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Performance of a New Blunt-Tip Needle for the Displacement of Critical Structure in Thermal Ablation

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Abstract

Purpose

To ascertain the performance of a new blunt-tip needle (HydroGuard®), which allows injection of fluids during needle advancement in order to safely approach, displace and insulate nearby critical structures during thermal ablation (TA).

Materials and Methods

This study included 27 consecutive patients treated by TA [cryoablation (CA), radiofrequency (RFA), and microwave MWA)] between April 2018 and January 2019. During TA, hydro- or gas dissection was performed with HydroGuard® needle to displace and protect critical structures close to the tumor (< 10 mm). Technical and clinical success, distance between critical structure and tumor before and after hydro/gas dissection and complications were recorded.

Results

Eighteen patients were treated by CA (66.7%), 7 by MWA (25.9%) and 2 by RFA (7.4%). Majority of patients were treated with a curative intent (24/27; 88.8%). Adjacent critical structures include vessels (n = 3), nerves (n = 10), ureter/renal pelvis (n = 3), bowel/rectum (n = 10), stomach: (n = 3), diaphragm (n = 2), and pleura (n = 1). Technical success was 100%. Clinical success was 88% (24/27). Median minimum distance to adjacent critical structures before hydro/gas dissection was 1 mm (range 0–9 mm; IQR: 0–3 mm) versus 10.5 mm (range 4–47 mm; IQR: 9.7–18 mm) after displacement. Of the 27 patients treated, four developed complications (14.8%; 95% CI: 1.4–28.2): 1 major (3.7%; 95% CI: 0–10.8) and 3 minors (11.1%; 95% CI: 0–23). Only one minor complication was related to inadequate hydro-dissection, resulting in close proximity of the critical structure to the ablation zone.

Conclusion

HydroGuard® is a safe and effective needle when used to approach, displace and insulate nearby critical structures during TA.

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Funding

This study was not supported by any funding.

Author information

Authors and Affiliations

  1. Interventional Radiology, Imagerie Interventionnelle, Nouvel Hôpital Civil, University Hospital of Strasbourg, 1 Place de l’Hôpital, BP 426, 67091, Strasbourg Cedex, France

    Pierre Auloge, Roberto L. Cazzato, Jean Caudrelier, Julia Weiss, Pierre De Marini, Guillaume Koch, Julien Garnon & Afshin Gangi

  2. Department of Radiology and Imaging, Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong

    Jeanie Betsy Chiang

Authors
  1. Pierre Auloge
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  2. Roberto L. Cazzato
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  3. Jeanie Betsy Chiang
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  4. Jean Caudrelier
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  5. Julia Weiss
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  6. Pierre De Marini
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  7. Guillaume Koch
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  8. Julien Garnon
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  9. Afshin Gangi
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Corresponding author

Correspondence to Pierre Auloge.

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Conflict of interest

Pierre Auloge, Roberto Luigi Cazzato, Jeanie Betsy Chiang, Jean Caudrelier, Julia Weiss, Pierre Demarini, Guillaume Koch, and Julien Garnonhave have no conflict of interest to disclose. Afshin Gangi is consultant for Apriomed AB (Uppasla, Sweden).

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The institutional review board approved this prospective single arm, single center observational study.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Auloge, P., Cazzato, R.L., Chiang, J.B. et al. Performance of a New Blunt-Tip Needle for the Displacement of Critical Structure in Thermal Ablation. Cardiovasc Intervent Radiol 43, 924–930 (2020). https://doi.org/10.1007/s00270-020-02472-y

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  • DOI: https://doi.org/10.1007/s00270-020-02472-y

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