Bleeding Remission with Microwave Ablation in a Transfusion-Dependent Patient with Hemorrhaging Angiosarcoma of the Pleura

Filippiadis, Dimitrios; Kapetanakis, Emmanouil I.; Spiliοpoulos, Stavros; Kostopanagiotou, Konstantinos; Tomos, Periklis; Kelekis, Alexis

doi:10.1016/j.jvir.2018.03.019

Cited by 6 publications

(6 citation statements)

References 4 publications

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“…[6][7][8] Microwave ablation is a minimally invasive therapeutic technique that has mainly been used for the treatment of active hemorrhage of the liver in cases of trauma or ruptured vascular tumors. 9,10,14 Some studies have shown that MWA is useful for controlling life-threatening hemorrhages even when active bleeding occurs in a large-diameter vessel. 9,10,15 Microwave ablation has also been used to treat hypertrophic rhinitis, allergic rhinitis, and epistaxis in China.…”

Section: Discussionmentioning

confidence: 99%

“…9,10,14 Some studies have shown that MWA is useful for controlling life-threatening hemorrhages even when active bleeding occurs in a large-diameter vessel. 9,10,15 Microwave ablation has also been used to treat hypertrophic rhinitis, allergic rhinitis, and epistaxis in China. 11,12,16,17 However, few studies have compared MWA and bipolar electrocautery with regard to control of recurrent epistaxis in adult patients.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] Microwave ablation (MWA) is a relatively new technique which has been used intraoperatively to achieve hemostasis at surgical margins in laparotomy. 9 Many studies have shown that MWA is safe and effective for the treatment of active hemorrhage of the liver 9 and hemorrhaging angiosarcoma, 10 minimizing intraoperative blood loss. In recent years, MWA has also been used to treat epistaxis, and it has shown a high success rate.…”

Section: Introductionmentioning

confidence: 99%

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Randomized Comparative Study of Microwave Ablation and Electrocautery for Control of Recurrent Epistaxis

Lou¹,

Jin²

2019

Ear Nose Throat J

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Objective: To compare the outcomes of adult patients with recurrent epistaxis treated intraoperatively with either bipolar electrocautery or microwave ablation (MWA). Study Design: Prospective randomized control study. Materials and Methods: One hundred ten patients with idiopathic recurrent epistaxis who met the inclusion criteria were randomly assigned into MWA group and bipolar electrocautery group. Primary outcomes were the proportion of patients in each group whose bleeding had stopped within 24 hours after treatment and time to achieve successful hemostasis. Secondary outcomes were the rebleeding rate after 3 days, 1 and 12 weeks, and 6 months and complications. Results: Successful immediate arrest of epistaxis was achieved in all patients. The times to achieve successful hemostasis were 2.13 ± 1.04 minutes in the MWA group and 6.60 ± 2.68 minutes in the bipolar electrocautery group ( P = .000). The rates of recurrent bleeding were similar in patients treated with the different approaches ( P = .231). However, secondary crusting was observed endoscopically in 59 patients in the bipolar electrocautery group, while pseudomembrane of the ablation zone was seen in 19 (36.5%) patients in the MWA group. Nevertheless, there were no severe postoperative complications, including septal perforation and orbit and brain complications, in either group at the 6-month follow-up. Conclusion: Bipolar electrocautery and MWA had similar outcomes for the treatment of adult patients with recurrent epistaxis. However, MWA resulted in rapid hemostasis with less local nasal pain and less crust. Thus, MWA could be a favorable treatment option for patients with idiopathic recurrent epistaxis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Randomized Comparative Study of Microwave Ablation and Electrocautery for Control of Recurrent Epistaxis

Lou¹,

Jin²

2019

Ear Nose Throat J

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“…[5][6][7][8][9] MWA has been used in selected cases of massive bleeding post-liver biopsy and in transfusion-dependent patient with haemorrhaging angiosarcoma of the pleura. 24,25 Guo et al in a prospective trial have applied MWA under ultrasound (with Doppler and CEUS) guidance reporting successful and fast haemostasis in seven patients with iatrogenic bleeding post-biopsy or drainage. 26 The results of the present study concerning efficacy and safety of percutaneous thermal ablation are in accordance to those of the aforementioned studies and case reports.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of percutaneous microwave ablation for post-procedural haemostasis: a bi-central retrospective study focusing on safety and efficacy

Kelekis

Zhao

Mazioti

et al. 2019

The British Journal of Radiology

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Objective: To review safety and efficacy of percutaneous microwave ablation (MWA) for post-procedural haemostasis. Methods: Institutional databases retrospective research identified 10 cases of iatrogenic bleeding who underwent percutaneous MWA for post-procedural haemostasis. Ultrasound examination with Doppler and contrast enhancement identified a source of active bleeding prior to ablation; additionally they were used as guiding modality for antenna insertion whilst, post-ablation, assessed the lack of active extravasation. Target locations included liver intercostal space spleen and thyroid gland. Technical success was defined as positioning of the antenna on the desired location. Treatment end point was considered the disappearance of active extravasation in both Doppler imaging and contrast-enhanced ultrasound. Results: Technical success (i.e. positioning of the antenna on the desired location) was achieved in all cases. No complications were noted. All patients post MWA remained haemodynamically stable with no need for transfusion and were discharged from the hospital the next morning. Imaging and clinical follow-up in all patients before exiting the hospital did not depict any sign of active extravasation or bleeding. Conclusion: Our limited experience reports preliminary data showing that MWA could be added in the armamentarium of percutaneous therapies for iatrogenic bleeding. More prospective studies with larger patient samples are necessary for verification of this technique as well as for drawing broader conclusions in order to evaluate the place of percutaneous ablation in the treatment algorithm of haemorrhage. Advances in knowledge: Percutaneous ablation might have a role in haemostasis in well-selected cases

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“… 8 , 9 , 10 MWA safely and effectively controls active liver hemorrhage, epithelioid hemangioma, and hemorrhaging angiosarcoma. 11 , 12 , 13 MWA does not require the placement of grounding pads. Some studies have suggested that MWA may be useful in cases with contraindications for transarterial embolization, in those unable to undergo angiographic examination, and in those for whom general anesthesia would be risky.…”

Section: Introductionmentioning

confidence: 99%

Rapid hemostasis: a novel and effective outpatient procedure using microwave ablation to control epistaxis of isolated mucosal bulge lesions

Lou

2021

Brazilian Journal of Otorhinolaryngology

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Bleeding Remission with Microwave Ablation in a Transfusion-Dependent Patient with Hemorrhaging Angiosarcoma of the Pleura

Cited by 6 publications

References 4 publications

Randomized Comparative Study of Microwave Ablation and Electrocautery for Control of Recurrent Epistaxis

Randomized Comparative Study of Microwave Ablation and Electrocautery for Control of Recurrent Epistaxis

Safety and efficacy of percutaneous microwave ablation for post-procedural haemostasis: a bi-central retrospective study focusing on safety and efficacy

Rapid hemostasis: a novel and effective outpatient procedure using microwave ablation to control epistaxis of isolated mucosal bulge lesions

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