Location: University of Pisa - Italy
Featured product: TATO Thermal Ablation Treatments for Oncology
How can TATO help me in ablation?
During the past 20 years, the objectives of ablation research endpoints have been to increase ablation
volumes while reducing the procedural times and increasing the reproducibility. This means higher
wattage, cooling optimization and larger calibre antennas. Large volumes of coagulative necrosis,
however, are not the only achievement that matters in daily clinical practice. While ablation can be considered a minimally invasive treatment, some risks exist and the principle
of beneficence against the principle of non-maleficence should be evaluated in order to optimize
the treatment, balancing safety and efficacy. By planning an ablation treatment, it is fundamental to
take into consideration the presence of factors affecting treatment safety or efficacy.
Treating Patients at high risk of bleeding
Among the potential complications affecting safety, bleeding is the most important to be prevented.
Unlike surgeons, Interventional Radiologists do not have direct control of haemostasis. For this reason,
ablation is considered as a high bleeding-risk procedure.
When abnormalities in the coagulation are present, the risk of the occurrence of perihepatic free
fluid after intervention or complications of any kind during follow-up is increased. The availability of
thinner antennas may be useful in patients at risk, such as those with cirrhosis, abnormal platelets, or
elevated values of INR.
Treating Nodules at high risk of bleeding and/or seeding
Nodules in subcapsular location treated with a direct
puncture are at higher risk of bleeding and seeding. The
latter especially if the nodule is not well differentiated
or presents an invasive tumoral pattern. Therefore, in
the treatment of subcapsular nodules, direct puncture
should be avoided.
In the impossibility of interposing healthy parenchyma,
“no touch” technique has been demonstrated as feasible
and useful. Multi-antenna microwave devices can be
useful in nodules with subcapsular location and every
time the physician prefers a no-touch technique.
Treating Nodules located near critical structures
Undesirable thermal damage can also affect safety and a “controlled ablation”, not growing too fast
and too much in length is desirable. Structures that can be damaged are represented by:
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