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Epilepsy
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Donald C. Barr, Andres M. Kanner
To establish if a patient is a candidate for a surgical resection or laser ablation, the following conditions have to be met: (1) the epileptogenic zone has to be clearly identified, (2) the resection does not pose more than a minimal risk, and (3) the patient (or consenting family member) can cooperate during the presurgical evaluation and must have a clear understanding of the benefits and limitations of the procedure.
Malignant Melanoma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Isolated limb infusion (ILI) is less invasive than ILP and can be easily repeated. It involves intra-arterial infusion of a cytotoxic agent into the affected limb via a percutaneous catheter. There have been suggestions, however, that ILI may be less effective than ILP. ILI is suitable for patients with low-volume disease and those with co-morbidities who may not be suitable for ILP. Laser ablation with carbon dioxide is useful for treating multiple small (<1 cm) lesions. Minimal post-operative complications are associated with laser ablation and wound healing occurs typically within 6 weeks.
The VANISH-2 Study: A Randomized, Blinded, Multicenter Study to Evaluate the Efficacy and Safety of Polidocanol Endovenous Microfoam 0.5% and 1.0% Compared with Placebo for the Treatment of Saphenofemoral Junction Incompetence
Published in Juan Carlos Jimenez, Samuel Eric Wilson, 50 Landmark Papers Every Vascular and Endovascular Surgeon Should Know, 2020
Juan Carlos Jimenez, Samuel Eric Wilson
This trial also demonstrated excellent symptom relief and appearance following this nonthermal, nontumescent method for treating patients with incompetent, symptomatic varicose veins. Several instruments for measuring patient satisfaction and symptomatic improvement were utilized and all demonstrated a statistically and clinically significant improvement in patients with chemical ablation compared with placebo. Although already considered a “noninvasive” technique, thermal (radiofrequency and laser) ablation requires injection with a spinal of tumescent solution to the subcutaneous tissue surrounding the GSV. Chemical ablation not only eliminates the risk of thermal spread to the surrounding tissues, it does not require injection of tumescent fluid which may significantly increase the discomfort to patients undergoing radiofrequency or laser ablation.
2022 Expert consensus on the use of laser ablation for papillary thyroid microcarcinoma
Published in International Journal of Hyperthermia, 2022
Lu Zhang, Wei Zhou, Jian Qiao Zhou, Qian Shi, Teresa Rago, Giovanni Gambelunghe, Da Zhong Zou, Jun Gu, Man Lu, Fen Chen, Jie Ren, Wen Cheng, Ping Zhou, Stefano Spiezia, Enrico Papini, Wei Wei Zhan
Key question 6: What clinical, laboratory and imaging evaluations should be requested before PLA is performed?Detailed medical history including current medical therapy, allergies, high blood pressure, diabetes, and any cardiovascular, brain, liver, lung or kidney diseases. Any underlying disease(s) should be effectively controlled before laser ablation. If the patient is receiving oral anticoagulants, discontinuation is recommended if their condition permits [26];Comprehensive evaluation of platelets count, coagulation and anticoagulation indicators;Preoperative confirmation of malignancy with FNA or core-needle biopsy (CNB) is mandatory [11,18];Complete blood count, viral serum indicators, complete thyroid function, calcitonin, electrocardiogram, laryngoscopy, and conventional US should be performed. Contrast-enhanced ultrasound (CEUS) should be performed only in selected cases according to local experience [11,18].
Clinical treatment of intra-epithelia cervical neoplasia with photodynamic therapy
Published in International Journal of Hyperthermia, 2020
Antonio Carlos Figueiredo Vendette, Henrique Luis Piva, Luis Alexandre Muehlmann, Delfrank Ananias de Souza, Antonio Claudio Tedesco, Ricardo Bentes Azevedo
Lesions classified as CIN1 have a low aggression condition and can either regress spontaneously over time or progress slowly toward CIN2 and CIN3. In clinical practice, patients with CIN1 only receive therapeutic intervention if there is a progression. CIN2 and CIN3 lesions present a risk of progressing more rapidly toward invasive lesions, but in the absence of local extension and lymphatic dissemination, they are treated using local therapeutic approaches such as High-Frequency Surgery (CAF), laser ablation, cryotherapy, or hysterectomy. Hysterectomy is considered a radical treatment for early cervical cancer, whereas the cervix and uterus are usually removed (simple hysterectomy). Laser ablation is a technique that uses a laser beam applied to the area to be treated to destroys the altered cells. Cryotherapy is a procedure that uses a cold chemical (liquid nitrogen) to destroy the wanted cells. High-Frequency Surgery uses electric energy (in high voltage) that is transformed into heat and can cut the desired tissue, avoiding at the same time bleeding. All these modalities have similar curative efficacy and must be chosen depending on the risk to the woman [13]. It is worth noting that the structural damage of the cervix, caused by abrasive or invasive techniques, can compromise patients’ reproductive capacity. In this sense, Photodynamic Therapy (PDT), in cervical neoplasia, is known to preserve cervical competence, favoring the uterus' physiological preservation [14].
Laser interstitial thermal therapy for treatment of cerebral radiation necrosis
Published in International Journal of Hyperthermia, 2020
Christopher S. Hong, Jason M. Beckta, Adam J. Kundishora, Aladine A. Elsamadicy, Veronica L. Chiang
Lastly, considering the efficacy of LITT for RN in brain metastases, we propose that given that the pathophysiology of RN is related to high dose radiation rather than underlying pathology, LITT might be successfully used for treatment of RN associated with other pathologies. We therefore recently reported successful cases of LITT for RN in cases of AVM and meningioma previously treated with radiosurgery (Table 1) [39,40]. Digital subtraction angiography was performed in the former case to ensure complete AVM obliteration prior to LITT, and intra-operative biopsies in both cases demonstrated RN histopathology. Both cases yielded significant radiographic and clinical responses to laser ablation as expected. Further studies exploring LITT for RN in these pathologies will help determine its long-term role in this field.