June 2014). MRI-TRUS fusion focal cryotherapy was offered to men with visible clinically significant prostate cancer (Galil SeedNet system)...
December 7, 2016: Urologic Oncology
https://www.readbyqxmd.com/read/27941791/bone-marrow-derived-immature-myeloid-cells-are-a-main-source-of-circulating-supar-contributing-to-proteinuric-kidney-disease
#18
Eunsil Hahm, Changli Wei, Isabel Fernandez, Jing Li, Nicholas J Tardi, Melissa Tracy, Shikha Wadhwani, Yanxia Cao, Vasil Peev, Andrew Zloza, Jevgenijs Lusciks, Salim S Hayek, Christopher O'Connor, Markus Bitzer, Vineet Gupta, Sanja Sever, David B Sykes, David T Scadden, Jochen Reiser
Excess levels of protein in urine (proteinuria) is a hallmark of kidney disease that typically occurs in conjunction with diabetes, hypertension, gene mutations, toxins or infections but may also be of unknown cause (idiopathic). Systemic soluble urokinase plasminogen activator receptor (suPAR) is a circulating factor implicated in the onset and progression of chronic kidney disease (CKD), such as focal segmental glomerulosclerosis (FSGS). The cellular source(s) of elevated suPAR associated with future and progressing kidney disease is unclear, but is likely extra-renal, as the pathological uPAR is circulating and FSGS can recur even after a damaged kidney is replaced with a healthy donor organ...
January 2017: Nature Medicine
https://www.readbyqxmd.com/read/27940654/endothelial-basement-membrane-laminin-511-is-essential-for-shear-stress-response
#19
Jacopo Di Russo, Anna-Liisa Luik, Lema Yousif, Sigmund Budny, Hans Oberleithner, Verena Hofschröer, Juergen Klingauf, Ed van Bavel, Erik Ntp Bakker, Per Hellstrand, Anirban Bhattachariya, Sebastian Albinsson, Frederic Pincet, Rupert Hallmann, Lydia M Sorokin
Shear detection and mechanotransduction by arterial endothelium requires junctional complexes containing PECAM-1 and VE-cadherin, as well as firm anchorage to the underlying basement membrane. While considerable information is available for junctional complexes in these processes, gained largely from in vitro studies, little is known about the contribution of the endothelial basement membrane. Using resistance artery explants, we show that the integral endothelial basement membrane component, laminin 511 (laminin α5), is central to shear detection and mechanotransduction and its elimination at this site results in ablation of dilation in response to increased shear stress...
January 17, 2017: EMBO Journal
https://www.readbyqxmd.com/read/27935553/percutaneous-irreversible-electroporation-ire-of-prostate-cancer-contrast-enhanced-ultrasound-ceus-findings-during-follow%C3%A2-up
#20
L P Beyer, B Pregler, C Nießen, K Michalik, M Haimerl, C Stroszczynski, E M Jung, P Wiggermann
PURPOSE: Irreversible electroporation (IRE) is a focal non-thermal ablation technique that can be used to treat prostate cancer (Pca). The objective was to document the evolution of the volume of the prostate gland and the ablation zone after IRE of Pca. MATERIAL AND METHODS: A retrospective analysis of the image findings of CEUS 1 day, 6 weeks, 3 months and 6 months after IRE of 25 patients was conducted. The prostate gland volumes and the size of the ablation zones were documented...
December 8, 2016: Clinical Hemorheology and Microcirculation
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