Percutaneous laser ablation under ultrasound guidance for fetal hyperechogenic microcystic lung lesions with hydrops: a single center cohort and a literature review

Ruano, Rodrigo; Silva, Marcos Marques da; Salustiano, Eugênia Maria Assunção; Kilby, Mark D.; Tannuri, Uenis; Zugaib, Marcelo

doi:10.1002/pd.3969

Cited by 53 publications

(53 citation statements)

References 48 publications

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“…The first case (Case 1, reported previously) had a very severe SCT (initial TFR, 1.93 cm 3 /g) with signs of cardiac failure (hydrops, heart area/chest area > 0.50, holosystolic mitral and tricuspid valve regurgitation, reversed end‐diastolic flow in the umbilical arteries but with normal umbilical vein and ductus venosus flow) in addition to severe anemia (middle cerebral artery peak systolic velocity (MCA‐PSV) of 2.21 multiples of the median (MoM) and hemoglobin 4.3 g/dL, hematocrit 13.6%, diagnosed by cordocentesis at the time of fetal intervention). Interstitial tumor laser ablation was performed at 24 weeks using a MultiBeam diode laser (Dornier Medtech, Kennesaw, GA, USA), with a continuous laser with 60 W power setting and 250 J of energy, resulting in fetal demise on postsurgical day 1.…”

Section: Resultsmentioning

confidence: 99%

Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas: cohort study and literature review

Sananès

Javadian

Britto

et al. 2016

Ultrasound in Obstet & Gyne

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Section: Resultsmentioning

confidence: 99%

Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas: cohort study and literature review

Sananès

Javadian

Britto

et al. 2016

Ultrasound in Obstet & Gyne

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“…The most common interventions nowadays are pleuroamniotic shunting [4,5,13,14] and, more recently, the intrafetal percutaneous vascular laser ablation of the feeding vessel (VLA), as described above [4,5,8,[15][16][17]21]. While pleuroamniotic shunting only targets the symptoms of BPS and does not lead to a reduction in size, the incidence of postnatal surgery was high, with 87.5% of newborns requiring sequestrectomy [4,5,13,14].…”

Section: Discussionmentioning

confidence: 99%

Outcome of Bronchopulmonary Sequestration with Massive Pleural Effusion after Intrafetal Vascular Laser Ablation

Gottschalk¹,

Strizek²,

Mallmann³

et al. 2017

Fetal Diagn Ther

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Objective: To assess the outcome of 12 fetuses with bronchopulmonary sequestration (BPS) and massive pleural effusion after intrafetal vascular laser ablation (VLA). Methods: All fetuses with BPS and massive pleural effusion that were treated with intrafetal VLA during a 5-year period (2012-2016) were reviewed for safety, intrauterine course, and postnatal outcome. Results: In the study period, 12 fetuses with BPS were treated with VLA. In 7 (58.3%) fetuses, complete cessation of blood flow was achieved after the first VLA, while in 5 (41.7%) fetuses, residual perfusion of the feeding vessel was demonstrated at follow-up. A second intervention was successful in 4 of 5 (80%) fetuses. Overall, in 11 of 12 (91.7%) fetuses, complete coagulation of the feeding vessel could be achieved, followed by a reduction in size or complete resolution of the BPS. All 11 fetuses with successful prenatal intervention were live-born at a median gestational age of 39⁺¹ (range, 37⁺⁵-41⁺²) weeks. Postnatally, 2 (18.2%) of the 11 newborns underwent sequestrectomy, as well as the preterm newborn on which a second fetal intervention was not feasible. Conclusion: VLA is an effective and safe treatment of BPS that appears to be of benefit in improving prognosis and decreasing the need for postnatal sequestrectomy.

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“…Moreover it have been performed in only few experienced centers, and therefore is limited to perform in several other centers. Although other less invasive procedures such as percutaneous interstitial ablation or injection of a sclerosing agent into the CCAM have also been performed, few successful cases were reported so far [4,5]. Therefore, additional studies are needed to identify the best treatment approach for fetuses with large CCAMs.…”

Section: Discussionmentioning

confidence: 99%

An unusual prenatal manifestation of a huge congenital cystic adenomatoid malformation with favorable perinatal outcome

et al. 2014

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Congenital cystic adenomatoid malformation (CCAM) is a rare condition which is easily detectable by prenatal ultrasonography. Fetuses with large CCAMs associating with hydrops are predisposed to perinatal mortality, therefore prenatal intervention is required. While macrocystic CCAM is treated prenatally by thoracentesis or thoraco-amniotic shunt, microcystic or mixed CCAM is difficult to manage in the fetus. In these latter lesions, fetal lobectomy, sclerotherapy, or laser ablation was used to treat lesions directly. We present an unusual prenatal case of mixed CCAM associating with hydrops and marked ascites, which was conservatively managed with prenatal abdomino-amniotic shunting and successfully treated by postnatal surgery.

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Percutaneous laser ablation under ultrasound guidance for fetal hyperechogenic microcystic lung lesions with hydrops: a single center cohort and a literature review

Abstract: Percutaneous vascular laser ablation seems to be effective for bronchopulmonary sequestration in hydropic fetuses. Outcomes were worst following interstitial ablation for microcystic congenital adenomatoid with hydrops.

Cited by 53 publications

References 48 publications

Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas: cohort study and literature review

Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas: cohort study and literature review

Outcome of Bronchopulmonary Sequestration with Massive Pleural Effusion after Intrafetal Vascular Laser Ablation

An unusual prenatal manifestation of a huge congenital cystic adenomatoid malformation with favorable perinatal outcome

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