Peer-Reviewed Journal Details
Mandatory Fields
Donlon, PT;Fallahi, H;Beard, WL;Shahzad, A;Heflin, L;Cox, W;Bloomberg, B;Lillic, JD;Ganta, CK;O'Sullivan, GJ;Ruvio, G;O'Shea, PM;O'Halloran, M;Prakash, P;Dennedy, MC
2019
January
International Journal Of Hyperthermia
Using microwave thermal ablation to develop a subtotal, cortical-sparing approach to the management of primary aldosteronism
Published
Optional Fields
RADIOFREQUENCY ABLATION LAPAROSCOPIC ADRENALECTOMY CLINICAL-OUTCOMES ADENOMA EXPRESSION MUTATIONS CORTEX AGE
36
905
914
Objective: To investigate the feasibility and efficacy of localized, subtotal, cortical-sparing microwave thermal ablation (MTA) as a potential curative management for primary aldosteronism. The study investigated with equal importance the selected ablation of small volumes of adrenal cortex while sparing adjacent cortex. Method: An in-vivo study was carried out in swine (n = 8) where MTA was applied under direct visualization, to the adrenal glands at 45 W or 70 W for 60 s, using a lateral, side-firing probe and a non-penetrative approach. Animals were survived for 48 h post-procedurally. Animals were investigated for markers of histological, immunohistochemical and biochemical evidence of adrenal function and adrenal damage by assessing samples drawn intra-operatively and at the time of euthanasia. Results: Selected MTA (70 W for 60 s) successfully ablated small adrenocortical volumes (similar to 0.8 cm(3)) characterized by coagulative necrosis and abnormal expression of functional markers (CYP11B1 and CYP17). Non-ablated, adjacent cortex was not affected and preserved normal expression of functional markers, without increased expression of markers of heat damage (HSP-70 and HMGB-1). Limited adrenal medullary damage was demonstrated histologically, clinically and biochemically. Conclusion: MTA offers potential as an efficient methodology for delivering targeted subtotal cortical-sparing adrenal ablation. Image-guided targeted MTA may also represent a safe future modality for curative management of PA, in the setting of both unilateral and bilateral disease.
0265-6736
10.1080/02656736.2019.1650205
Grant Details
Publication Themes