1.Expert consensus on microwave ablation for benign breast nodules.
Chinese Journal of Internal Medicine 2023;62(4):369-373
Because mammary glands are regulated by endocrine factors, they are prone to various abnormalities and disorders. Breast nodules are common and occur frequently in clinical practice. The clinical management of breast nodules mainly includes follow-up observation, lesion biopsy, and surgical intervention, and surgical intervention is an effective treatment. Ultrasound-guided percutaneous microwave ablation is a new minimally invasive treatment technology developed in recent years. It has the advantages of short operation time, no scarring, less damage to the lactiferous duct, quick recovery, and good curative effects without bleeding. The establishment of an expert consensus on microwave ablation for benign breast nodules aims to provide a reliable clinical basis for microwave ablation of benign breast nodules, standardize the treatment process, and improve treatment efficacy, so as to serve as a reference for physicians in clinical practice.
Humans
;
Consensus
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Microwaves/therapeutic use*
;
Catheter Ablation
;
Thyroid Nodule/surgery*
;
Radiofrequency Ablation
;
Treatment Outcome
2."Leverage pry-off method" for effective prevention of thermal injury during microwave ablation of benign thyroid nodules.
Feng Lin WU ; Qiao Zhi WU ; Wen Wei XU ; Zhi Hong WU ; Le Rong LIU ; Lin ZHOU
Journal of Southern Medical University 2023;43(1):122-127
OBJECTIVE:
To assess the safety and efficacy of"leverage pry-off method"for preventing thermal injury during microwave ablation of benign thyroid nodules.
METHODS:
From July, 2017 to September, 2019, a total of 348 patients with benign thyroid nodules underwent ultrasound-guided microwave ablation. For protecting from thermal injury during the ablation, "hydrodissection technique" was used in 174 of the patients (admitted from July, 2017 to August, 2018) and "leverage pry-off method" in the other 174 patients (admitted from September, 2018 to September, 2019). All the patients were followed up for 1 to 12 months after the operation for observation of severe complications and nodular residues.
RESULTS:
Ultrasound-guided microwave ablation was completed in all the 348 patients. The most common severe complication associated with the ablation was voice change, occurring in 3 cases (1.7%) in "hydrodissection technique" group and in 4 (2.3%) in the "leverage pry-off method" group, showing no significant difference between the two groups (P>0.05). During the follow-up, no significant difference was found in the rate of nodular residues between the "hydrodissection technique" group and "hydrodissection technique" group (9.8% vs 10.9% (P>0.05).
CONCLUSIONS
The "leverage pry-off method" is simple and effective for preventing thermal injury during microwave ablation of benign thyroid nodules.
Humans
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Microwaves/therapeutic use*
;
Thyroid Nodule/surgery*
;
Burns
;
Hospitalization
;
Radiofrequency Ablation
3.Effect of Calcification on the Ultrasound-Guided Radiofrequency Ablation of Papillary Thyroid Carcinoma.
Yi-Ming LI ; Lin YAN ; Jing XIAO ; Ming-Bo ZHANG ; Yu-Kun LUO
Acta Academiae Medicinae Sinicae 2023;45(5):803-808
Objective To investigate the effect of calcification on the ultrasound-guided radiofrequency ablation(RFA)of papillary thyroid carcinoma(PTC).Methods We retrospectively analyzed the preoperative and follow-up data of 164 patients(182 nodules)with PTC treated by percutaneous ultrasound-guided RFA in the First Medical Center of Chinese PLA General Hospital from January 1,2018 to December 31,2021.The tumor status 12 months after RFA was taken as the endpoint event.The univariate Logistic regression analysis was employed to predict the influencing factors of incomplete ablation.The factors were then included in the multivariate Logistic regression analysis for prediction of the independent risk factors of incomplete ablation.Results The maximum nodule diameter(OR=1.16,95%CI=1.04-1.29,P=0.009)and calcification ratio >2/3(OR=19.27,95%CI=4.02-92.28,P<0.001)were the factors influencing the disappearance of lesion 12 months after RFA.Conclusions PTC with calcification can be treated with ultrasound-guided RFA.In the case of calcification ratio ≤ 2/3,this therapy demonstrates the effect equivalent to that of no calcification.
Humans
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Thyroid Cancer, Papillary/surgery*
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Retrospective Studies
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Neoplasm Recurrence, Local
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Radiofrequency Ablation/methods*
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Calcinosis
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Thyroid Neoplasms/pathology*
;
Ultrasonography, Interventional
7.Safety and efficacy of high-power, short-duration superior vena cava isolation in combination with conventional radiofrequency ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial.
Jiang Bo DUAN ; Jin Shan HE ; Cun Cao WU ; Long WANG ; Ding LI ; Feng ZE ; Xu ZHOU ; Cui Zhen YUAN ; Dan Dan YANG ; Xue Bin LI
Chinese Journal of Cardiology 2022;50(11):1069-1073
Objective: For patients with paroxysmal atrial fibrillation, superior vena cava isolation on the basis of pulmonary vein isolation may further improve the long-term success rate of radiofrequency ablation. We aimed to explore the efficacy and safety of superior vena cava isolation by high-power and short-duration (HPSD) ablation plus conventional radiofrequency ablation (RA) in patients with paroxysmal atrial fibrillation. Methods: It was a prospective randomized controlled study. From January 1, 2019 to June 1, 2020, 180 patients who underwent radiofrequency ablation for paroxysmal atrial fibrillation in our center were consecutively screened. Patients were eligible if there was a trigger potential and the muscle sleeve length was greater than 3 cm. A total of 60 eligible patients were finally included and randomly divided into HPSD group (HPSD plus RA) and common power and duration (CPD) group (CPD plus RA) by random number table method (n=30 in each group). Efficacy was evaluated by ablation points, isolation time and ablation time. Safety was evaluated by the incidence of POP, cardiac tamponade, phrenic nerve injury, sinoatrial node injury and all-cause. Results: Superior vena cava isolation was achieved by 14 (13, 15) points in the HPSD group, which was significantly less than that in the CPD group (20(18, 22), P<0.001). The superior vena cava isolation time was 8 (7, 9) minutes in the HPSD group, which was significantly shorter than in the CPD group (17(14, 20) minutes, P<0.001). The average ablation time significantly shorter in HPSD group than in CPD group (78.0(71.1, 80.0) s vs. 200(167.5, 212.5)s, P<0.001). The average impedance drop was more significant in the HPSD group than in the CPD group (20.00(18.75, 21.00)Ω (and the percentage of impedance drop was 15%) vs. 12.00(11.75, 13.25)Ω (the percentage of impedance decrease was 12%), P<0.001). There was 1 POP (3.3%) in the HPSD group, and 3 POPs (10.0%) in the CPD group (P>0.05). There was no cardiac tamponade, phrenic nerve injury, sinoatrial node injury and death in both groups. Conclusions: HPSD technique for the isolation of superior vena cava is safe and effective in patients with paroxysmal atrial fibrillation undergoing conventional radiofrequency ablation.
Humans
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Atrial Fibrillation/surgery*
;
Vena Cava, Superior/surgery*
;
Prospective Studies
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Treatment Outcome
;
Radiofrequency Ablation
8.Impact of NLR on atrial fibrillation recurrence after radiofrequency ablation in atrial fibrillation patients combined with heart failure.
Jie Ying DUAN ; Peng YANG ; Yue WANG ; Ru Jie ZHENG ; Ming Yue YUAN ; Xiao Cun YANG ; Yuan LI ; Ying WANG
Chinese Journal of Cardiology 2022;50(11):1074-1079
Objective: To investigate the predictive value of neutrophils-to-lymphocytes ratio (NLR) for atrial fibrillation recurrence after radiofrequency ablation in atrial fibrillation patients combined with heart failure. Methods: This is a retrospective cohort study. Patients with atrial fibrillation and heart failure who received radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2019 to June 2020 were included. Patient were followed up in the outpatient clinic at 3, 6, 9 and 12 months after radiofrequency ablation and were divided into recurrent and non-recurrent groups according to the absence or presence of atrial fibrillation. Demographic data, echocardiographic indices and inflammation-related indices including NLR were collected and compared between the two groups. Spearman rank correlation was performed to analyze the correlation of NLR with atrial fibrillation recurrence after radiofrequency ablation. Multivariate logistic regression analysis was used to determine independent risk factors of atrial fibrillation recurrence after radiofrequency ablation. The receiver operating characteristic (ROC) curve was used to evaluate the value of NLR in predicting the atrial fibrillation recurrence after radiofrequency ablation. Results: A total of 883 patients were included, of which 460 (52.1%) were male, mean age was (64.4±10.7) years old. There were 246 patients (27.9%) in the recurrence group and 637 patients (72.1%) in the non-recurrence group. Compared with the non-recurrent group, the duration of atrial fibrillation, NLR, neutrophil count, N-terminal B-type natriuretic peptide precursor (NT-proBNP) and body mass index levels were significantly higher, while lymphocyte count was significantly lower in the recurrence group than in the non-recurrent group (all P<0.05). Spearman rank correlation analysis showed that NLR was positively correlated with the atrial fibrillation recurrence (r=0.333, P<0.05). Multivariate logistic regression analysis showed that NLR was an independent risk factor for atrial fibrillation recurrence after radiofrequency ablation in atrial fibrillation patients combined heart failure (OR=1.634, P<0.001). The ROC curve showed that the area under the curve (AUC) of NLR in predicting the recurrence of atrial fibrillation after radiofrequency ablation was 0.715 (95%CI: 0.668-0.762, P<0.001), with a sensitivity of 55.61% and a specificity of 84.54%. Conclusion: NLR is a useful predictor of atrial fibrillation recurrence after radiofrequency ablation in atrial fibrillation patients combined with heart failure.
Humans
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Male
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Middle Aged
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Aged
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Female
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Atrial Fibrillation/surgery*
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Retrospective Studies
;
Catheter Ablation
;
Radiofrequency Ablation
;
Heart Failure
9.A case of ultrasound-guided microwave ablation for Graves disease.
Yan Ning SONG ; Wen Yuan SHI ; Jia Jia CHEN ; Qiao WANG ; Xiao Qiao LI ; Min LIU ; Bing Yan CAO ; Xin NI ; Chun Xiu GONG
Chinese Journal of Pediatrics 2022;60(10):1081-1082

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