Pleural puncture that excludes the ablation zone decreases the risk of pneumothorax after percutaneous microwave ablation in porcine lung Journal Article


Authors: Lee, K. S.; Takaki, H.; Yarmohammadi, H.; Srimathveeravalli, G.; Luchins, K.; Monette, S.; Nair, S.; Kishore, S.; Erinjeri, J. P.
Article Title: Pleural puncture that excludes the ablation zone decreases the risk of pneumothorax after percutaneous microwave ablation in porcine lung
Abstract: Purpose To test the hypothesis that the geometry of probe placement with respect to the pleural puncture site affects the risk of pneumothorax after microwave (MW) ablation in the lung. Materials and Methods Computed tomography-guided MW ablation of the lung was performed in 8 swine under general anesthesia and mechanical ventilation. The orientation of the 17-gauge probe was either perpendicular (90°) or parallel (< 30°) with respect to the pleural puncture site, and the ablation power was 30 W or 65 W for 5 minutes. After MW ablation, swine were euthanized, and histopathologic changes were assessed. Frequency and factors affecting pneumothorax were evaluated by multivariate analysis. Results Among 62 lung MW ablations, 13 (21%) pneumothoraces occurred. No statistically significant difference was noted in the rate of pneumothorax between the perpendicular and the parallel orientations of the probe (31% vs 14%; odds ratio [OR], 2.8; P =.11). The pneumothorax rate was equal for 65-W and 30-W ablation powers (21% and 21%; OR, 1.0; P =.94). Under multivariate analysis, 2 factors were independent positive predictors of pneumothorax: ablation zone inclusive of pleural insertion point (OR, 7.7; P =.02) and time since intubation (hours) (OR, 2.7; P =.02). Conclusions Geometries where the pleural puncture site excluded the ablation zone decreased pneumothorax in swine undergoing MW ablation in the lung. Treatment planning to ensure that the pleural puncture site excludes the subsequent ablation zone may reduce the rate of pneumothorax in patients undergoing MW ablation in the lung. © 2015 SIR.
Journal Title: Journal of Vascular and Interventional Radiology
Volume: 26
Issue: 7
ISSN: 1051-0443
Publisher: Elsevier Science, Inc.  
Date Published: 2015-07-01
Start Page: 1052
End Page: 1058
Language: English
DOI: 10.1016/j.jvir.2015.01.016
PROVIDER: scopus
PUBMED: 25753501
PMCID: PMC5652064
DOI/URL:
Notes: Export Date: 2 July 2015 -- Source: Scopus
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MSK Authors
  1. Joseph Patrick Erinjeri
    204 Erinjeri
  2. Sebastien Monette
    151 Monette
  3. Sirish Kishore
    14 Kishore
  4. Kyungmouk Steve Lee
    6 Lee
  5. Haruyuki Takaki
    7 Takaki
  6. Sreejit   Nair
    2 Nair