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AJR Am J Roentgenol. 2011 Oct;197(4):W576-80. doi: 10.2214/AJR.11.6408.

Complications after 1000 lung radiofrequency ablation sessions in 420 patients: a single center's experiences.

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  • 1Department of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-city, Mie 14-8507, Japan. masataka-k@clin.medic.mie-u.ac.jp

Abstract

OBJECTIVE:

This study retrospectively evaluates complications after lung radiofrequency ablation (RFA).

MATERIALS AND METHODS:

Complications were assessed for each RFA session in 420 consecutive patients with 1403 lung tumors who underwent 1000 RFA sessions with a cool-tip RFA system. A major complication was defined as a grade 3 or 4 adverse event. Risk factors affecting frequent major complications that occurred with an incidence of 1% or more were detected using multivariate analysis.

RESULTS:

Four deaths (0.4% [4/1000]) related to RFA procedures occurred. Three patients died of interstitial pneumonia. The other patient died of hemothorax. The major complication rate was 9.8% (98/1000). Frequent major complications were aseptic pleuritis (2.3% [23/1000]), pneumonia (1.8% [18/1000]), lung abscess (1.6% [16/1000]), bleeding requiring blood transfusion (1.6% [16/1000]), pneumothorax requiring pleural sclerosis (1.6% [16/1000]), followed by bronchopleural fistula (0.4% [4/1000]), brachial nerve injury (0.3% [3/1000]), tumor seeding (0.1% [1/1000]), and diaphragm injury (0.1% [1/1000]). Puncture number (p < 0.02) and previous systemic chemotherapy (p < 0.05) were significant risk factors for aseptic pleuritis. Previous external beam radiotherapy (p < 0.001) and age (p < 0.02) were significant risk factors for pneumonia, as were emphysema (p < 0.02) for lung abscess, and serum platelet count (p < 0.002) and tumor size (p < 0.02) for bleeding. Emphysema (p < 0.02) was a significant risk factor for pneumothorax requiring pleural sclerosis.

CONCLUSION:

Lung RFA is a relatively safe procedure, but it can be fatal. Risk factors found in this study will help to stratify high-risk patients.

PMID:
21940529
[PubMed - indexed for MEDLINE]
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