Background:The intra-operative real-time assessment of tissue viability can potentially improve therapy delivery and clinical outcome in cardiovascular therapies.Cardiac ablation therapy for the treatment of supravent...Background:The intra-operative real-time assessment of tissue viability can potentially improve therapy delivery and clinical outcome in cardiovascular therapies.Cardiac ablation therapy for the treatment of supraventricular or ventricular arrhythmia continues to be done without being able to assess if the intended lesion and lesion size have been achieved.Here,we report a method for continuous measurements of cardiac muscle microcirculation to provide an instrument for real-time ablation monitoring.Methods:We performed two acute open chest animal studies to assess the ability to perform real-time monitoring of creation and size of ablation lesion using a standard RF irrigated catheter.Radiofrequency ablation and laser Doppler were applied to different endocardial areas of alive open-chest pig.Results:We performed two experiments at three different RF ablation energy setting and different ablation times.Per-fusion signals before and after ablation were found extensively and distinctively different.By in-creasing the ablation energy and time,the perfusion signal was decreasing.Conclusion:In vivo assessing the local microcirculation during RF ablation by laser Doppler can potentially be useful to differentiate between viable and nonviable ablated beating heart in real time.展开更多
We read with great interest the recently published study of Vitale et al.(1)aiming to compare the survival outcomes of liver resection(LR),percutaneous radiofrequency(RF)ablation and transarterial chemoembolization(CE...We read with great interest the recently published study of Vitale et al.(1)aiming to compare the survival outcomes of liver resection(LR),percutaneous radiofrequency(RF)ablation and transarterial chemoembolization(CEL)in patients with early-stage multinodular hepatocellular carcinoma(HCC)(i.e.,defined as 2 to 3 nodules each measuring≤3 cm on compensated cirrhosis)not eligible for liver transplantation.This Italian multicenter retrospective cohort study used data from two national registries between January 2008 and December 2020:Hepatocarcinoma Recurrence on the Liver Study(HERCOLES)group for patients who underwent LR and Italian Liver Cancer(ITALICA)group for patients who underwent RF or CEL.展开更多
Hepatocellular carcinoma(HCC)is the fifth most common neoplasm in the world,closely correlated with viral hepatitis and liver cirrhosis.The vast majority of HCC patients present at a late stage and are unsuitable for ...Hepatocellular carcinoma(HCC)is the fifth most common neoplasm in the world,closely correlated with viral hepatitis and liver cirrhosis.The vast majority of HCC patients present at a late stage and are unsuitable for surgery due to limited liver functional reserve.Tumors can involve major vessels or hilar structures,necessitating major liver resection and/or rendering liver resection unfeasible.A series of new technologies have been developed to optimise HCC management.Stem cell therapy improves impaired liver functional reserve prior to liver resection.Intravascular radiofrequency ablation recanalises the portal vein invaded by tumour thrombus and endobiliary radiofrequency ablation restores and extends biliary patency of the bile duct invaded by malignancy.Laparoscopic radiofrequency assisted liver resection minimizes blood loss and avoids liver warm ischemia,while increasing parenchymal sparing.These benefits combined maximize the safety of liver resection.展开更多
文摘Background:The intra-operative real-time assessment of tissue viability can potentially improve therapy delivery and clinical outcome in cardiovascular therapies.Cardiac ablation therapy for the treatment of supraventricular or ventricular arrhythmia continues to be done without being able to assess if the intended lesion and lesion size have been achieved.Here,we report a method for continuous measurements of cardiac muscle microcirculation to provide an instrument for real-time ablation monitoring.Methods:We performed two acute open chest animal studies to assess the ability to perform real-time monitoring of creation and size of ablation lesion using a standard RF irrigated catheter.Radiofrequency ablation and laser Doppler were applied to different endocardial areas of alive open-chest pig.Results:We performed two experiments at three different RF ablation energy setting and different ablation times.Per-fusion signals before and after ablation were found extensively and distinctively different.By in-creasing the ablation energy and time,the perfusion signal was decreasing.Conclusion:In vivo assessing the local microcirculation during RF ablation by laser Doppler can potentially be useful to differentiate between viable and nonviable ablated beating heart in real time.
文摘We read with great interest the recently published study of Vitale et al.(1)aiming to compare the survival outcomes of liver resection(LR),percutaneous radiofrequency(RF)ablation and transarterial chemoembolization(CEL)in patients with early-stage multinodular hepatocellular carcinoma(HCC)(i.e.,defined as 2 to 3 nodules each measuring≤3 cm on compensated cirrhosis)not eligible for liver transplantation.This Italian multicenter retrospective cohort study used data from two national registries between January 2008 and December 2020:Hepatocarcinoma Recurrence on the Liver Study(HERCOLES)group for patients who underwent LR and Italian Liver Cancer(ITALICA)group for patients who underwent RF or CEL.
文摘Hepatocellular carcinoma(HCC)is the fifth most common neoplasm in the world,closely correlated with viral hepatitis and liver cirrhosis.The vast majority of HCC patients present at a late stage and are unsuitable for surgery due to limited liver functional reserve.Tumors can involve major vessels or hilar structures,necessitating major liver resection and/or rendering liver resection unfeasible.A series of new technologies have been developed to optimise HCC management.Stem cell therapy improves impaired liver functional reserve prior to liver resection.Intravascular radiofrequency ablation recanalises the portal vein invaded by tumour thrombus and endobiliary radiofrequency ablation restores and extends biliary patency of the bile duct invaded by malignancy.Laparoscopic radiofrequency assisted liver resection minimizes blood loss and avoids liver warm ischemia,while increasing parenchymal sparing.These benefits combined maximize the safety of liver resection.
