Cryoablation

冷冻消融
  • 文章类型: Case Reports
    骨样骨瘤是以严重局部疼痛为特征的良性骨肿瘤,经常挑战年轻患者的日常生活。虽然这些肿瘤通常是孤立的,已经报道了罕见的多发性骨样骨瘤病例。本研究论文介绍了2例年轻的多发性骨样骨瘤患者,突出他们的临床表现,诊断检查,冷冻消融治疗,和后续行动。本文强调了冷冻消融作为这些具有挑战性的病例的微创治疗选择的有效性。
    Osteoid osteomas are benign bone tumors characterized by severe localized pain, often challenging the daily lives of young patients. While these tumors are typically solitary, rare cases of multiple osteoid osteomas have been reported. This research paper presents a case series of 2 young patients with multiple osteoid osteomas, highlighting their clinical presentation, diagnostic workup, treatment with cryoablation, and follow-up. The paper emphasizes the effectiveness of cryoablation as a minimally invasive treatment option for these challenging cases.
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  • 文章类型: Journal Article
    生物有机体在人类健康中起着重要的作用,以共生或致病的方式。利用灭活生物体或活生物体是治疗疾病的有希望的方法。作为两种类型的冷冻,冷冻消融可以使需要时必须处于非致病状态的生物体失活,而冷冻保存是解决基于生物体的治疗所挑战的长期储存问题的一种简便方法。在这次审查中,我们介绍了冷冻生物有机体用于生物医学应用的最新研究。首先,冷冻消融和冷冻保存的冷冻策略,以及他们相应的技术要点,是插图。此外,介绍了冷冻生物有机体的生物医学应用,包括移植,组织再生,抗感染治疗,和抗肿瘤治疗。充分讨论了冷冻生物用于生物医学应用的挑战和前景。我们认为,冷冻方法将为灭活或基于活生物体的治疗系统的标准化和商业化提供潜在的方向,并促进基于生物的治疗的临床应用。
    Biological organisms play important roles in human health, either in a commensal or pathogenic manner. Harnessing inactivated organisms or living organisms is a promising way to treat diseases. As two types of freezing, cryoablation makes it simple to inactivate organisms that must be in a non-pathogenic state when needed, while cryopreservation is a facile way to address the problem of long-term storage challenged by living organism-based therapy. In this review, we present the latest studies of freezing biological organisms for biomedical applications. To begin with, the freezing strategies of cryoablation and cryopreservation, as well as their corresponding technical essentials, are illustrated. Besides, biomedical applications of freezing biological organisms are presented, including transplantation, tissue regeneration, anti-infection therapy, and anti-tumor therapy. The challenges and prospects of freezing living organisms for biomedical applications are well discussed. We believe that the freezing method will provide a potential direction for the standardization and commercialization of inactivated or living organism-based therapeutic systems, and promote the clinical application of organism-based therapy.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    本研究旨在设计一种标准化支气管镜钬激光消融持续冷冻消融治疗气管插管后组织增生所致气道狭窄的方法,并对其安全性和可行性进行回顾性分析。收集气管插管后因气管黏膜组织增生导致气道狭窄而接受支气管镜钬激光消融术连续冷冻消融术的患者资料。患者的基线特征,消融效应,分析手术并发症和其他数据。总的来说,16名患者参加了这项研究。平均而言,气道狭窄发生96.00(四分位距,69.75-152.50)天后气管插管和支气管镜钬激光消融连续冷冻消融平均花费90.38分钟(标准偏差:16.78)。第一次连续冷冻消融后,75.0%(12/16)的患者完整消融增生组织,25.0%(4/16)的增生组织大部分(>50%)被切除。总之,18.75%(3/16)和6.25%(1/16)的患者在第二次和第三次冷冻消融术后完全消融增生组织,分别。此外,1例(6.25%)术后伤口出血最少,无其他手术并发症发生。在最后一次冷冻消融术后1个月和6个月的随访中,所有入选患者均未发现气道狭窄。根据我们的小样本研究结果,表明支气管镜下钬激光消融持续冷冻消融治疗气管插管后组织增生引起的气道狭窄是安全有效的。
    This study aimed to design a standardised bronchoscopic holmium laser ablation continuous cryoablation for the treatment of airway stenosis caused by tissue hyperplasia after tracheal intubation and to retrospectively analyse its safety and feasibility. We collected the data of patients who had undergone bronchoscopic holmium laser ablation continuous cryoablation due to airway stenosis caused by tracheal mucosal tissue hyperplasia after tracheal intubation. The patients\' baseline characteristics, ablation effects, surgical complications and other data were analysed. In total, 16 patients were enrolled in this study. On average, airway stenosis occurred 96.00 (interquartile range, 69.75-152.50) days after tracheal intubation and bronchoscopic holmium laser ablation continuous cryoablation took an average of 90.38 minutes (standard deviation: 16.78). After the first continuous cryoablation, 75.0% (12/16) of the patients had complete ablation of hyperplastic tissue, and 25.0% (4/16) had most of the hyperplastic tissue (>50%) removed. Altogether, 18.75% (3/16) and 6.25% (1/16) of the patients had complete ablation of hyperplastic tissue after the second and third cryoablation, respectively. Moreover, one patient (6.25%) had minimal wound bleeding postoperatively, and no other surgical complications occurred. No airway stenosis was found in all enrolled patients during follow-up 1 and 6 months after the last cryoablation. According to the above results of our small sample study indicated that bronchoscopic holmium laser ablation continuous cryoablation seems safe and effective for treating airway stenosis caused by tissue hyperplasia after tracheal intubation.
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  • 文章类型: Journal Article
    前列腺癌的治疗选择通常需要积极的监测,手术,辐射,或上述的组合。疾病复发仍然是一个令人担忧的问题,文献报道了广泛的复发率。在复发的背景下,挽救性治疗方案包括挽救性前列腺切除术,打捞高强度聚焦超声(HIFU),立体定向身体放射治疗(SBRT),抢救近距离放射治疗,和抢救冷冻消融。在这次审查中,我们分析了目前可用的与挽救性冷冻消融治疗放疗后复发性前列腺癌相关的数据.
    The treatment options for prostate cancer typically entail active surveillance, surgery, radiation, or a combination of the above. Disease recurrence remains a concern, with a wide range of recurrence rates having been reported in the literature. In the setting of recurrence, the salvage treatment options include salvage prostatectomy, salvage high-intensity focused ultrasound (HIFU), stereotactic body radiotherapy (SBRT), salvage brachytherapy, and salvage cryoablation. In this review, we analyze the currently available data related to salvage cryoablation for recurrent prostate cancer following radiation.
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  • 文章类型: Journal Article
    冷冻消融术是一种用于外科手术治疗心房颤动的完善的医疗程序。低温导管治疗通过冷冻肺静脉的内部诱导细胞坏死,目的是破坏异常的心脏电信号。然而,低温引起的组织损伤也可能导致心脏手术后的其他并发症。在这个意义上,导管消融模拟可以为训练和冷冻治疗干预提供更安全的环境.因此,在本文中,我们提出了一种新颖的方法,通过使用计算机工具开发模拟框架来预测病变大小,并确定最佳温度条件,以降低重大并发症的风险,从而帮助更好地了解体温率如何影响该手术.结果表明,-40°C左右的温度分布导致渗透减少,减少坏死损伤,和组织中更小的病变大小。相反,接近-60°C的冷冻治疗实现了组织内部更大的温度流动深度和更大的病变横截面面积。随着进一步的发展和验证,该框架可以代表提供个性化建模的成本效益高的策略,更好地规划基于冷冻导管的治疗,预防手术并发症。
    Cryoablation is a well-established medical procedure for surgically treating atrial fibrillation. Cryothermal catheter therapy induces cellular necrosis by freezing the insides of pulmonary veins, with the goal of disrupting abnormal electrical heart signals. Nevertheless, tissue damage induced by cold temperatures may also lead to other complications after cardiac surgery. In this sense, the simulation of catheter ablation can provide safer environments for training and the performance of cryotherapy interventions. Therefore, in this paper, we propose a novel approach to help better understand how temperature rates can affect this procedure by using computer tools to develop a simulation framework to predict lesion size and determine optimal temperature conditions for reducing the risk of major complications. The results showed that a temperature profile of around -40 °C caused less penetration, reduced necrotic damage, and smaller lesion size in the tissue. Instead, cryotherapy close to -60 °C achieved a greater depth of temperature flow inside the tissue and a larger cross-section area of the lesion. With further development and validation, the framework could represent a cost-effective strategy for providing personalized modeling, better planning of cryocatheter-based treatment, and preventing surgical complications.
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  • 文章类型: Journal Article
    纳米脉冲刺激(NPS)疗法在纳秒域中施加电脉冲,以启动受治疗组织中的调节细胞死亡。这种非热疗法已被用于治疗广泛的鼠类肿瘤,并已被证明可以激活免疫系统以抑制再攻击肿瘤的生长,以及未经处理的,当伴随着免疫系统刺激物注射到治疗的肿瘤时,腹腔镜肿瘤。临床试验已经开始使用NPS治疗基底细胞癌和肝细胞癌。
    当皮内注射肿瘤细胞以使其在小鼠皮肤内生长时,可以容易地对小鼠肿瘤进行成像。在半透明的光柱上拉动皮肤使光通过皮肤发光,并且使得容易治疗肿瘤和识别治疗区域。
    描述了使用小鼠肿瘤模型的原始研究,包括黑色素瘤,鳞状细胞癌,肺癌,乳腺癌,和胰腺癌.已经确定了消融这些肿瘤所需的能量,胰腺癌和肺癌显示出90%消融,240mJ/mm3,肺癌和鳞状细胞癌需要360mJ/mm3,黑色素瘤需要480mJ/mm3。NPS疗法引发了可变的免疫反应,通过注射的再攻击肿瘤细胞的排斥反应表明,黑色素瘤和肝细胞癌表现出最强的反应和肺癌,最弱的反应。根据原始研究数据,综述了使用NPS治疗的人体临床试验.
    NPS治疗提供了一种非热,肿瘤学的无药方法,这只能通过向肿瘤施加能量来限制。这种新的免疫原性方式刚刚开始在临床上应用。数名医务人员进行的首次大型临床试验的87%疗效令人印象深刻,表明NPS是癌症治疗的有效新方式。
    UNASSIGNED: Nano-Pulse Stimulation (NPS) therapy applies electric pulses in the nanosecond domain to initiate regulated cell death in the treated tissues. This nonthermal therapy has been used to treat a wide range of murine tumors and has been shown to activate the immune system to inhibit the growth of rechallenge tumors, as well as untreated, abscopal tumors when accompanied by the injection of immune system stimulants into the treated tumors. Clinical trials have begun using NPS to treat basal cell carcinoma and hepatocellular carcinoma.
    UNASSIGNED: Murine tumors can be easily imaged when the tumor cells are injected intradermally so that they grow within the mouse skin. Pulling the skin over a translucent light post shines light through the skin and makes it easy to treat the tumor and identify the treatment zone.
    UNASSIGNED: Original research using murine tumor models is described, including melanoma, squamous cell carcinoma, lung carcinoma, breast carcinoma, and pancreatic carcinoma. The energy required to ablate these tumors has been determined with pancreatic carcinoma and lung carcinoma exhibiting 90% ablation with 240 mJ/mm3, lung carcinoma and squamous cell carcinoma requiring 360 mJ/mm3, and melanoma requiring 480 mJ/mm3. NPS therapy initiated a variable immune response indicated by the rejection of injected rechallenge tumor cells with melanoma and hepatocellular carcinoma exhibiting the strongest response and lung carcinoma, the weakest response. Following the original research data, a review of human clinical trials using NPS therapy is presented.
    UNASSIGNED: NPS therapy offers a nonthermal, drug-free approach for oncology, which is limited only by applying energy to the tumor. This new immunogenic modality is just beginning to be applied in the clinic. The 87% efficacy of the first large clinical trial conducted by several medical personnel is impressive and indicates that NPS is an effective new modality for cancer treatment.
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  • 文章类型: Journal Article
    冷冻消融术已成为公认的治疗心房颤动(AF)的介入策略。许多试验已经研究了冷冻消融作为AF的一线疗法。这项荟萃分析旨在评估冷冻消融术对有症状房颤患者的生活质量(QoL)和安全性结果的影响,与抗心律失常药物(AAD)相比。
    对PubMed的全面搜索,EMBASE,和CochraneLibrary数据库进行随机对照试验(RCT),比较冷冻消融术和AAD作为AF的一线治疗,直至2023年5月.连续结果数据采用均差(MD)和95%置信区间(CI)进行分析。和二分结局数据使用95%CI的相对风险(RR)进行分析。评估的主要结果是QoL和严重不良事件。
    我们的分析包括四个RCT,涉及928名患者。与AAD治疗相比,冷冻消融与房颤对生活质量(AFEQT)评分(3项试验;MD7.46,95%CI2.50至12.42;p=0.003;I2=79%)和EQ-VAS评分(2项试验;MD1.49,95%CI1.13至1.86;p<0.001;I2=0%)的显着改善相关。此外,与AAD治疗相比,冷冻消融显示EQ-5D评分较基线略有增加,无统计学意义(2项试验;MD0.03,95%CI-0.01至0.07;p=0.07;I2=79%)。此外,与AAD治疗相比,冷冻消融治疗严重不良事件的发生率显着降低(4项试验;11.8%vs.16.3%;RR,0.73;95%CI,0.54-1.00;p=0.05;I2=0%)。冷冻消融还与总体不良事件的减少有关。持续性房颤的发生率,住院治疗,和额外的消融。然而,两个治疗组的主要不良心血管事件和急诊就诊次数无显著差异.
    冷冻消融,作为有症状的房颤患者的一线治疗,显著改善房颤患者的生活质量,减少严重不良事件,以及整体不良事件,持续性房颤,住院治疗,以及与AAD相比的额外消融。
    UNASSIGNED: Cryoablation has emerged as a recognized interventional strategy for the treatment of atrial fibrillation (AF). Numerous trials have investigated cryoablation as a first-line therapy for AF. This meta-analysis aimed to evaluate the impact of cryoablation on quality of life (QoL) and safety outcomes compared to antiarrhythmic drugs (AADs) in patients with symptomatic AF.
    UNASSIGNED: A comprehensive search of the PubMed, EMBASE, and Cochrane Library databases was conducted for randomized controlled trials (RCTs) comparing cryoablation and AADs as first-line treatments for AF until May 2023. Continuous outcome data were analyzed using mean differences (MDs) with 95% confidence intervals (CIs), and dichotomous outcome data were analyzed using relative risks (RRs) with 95% CIs. The primary outcomes assessed were QoL and serious adverse events.
    UNASSIGNED: Our analysis included four RCTs involving 928 patients. Cryoablation was associated with a significant improvement in the AF Effect on Quality of Life (AFEQT) score (3 trials; MD 7.46, 95% CI 2.50 to 12.42; p = 0.003; I 2 = 79%) and EQ-VAS score (2 trials; MD 1.49, 95% CI 1.13 to 1.86; p < 0.001; I 2 = 0%) compared to AAD therapy. Additionally, cryoablation demonstrated a modest increase in EQ-5D score from baseline compared to AAD therapy, with no statistically significance (2 trials; MD 0.03, 95% CI -0.01 to 0.07; p = 0.07; I 2 = 79%). Furthermore, the rate of serious adverse events was significantly lower with cryoablation compared to AAD therapy (4 trials; 11.8% vs. 16.3%; RR, 0.73; 95% CI, 0.54-1.00; p = 0.05; I 2 = 0%). Cryoablation was also associated with a reduction in overall adverse events, incidence of persistent AF, hospitalizations, and additional ablation. However, there was no significant difference in major adverse cardiovascular events and emergency department visits between the two treatment groups.
    UNASSIGNED: Cryoablation, as a first-line treatment for symptomatic AF patients, significantly improved AF-specific quality of life and reduced serious adverse events, as well as overall adverse events, persistent AF, hospitalizations, and additional ablation compared to AADs.
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  • 文章类型: Case Reports
    一名患有vonHippel-Lindau病的50岁男子因右肾上极的两个相邻肾细胞癌接受了冷冻消融(CRA)。尽管CRA后立即计算机断层扫描(CT)显示部分肝实质累及冰球,治疗完成,无并发症.CRA后第2天的对比增强CT显示,消融肝实质附近的第6段门静脉中有血栓,促使开始口服抗凝治疗。患者于CRA后第4天出院,无任何后遗症,6周后进行的对比增强CT随访显示门静脉血栓消退。
    A 50-year-old man with von Hippel-Lindau disease underwent cryoablation (CRA) for two adjacent renal cell carcinomas in the upper pole of his right kidney. Although computed tomography (CT) immediately after CRA revealed involvement of part of the liver parenchyma in the ice-ball, the treatment was completed without complications. Contrast-enhanced CT on day 2 post-CRA revealed a thrombus in the portal vein of segment 6 near the ablated liver parenchyma, prompting the initiation of oral anticoagulation. The patient was discharged on day 4 after CRA without any sequelae, and a follow-up contrast-enhanced CT done 6 weeks later demonstrated resolution of the portal vein thrombus.
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