Patient selection - clinical and imaging criteria - for percutaneous lung malignancies ablation: a single centre experience and a literature review

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Ultra low profile polymer-filled stent graft for abdominal aortic aneurysm treatment: two-years follow-up

Purpose: To evaluate 2 years follow-up of the Ovation Abdominal Stent Graft System (TriVascular Inc, Santa Rosa, Calif) for endovascular repair of abdominal aortic aneurysms (AAAs). Methods and Materials: This multicenter retrospective study included 36 patients (median age 73.6 yo) with AAAs (mean diameter, 5.65 cm) treated with the Ovation stent graft and a follow-up available at least of 2 years. Safety and effectiveness of the Ovation stent graft was evaluated. Indications for EVAR were the following: AAA 655 cm, neck lenght 65 7 mm, angulation 6460o and diameter < 30 mm; the presence of neck calcification and thrombosis was not considered a contraindication; distal iliac landing zones length of 10 mm, and diameter between 5 and 20 mm. Patients were treated under a common protocol, including clinical and imaging follow-up at discharge, 30 days, 6 months, and annually through 5 years. Adverse events, clinical and imaging data and possible re-intervention were recorded. Results: Ovation stent graft was successfully implanted in 36 patients (100%). None of the patients required conversion to open surgery, none presented an aneurysm rupture. Endograft stent fracture or migration was not observed. No type I, III or IV endoleaks were observed; in 12 patients (33.3%) a type II endoleak was registered: with sac enlargement in one case not treated due to concomitant comorbidities and patient's decision. Conclusion: The 2-years results of the Ovation Stent Graft System demonstrated excellent safety and effectiveness in treatment of patients with AAAs, particularly in patients with challenging anatomic characteristics

Complications of microwave and radiofrequency lung ablation: personal experience and review of the literature.

Abstract PURPOSE: Complications correlated with percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) of lung tumours were retrospectively reviewed to compare them with data from the literature and to assess risk factors related with the procedures. MATERIALS AND METHODS: From January 2003 to January 2009, 29 patients (36 lung lesions) were treated with RFA; from January 2007 to January 2009, 16 patients (17 lung lesions) were treated with MWA. Complications recorded at our institution are reported following the Society of Interventional Radiology guidelines. A systematic review of the literature was performed. RESULTS: Any major complication of RFA or MWA was recorded. In agreement with the literature, pneumothorax was the most frequent complication, even though the incidence in our series was lower than reported in the literature (3.5% vs. 4.3-18%). Other complications of RFA were pleural effusion and subcutaneous emphysema. No massive haemorrhages, haemoptysis, abscesses, pneumonia, infections or tumour seeding were recorded in our series. The most common complication of MWA was pneumothorax (25% vs. 39% reported in the literature). Pleural effusion was a common reaction, but therapeutic drainage was never required. CONCLUSIONS: Pneumothorax is the most common complication of both techniques. RFA and MWA are both excellent choices in terms of safety and tolerance

Current role of interventions in metastatic kidney tumors: single center experience.

Abstract This study on the treatment of kidney tumor metastases aims to expose our experience in different interventional therapies for renal cell carcinomas metastasis in different organs, broaching their complications and comparing our results with the literature. In the last 5 years, after informed consent, 22 patients with metastatic kidney tumors were enrolled in this retrospective observational study. According to lesion sites, different interventional procedures may be performed: RFA for pancreas, lung, adrenal gland and liver lesions; TAE and RFA for bone lesions and IVC filter positioning for thrombosis of renal vein. There were mainly satisfactory results: complete necrosis of pancreas, lung and adrenal gland metastasis with a technical success rate of 100%; after TAE and RFA of bone lesions, an acceptable blood loss was registered during surgical intervention; no recurrences after liver metastasis ablation were observed in a period of 3 months; positioning of IVC filter was technically correct in 100% of patients; few complications, such as diffuse abdominal pain for pancreas, pneumothorax in the lung RCC metastasis and a post-RFA syndrome for the adrenal. There was a nodular recurrence along the ablation margin in one liver RCC metastasis. Inclusion criteria were relatively strict and only 22 patients were included in this study. The follow-up has been relatively short to date, so we are not certain of the long-term results, though these are comparable to those found in literature. It is possible to conclude that Interventional radiology plays an important role in RCC metastasis treatment, if we have few complications and improved outcomes

Juvenile Angiofibroma: What Is on Stage?

Objectives/Hypothesis: The aim of the present study is to validate and compare four of the most widely used staging systems for juvenile angiofibroma on a homogeneous cohort of patients. Study Design: Retrospective case series. Methods: A retrospective review of patients treated with endoscopic or endoscopic-assisted surgical resection between 1999 and 2020 was carried out. Each case was classified according to the following staging systems: Andrews-Fisch (1989), Radkowski (1996), University of Pittsburgh Medical Center (2010), and Janakiram (2017). Spearman's rank correlation test and areas under the curve of receiver operator curves were used to assess the correlation between outcomes of interests (blood loss, surgical time, need for transfusion, and persistence of disease) and stage of disease. Results: Seventy-nine patients were included, with a median follow-up time of 25 months (range 12\u2013127 months). Median surgical time was 217 minutes (range 52\u2013625). Median blood loss was 500 mL (range 40\u20135200) and 27 patients (34.2%) required blood transfusions. Seven patients (8.9%) showed persistence of disease. All classification systems showed a similar association with blood loss, surgical time, persistence of disease, and need for transfusion. Conclusions: Involvement of the infratemporal fossa and intracranial extension was identified as red flags for surgical planning and preoperative counseling, as associated with increased risk for transfusion and persistent/recurrent disease, respectively. No classification system was found to be better than the others in predicting the most important outcomes. Therefore, the simplest and most easily applicable system would be the preferred one to be used in clinical practice. Level of Evidence: Level 4 case series Laryngoscope, 2021