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DOI: 10.1055/s-2008-1079913
Large HCC ablation by a new saline-enhanced expandable radiofrequency device
Purpose: Evaluation of a new device designed for large volumes of necrosis by radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC).
Methods and materials: Twenty-nine consecutive patients with 31 HCC >3cm in size (range 3–7.5cm, mean 5.5cm) underwent US-guided-percutaneous-RFA using an expandable electrode with seven active arrays and saline injection, designed to create tissue ablation up to 7cm (StarBurst-XLienhanced, RITA Medical Systems. CA, USA). Treatments were performed in general anesthesia (6 patients) or deep sedation (23 patients). Treatment efficacy was assessed by three-phase-enhanced-CT and bimonthly US follow-up.
Results: One to 5 electrodes insertions (mean 2.6) were performed per patient. Complete necrosis at CT was achieved in 23/31 HCC nodules (74%) in 22 patients. Follow-up of these 22 patients ranged from 2 to 15 months (mean 8.3 months). 6/22 (28%) patients showed new intrahepatic recurrences within 5–10 months (mean 8.3 months). Major complications were: post-ablation syndrome in 7/29 (24%), peritoneal effusion in 4/29 (14%), pleural effusion in 2/29 (7%) and transient obstructive jaundice in 1/29 (3.4%) patients. One patient died 6 months after treatment because of the tumor.
Conclusion: StarBurst-XLi-enhanced is an effective and safe device for the treatment of large HCC.