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Wang L, Lu M, Zhuang M, Liang Y, Wang SS, Li JM. Microwave ablation with hydrodissection used for the treatment of vascular malformations: effectiveness and safety study. Front Oncol 2024; 14:1146972. [PMID: 38894863 PMCID: PMC11183287 DOI: 10.3389/fonc.2024.1146972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
Object The aim of the study was to investigate the safety, effectiveness, and peripheral nerve protection in ultrasound-guided microwave ablation (US-guided-MWA) for vascular malformations (VMs) closely related to peripheral nerve. Materials and methods From August 2019 to February 2022, 31 patients with 39 VMs received US-guided-MWA. All lesions were confirmed to be closely related to the peripheral nerve by imaging evaluation. Hydrodissection was applied to protect surrounding normal tissue, including peripheral nerves. The patients were followed up at 1day, 2 days, 3 days, 1 week, 1 month, 3 months after operation. Measurements of lesion volume, volume reduction ratio (VRR), sensory and functional abnormalities of adjacent nerves, number of treatments, complication details, personal satisfaction, recurrence, and symptom improvement were recorded. Results Among the 39 VMs, the maximum volume is 128.58ml, while the minimum volume is 0.99ml. After a mean follow-up of 13.06 ± 4.83 months, the mean numerical rating scale (NRS) score decreased from 5.13 ± 1.65 to 0.53 ± 0.83 (P<0.0001). The mean mass volume was reduced from 18.34 ± 24.68 ml to 1.35 ± 2.09 ml (P=0.0001). The VRR of all lesions was 92.06%. However, the mean number of treatments was only 1.64 ± 0.87. All patients were satisfied with the technique, with a mean satisfaction score (SC) of 9.23 ± 1.13. There were no motor function abnormalities of the related nerves. 10 patients felt numbness in the ablation area after ablation, and gradually recovered after 1 month. Conclusion US-guided-MWA serves as a novel alternative approach for patients with VMs. Preoperative evaluation of the relationship between VMs and peripheral nerves combined with intraoperative hydrodissection is an effective and safe method to prevent nerve injury.
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Affiliation(s)
- Lu Wang
- Department of Ultrasound, Sichuan Cancer Hospital, Chengdu, China
| | - Man Lu
- Department of Ultrasound, Sichuan Cancer Hospital, Chengdu, China
| | - Min Zhuang
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Ying Liang
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shi Shi Wang
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jia Mi Li
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
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Mohnasky M, Brondon J, Lee SY, Kim KR. Sociodemographic characteristics of pediatric patients with vascular malformations: Results of a single site study. Front Pediatr 2023; 11:1078611. [PMID: 36873648 PMCID: PMC9978219 DOI: 10.3389/fped.2023.1078611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Vascular malformations, the abnormal development of blood vessels, are a rare set of congenital anomalies. The sociodemographic factors associated with vascular malformations in pediatric patients are poorly understood. This study examined sociodemographic factors of 352 patients presenting to a single vascular anomaly center from July 2019 to September 2022. Characteristics such as race, ethnicity, sex, age at presentation, degree of urbanization, and insurance status were recorded. This data was analyzed by comparing the different types of vascular malformations, including arteriovenous malformation, capillary malformation, venous malformation (VM), lymphatic malformation (LM), lymphedema, and overgrowth syndrome. Patients were primarily white, not Hispanic or Latino, female, had private health insurance, and were from the most urban setting. No differences in sociodemographic factors were found among the different vascular malformations except patients with VM presented at a later age than patients with LM or overgrowth syndrome. This study provides novel insight into the sociodemographic factors of pediatric patients presenting with vascular malformations and indicates a need for their improved recognition for the timely initiation of treatment.
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Affiliation(s)
- Michael Mohnasky
- School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Jennifer Brondon
- School of Medicine, University of North Carolina, Chapel Hill, NC, United States.,Department of Pediatrics, University of North Carolina, Chapel Hill, NC, United States
| | - Sang Yub Lee
- Department of Radiology, Samsung Medical Center, Seoul, South Korea
| | - Kyung Rae Kim
- School of Medicine, University of North Carolina, Chapel Hill, NC, United States.,Department of Radiology, University of North Carolina, Chapel Hill, NC, United States
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Serio VB, Palmieri M, Loberti L, Granata S, Fallerini C, Vaghi M, Renieri A, Pinto AM. Nosological and Theranostic Approach to Vascular Malformation through cfDNA NGS Liquid Biopsy. J Clin Med 2022; 11:jcm11133740. [PMID: 35807022 PMCID: PMC9267326 DOI: 10.3390/jcm11133740] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 02/06/2023] Open
Abstract
Several different nosological classifications have been used over time for vascular malformations (VMs) since clinical and pathological signs are largely overlapping. In a large proportion of cases, VMs are generated by somatic mosaicism in key genes, belonging to a few different molecular pathways. Therefore, molecular characterization may help in the understanding of the biological mechanisms related to the development of pathology. Tissue biopsy is not routinely included in the diagnostic path because of the need for fresh tissue specimens and the risk of bleeding. Bypassing the need for bioptic samples, we took advantage of the possibility of isolating cell-free DNA likely released by the affected tissues, to molecularly characterize 53 patients by cfDNA-NGS liquid biopsy. We found a good match between the identified variant and the clinical presentation. PIK3CA variants were found in 67% of Klippel Trenaunay Syndrome individuals; KRAS variants in 60% of arteriovenous malformations; MET was mutated in 75% of lymphovenous malformations. Our results demonstrate the power of cfDNA-NGS liquid biopsy in VMs clinical classification, diagnosis, and treatment. Indeed, tailored repurposing of pre-existing cancer drugs, such as PIK3CA, KRAS, and MET inhibitors, can be envisaged as adjuvant treatment, in addition to surgery and/or endovascular treatment, in the above-defined VMs categories, respectively.
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Affiliation(s)
- Viola Bianca Serio
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
| | - Maria Palmieri
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
| | - Lorenzo Loberti
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 2-53100 Siena, Italy;
| | - Stefania Granata
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 2-53100 Siena, Italy;
| | - Chiara Fallerini
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
| | - Massimo Vaghi
- Radiologia Interventistica, Ospedale Maggiore di Crema, Largo Ugo Dossena, 2-26013 Crema, Italy;
- Chirurgia Vascolare, Ospedale Maggiore di Crema, Largo Ugo Dossena, 2-26013 Crema, Italy
| | - Alessandra Renieri
- Medical Genetics Unit, University of Siena, Policlinico “Santa Maria alle Scotte”, Viale Bracci, 2-53100 Siena, Italy; (V.B.S.); (M.P.); (L.L.); (S.G.); (C.F.)
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 2-53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 2-53100 Siena, Italy;
- Correspondence: ; Tel.: +39-0577-233303; Fax: +39-0577-233325
| | - Anna Maria Pinto
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, 2-53100 Siena, Italy;
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Bush RL. Treatment strategies for various venous disorders. THE JOURNAL OF CARDIOVASCULAR SURGERY 2021; 62:411-412. [PMID: 33890757 DOI: 10.23736/s0021-9509.21.11930-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Ruth L Bush
- University of Houston College of Medicine, Houston, TX, USA - .,Central Texas VA Health Care System, Temple, TX, USA -
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