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Pulmonary hemorrhage complicating radiofrequency ablation, from mild hemoptysis to life-threatening pattern.
MedLine Citation:
PMID:  20665216     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: To assess risk factors and the extent of pulmonary hemorrhage complicating radiofrequency ablation (RFA) of pulmonary neoplasms.
MATERIALS AND METHODS: This retrospective study involved 248 ablation sessions for lung tumors (20 primary lesions and 228 metastatic lesions) in 164 patients (mean age 59.7 years, SD: 10.2). Both unipolar and bipolar radiofrequency systems were used under CT fluoroscopic guidance. Extent and underlying factors associated with development of pulmonary hemorrhage were analyzed.
RESULTS: Incidence of intra-parenchymal pulmonary hemorrhage, pleural effusion, and hemoptysis were 17.7% (44/248 sessions), 4% (8/248 sessions), and 16.1% (40/248 sessions), respectively. Death because of massive bleeding occurred in one session (0.4%). Significant risk factors associated with intra-parenchymal hemorrhage included: lesions of <1.5 cm diameter (P=0.007); basal and middle lung zone lesions (P=0.026); increased needle track distance traversing the lung parenchyma>2.5 cm (P=0.0017); traversing pulmonary vessels in the track of ablation (P<0.001); and the use of multi-tined electrodes (P=0.004). Concomitant incidence of pulmonary hemorrhage and pneumothorax was 29.2% (14/48 sessions).
CONCLUSION: While typically safe, RFA of pulmonary neoplasms can result in pulmonary hemorrhage ranging from mild to life-threatening. Management of this complication is mainly preventive through adequate patient selection for ablation therapy and exclusion of technically avoidable risk factors.
Authors:
Nour-Eldin A Nour-Eldin; Nagy N N Naguib; Martin Mack; John E Abskharon; Thomas J Vogl
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Publication Detail:
Type:  Journal Article     Date:  2010-07-28
Journal Detail:
Title:  European radiology     Volume:  21     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  197-204     Citation Subset:  IM    
Affiliation:
Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany. nour410@hotmail.com
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