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Focal Ablation

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https://www.readbyqxmd.com/read/28809681/a-prototype-therapy-system-for-transcutaneous-application-of-boiling-histotripsy
#1
Adam D Maxwell, Petr V Yuldashev, Wayne Kreider, Tatiana D Khokhlova, George R Schade, Timothy L Hall, Oleg A Sapozhnikov, Michael R Bailey, Vera A Khokhlova
Boiling histotripsy is a method of focused ultrasound surgery that noninvasively applies millisecond-length pulses with high-amplitude shock fronts to generate liquefied lesions in tissue. Such a technique requires unique outputs compared to a focused ultrasound thermal therapy apparatus, particularly to achieve high in situ pressure levels through intervening tissue. This article describes the design and characterization of a system capable of producing the necessary pressure to transcutaneously administer boiling histotripsy therapy through clinically relevant overlying tissue paths using pulses with duration up to 10 ms...
August 14, 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28809083/laser-induced-focused-ultrasound-for-cavitation-treatment-toward-high-precision-invisible-sonic-scalpel
#2
Taehwa Lee, Wei Luo, Qiaochu Li, Hakan Demirci, L Jay Guo
Beyond the implementation of the photoacoustic effect to photoacoustic imaging and laser ultrasonics, this study demonstrates a novel application of the photoacoustic effect for high-precision cavitation treatment of tissue using laser-induced focused ultrasound. The focused ultrasound is generated by pulsed optical excitation of an efficient photoacoustic film coated on a concave surface, and its amplitude is high enough to produce controllable microcavitation within the focal region (lateral focus <100 µm)...
August 15, 2017: Small
https://www.readbyqxmd.com/read/28800192/efficacy-and-safety-of-driver-guided-catheter-ablation-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#3
F Daniel Ramirez, David H Birnie, Girish M Nair, Agnieszka Szczotka, Calum J Redpath, Mouhannad M Sadek, Pablo B Nery
INTRODUCTION: Targeting localized drivers (electrical rotors or focal impulses) during catheter ablation for atrial fibrillation (AF) has been proposed as a strategy to improve procedural success. However, the strength and quality of the evidence to support this approach is unclear. METHODS AND RESULTS: Clinical studies reporting efficacy or safety outcomes of driver-guided ablation for AF were identified in Medline, Embase, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Pubmed, and conference abstracts from major scientific meetings...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28795289/beyond-pulmonary-vein-isolation-the-role-of-additional-sites-in-catheter-ablation-of-atrial-fibrillation
#4
REVIEW
Li-Wei Lo, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Fa-Po Chung, Shih-Ann Chen
PURPOSE OF REVIEW: Pulmonary vein (PV) isolation is the cornerstone of atrial fibrillation (AF) ablation. However, the long-term procedural outcome remains suboptimal and there is a frequent need for repeat ablation procedure, especially in patients with non-paroxysmal AF. The review article summarizes the rationales, recent evidences, and strategies of ablation of extra-PV sites and its clinical outcomes. RECENT FINDINGS: It is a consensus that durable PV isolations are a definite therapy in patients with paroxysmal AF...
August 9, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28794877/effects-of-hifu-induced-cavitation-on-flooded-lung-parenchyma
#5
Frank Wolfram, Georg Dietrich, Carsten Boltze, Klaus Vitold Jenderka, Thomas Günther Lesser
BACKGROUND: High intensity focused ultrasound (HIFU) has gained clinical interest as a non-invasive local tumour therapy in many organs. In addition, it has been shown that lung cancer can be targeted by HIFU using One-Lung Flooding (OLF). OLF generates a gas free saline-lung compound in one lung wing and therefore acoustic access to central lung tumours. It can be assumed that lung parenchyma is exposed to ultrasound intensities in the pre-focal path and in cases of misguiding. If so, cavitation might be induced in the saline fraction of flooded lung and cause tissue damage...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28783621/treatment-of-cancer-in-vitro-using-radiation-and-high-frequency-bursts-of-sub-microsecond-electrical-pulses
#6
Michael B Sano, Olga Volotskova, Lei Xing
High frequency irreversible electroporation (H-FIRE) is an emerging cancer therapy which uses bursts of short duration, alternating polarity, high voltage electrical pulses to focally ablate tumors. Here, we present a preliminary investigation of the combinatorial effects of H-FIRE and ionizing radiation. In vitro cell cultures were exposed to bursts of 500 ns pulses and single radiation doses of 2 or 20 Gy then analyzed for 14 days. H-FIRE and RT appear to induce different delayed cell death mechanisms and in all treatment groups, combinatorial therapy resulted in lower overall viabilities...
August 2, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28776822/ripple-mapping-initial-multicenter-experience-of-an-intuitive-approach-to-overcoming-the-limitations-of-3d-activation-mapping
#7
Vishal Luther, Nuno Cortez-Dias, Luis Carpinteiro, João de Sousa, Richard Navaratnum Balasubramaniam, Sharad C Agarwal, David Farwell, Solomon Mark Sopher, Girish Babu, Richard Till, Nikki Jones, Stuart Tan, Anthony Chow, Martin Lowe, Jem Lane, Naveen Pappachan, Nick Wf Linton, Prapa Kanagaratnam
BACKGROUND: Ripple Mapping (RM) displays electrograms as moving bars over a 3D surface displaying bipolar voltage, and has shown in a single-center series to be effective for atrial tachycardia (AT) mapping without annotation of local activation time or window-of-interest assignment. We tested the reproducibility of these findings in operators naive to RM, using it for the first time in post ablation AT. METHODS: Maps were collected with multielectrode catheters and CARTO ConfiDENSE...
August 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28769762/loss-of-irf2bp2-in-microglia-increases-inflammation-and-functional-deficits-after-focal-ischemic-brain-injury
#8
Shelly A Cruz, Aswin Hari, Zhaohong Qin, Pascal Couture, Hua Huang, Diane C Lagace, Alexandre F R Stewart, Hsiao-Huei Chen
Ischemic stroke causes neuronal cell death and triggers a cascade of inflammatory signals that contribute to secondary brain damage. Microglia, the brain-resident macrophages that remove dead neurons, play a critical role in the brain's response to ischemic injury. Our previous studies showed that IRF2 binding protein 2 (IRF2BP2) regulates peripheral macrophage polarization, limits their inflammatory response and reduces susceptibility to atherosclerosis. Here, we show that loss of IRF2BP2 in microglia leads to increased inflammatory cytokine expression in response to lipopolysaccharide challenge and impaired activation of anti-inflammatory markers in response to interleukin-4 (IL4) stimulation...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28765764/focal-ablation-for-atrial-tachycardia-from-the-double-exit-of-the-marshall-bundle-inducing-atrial-fibrillation
#9
Jung Yeon Chin, Jong Woo Kim, Ki-Woon Kang
Atrial fibrillation (AF) from the ligament/vein of Marshall (LOM/VOM) has previously been described. We report the case of a 23-year-old woman with an antiarrhythmic drug-resistant AF induced by two distinct atrial tachycardias (ATs). Focal ablation of these ATs from the double-exit of the Marshall bundle using a three-dimensional map eliminated AF triggering, even though pulmonary vein electrical isolation is the cornerstone for paroxysmal AF. Such mechanisms are important as triggering factors to plan ablation for paroxysmal AF...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28747272/efficacy-and-safety-of-radiofrequency-ablation-for-focal-hepatic-lesions-adjacent-to-gallbladder-reconfiguration-of-the-ablation-zone-through-probe-relocation-and-ablation-time-reduction
#10
In Young Choi, Pyo Nyun Kim, Sung Gu Lee, Hyung Jin Won, Yong Moon Shin
PURPOSE: To evaluate the safety and efficacy of radiofrequency (RF) ablation for treatment of focal hepatic lesions adjacent to the gallbladder with electrode relocation and ablation time reduction. MATERIALS AND METHODS: Thirty-nine patients who underwent RF ablation for focal hepatic lesions adjacent to the gallbladder (≤ 10 mm) were evaluated retrospectively from January 2011 to December 2014 (30 men and 9 women; age range, 51-85 y; mean age, 65 y). Of 36 patients with hepatocellular carcinoma, 3 had a second treatment for recurrence (mean tumor size, 15 mm ± 6)...
July 23, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28733070/spatial-relationship-of-sites-for-atrial-fibrillation-drivers-and-atrial-tachycardia-in-patients-with-both-arrhythmias
#11
Tina Baykaner, Junaid A B Zaman, Albert J Rogers, Rachita Navara, Mahmood AlHusseini, Ryan T Borne, Shirley Park, Paul J Wang, David E Krummen, William H Sauer, Sanjiv M Narayan
INTRODUCTION: Atrial fibrillation (AF) often converts to and from atrial tachycardia (AT), but it is undefined if these rhythms are mechanistically related in such patients. We tested the hypothesis that critical sites for AT may be related to regional AF sources in patients with both rhythms, by mapping their locations and response to ablation on transitions to and from AF. METHODS: From 219 patients undergoing spatial mapping of AF prior to ablation at 3 centers, we enrolled 26 patients in whom AF converted to AT by ablation (n=19) or spontaneously (n=7; left atrial size 42±6cm, 38% persistent AF)...
July 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28725242/focal-application-of-low-dose-rate-brachytherapy-for-prostate-cancer-a-pilot-study
#12
S Sara Mahdavi, Ingrid T Spadinger, Septimiu E Salcudean, Piotr Kozlowski, Silvia D Chang, Tony Ng, Julio Lobo, Guy Nir, Hamid Moradi, Michael Peacock, W James Morris
PURPOSE: To evaluate the feasibility and to report the early outcomes of focal treatment of prostate cancer using low-dose-rate brachytherapy (LDR-PB). MATERIAL AND METHODS: Seventeen patients were screened with multi-parametric magnetic resonance imaging (mpMRI), 14 of whom proceeded to receive trans-perineal template mapping biopsy (TTMB). Focal LDR-PB was performed on five eligible patients using dual air kerma strength treatment plans based on planning target volumes derived from cancer locations and determined by TTMB...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28721494/a-comprehensive-characterization-of-parameters-affecting-high-frequency-irreversible-electroporation-lesions
#13
Tyler Miklovic, Eduardo L Latouche, Matthew R DeWitt, Rafael V Davalos, Michael B Sano
Several focal therapies are being investigated clinically to treat tumors in which surgery is contraindicated. Many of these ablation techniques, such as radiofrequency ablation and microwave ablation, rely on thermal damage mechanisms which can put critical nerves or vasculature at risk. Irreversible electroporation (IRE) is a minimally invasive, non-thermal technique to destroy tumors. A series of short electric pulses create nanoscale defects in the cell membrane, eventually leading to cell death. Typical IRE protocols deliver a series of 50-100 µs monopolar pulses...
July 18, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28720474/nitrous-oxide-cryotherapy-for-treatment-of-esophageal-squamous-cell-neoplasia-initial-multicenter-international-experience-with-a-novel-portable-cryoballoon-ablation-system-with-video
#14
Marcia Irene Canto, Julian Abrams, Hannah Kunzli, Bas Weusten, Yoshihiro Komatsu, Blair Jobe, Charles J Lightdale
BACKGROUND AND AIMS: Early esophageal squamous cell neoplasia (ESCN) can be successfully treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or radiofrequency ablation (RFA). A new portable, battery-powered cryotherapy system using nitrous oxide (cryoballoon focal ablation system (CbFAS) has been used for Barrett's esophagus. It consists of a small hand-held device containing liquid nitrous oxide, which converts to gas within a low-pressure-compliant through-the-scope balloon and freezes targeted mucosa in contact with the balloon...
July 15, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28708182/multi-beam-pulsed-laser-patterning-of-plasmonic-films-using-broadband-diffractive-optical-elements
#15
A A Kuchmizhak, A P Porfirev, S A Syubaev, P A Danilov, A A Ionin, O B Vitrik, Yu N Kulchin, S N Khonina, S I Kudryashov
Multi-sector broadband diffractive optical elements (DOEs) were designed and fabricated from fused silica for high-efficiency multiplexing of femtosecond and nanosecond Gaussian laser beams into multiple (up to one 100) optically tunable microbeams with increased high-numerical aperture (NA) focal depths. Various DOE-related issues, such as high-NA laser focusing, laser pulsewidth, and DOE symmetry-dependent heat conduction effects, as well as the corresponding spatial resolution, were discussed in the context of high-throughput laser patterning...
July 15, 2017: Optics Letters
https://www.readbyqxmd.com/read/28705474/rf-ablation-in-periventricular-heterotopia-related-epilepsy
#16
Massimo Cossu, Laura Mirandola, Laura Tassi
Drug-resistant focal epilepsy is a common occurrence in patients with gray matter nodular heterotopia (NH), and surgical treatment is often considered in these cases. NH-related epileptogenicity is sustained by complex networks, which may involve the nodules and extralesional cortex in various combinations. Therefore, invasive EEG is usually required to identify the structures involved in seizure generation. It has been reported that surgery may be effective in cases with unilateral lesions, whereas bilateral cases are not optimal candidates for surgical success...
July 3, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28687623/nonmuscle-myosin-iib-regulates-epicardial-integrity-and-epicardium-derived-mesenchymal-cell-maturation
#17
Xuefei Ma, Derek C Sung, Yanqin Yang, Yoshi Wakabayashi, Robert S Adelstein
Nonmuscle myosin IIB (NMIIB; heavy chain encoded by MYH10) is essential for cardiac myocyte cytokinesis. The role of NMIIB in other cardiac cells is not known. Here, we show that NMIIB is required in epicardial formation and functions to support myocardial proliferation and coronary vessel development. Ablation of NMIIB in epicardial cells results in disruption of epicardial integrity with a loss of E-cadherin at cell-cell junctions and a focal detachment of epicardial cells from the myocardium. NMIIB-knockout and blebbistatin-treated epicardial explants demonstrate impaired mesenchymal cell maturation during epicardial epithelial-mesenchymal transition...
August 15, 2017: Journal of Cell Science
https://www.readbyqxmd.com/read/28681404/integration-of-deployable-fluid-lenses-and-reflectors-with-endoluminal-therapeutic-ultrasound-applicators-preliminary-investigations-of-enhanced-penetration-depth-and-focal-gain
#18
Matthew S Adams, Vasant A Salgaonkar, Serena Scott, Graham Sommer, Chris J Diederich
PURPOSE: Catheter-based ultrasound applicators can generate thermal ablation of tissues adjacent to body lumens, but have limited focusing and penetration capabilities due to the small profile of integrated transducers required for the applicator to traverse anatomical passages. This study investigates a design for an endoluminal or laparoscopic ultrasound applicator with deployable acoustic reflector and fluid lens components, which can be expanded after device delivery to increase the effective acoustic aperture and allow for deeper and dynamically adjustable target depths...
July 6, 2017: Medical Physics
https://www.readbyqxmd.com/read/28678805/ablation-as-targeted-perturbation-to-rewire-communication-network-of-persistent-atrial-fibrillation
#19
Susumu Tao, Samuel F Way, Joshua Garland, Jonathan Chrispin, Luisa A Ciuffo, Muhammad A Balouch, Saman Nazarian, David D Spragg, Joseph E Marine, Ronald D Berger, Hugh Calkins, Hiroshi Ashikaga
Persistent atrial fibrillation (AF) can be viewed as disintegrated patterns of information transmission by action potential across the communication network consisting of nodes linked by functional connectivity. To test the hypothesis that ablation of persistent AF is associated with improvement in both local and global connectivity within the communication networks, we analyzed multi-electrode basket catheter electrograms of 22 consecutive patients (63.5 ± 9.7 years, 78% male) during persistent AF before and after the focal impulse and rotor modulation-guided ablation...
2017: PloS One
https://www.readbyqxmd.com/read/28675362/liver-resections-in-a-high-volume-center-form-standard-procedures-to-extreme-surgery-and-ultrasound-guided-resections
#20
Florin Botea, Mihnea Ionescu, Vladislav Braşoveanu, Doina Hrehoreţ, Sorin Alexandrescu, Mihai Grigorie, Oana Stanciulea, Diana Nicolaescu, Dana Tomescu, Gabriela Droc, Daniela Ungureanu, Ruxandra Fota, Adina Croitoru, Liana Gheorghe, Cristian Gheorghe, Ioana Lupescu, Mugur Grasu, Mirela Boroş, Radu Dumitru, Mihai Toma, Vlad Herlea, Irinel Popescu
Background: Liver resection (LR) is the treatment of choice for most benign and malignant focal liver lesions, as well as in selected patients with liver trauma. Few other therapies can compete with LR in selected cases, such as liver transplantation in hepatocellular carcinoma (HCC) and ablative therapies in small HCCs or liver metastases. The present paper analyses a single center experience in LR, reviewing the indications of LR, the operative techniques and their short-term results. MATERIAL AND METHOD: Between January 2000 and December 2016, in "œDan Setlacec" Center of General Surgery and Liver Transplantation were performed 3165 LRs in 3016 patients, for pathologic conditions of the liver...
May 2017: Chirurgia
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