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Neurosurgery. 2019 May 11. pii: nyz141. doi: 10.1093/neuros/nyz141. [Epub ahead of print]

Laser Ablation of Abnormal Neurological Tissue Using Robotic Neuroblate System (LAANTERN): Procedural Safety and Hospitalization.

Author information

1
Department of Neurosurgery, University of California San Diego, San Diego, California.
2
Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
3
Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Denmark.
4
Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
5
Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina.
6
Orlando Neurosurgery, Orlando, Florida.
7
Division of Neurosurgery, University of British Columbia, Vancouver, Canada.
8
Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
9
Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
10
Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
11
Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas.
12
Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
13
Department of Neurosurgery, Washington University, St. Louis, Missouri.
14
Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota.

Abstract

BACKGROUND:

Stereotactic laser ablation (SLA) has demonstrated potential utility for a spectrum of difficult to treat neurosurgical pathologies in multiple small and/or retrospective single-institutional series. Here, we present the safety profile of SLA of intracranial lesions from the Laser Ablation of Abnormal Neurological Tissue using Robotic NeuroBlate System (LAANTERN; Monteris Medical) multi-institutional, international prospective observational registry.

OBJECTIVE:

To determine the procedural safety of SLA for intracranial lesions.

METHODS:

Prospective procedural safety and hospitalization data from the first 100 treated LAANTERN patients was collected and analyzed.

RESULTS:

Mean age and baseline Karnofsky Performance Status (KPS) were 51(± 17) yr and 83(± 15), respectively. In total, 81.2% of patients had undergone prior surgical or radiation treatment. Most patients had a single lesion (79%) ablated through 1 burr hole (1.2 ± 0.7 per patient), immediately following a lesion biopsy. In total, >90% of the lesion was ablated in 72% of treated lesions. Average total procedural time was 188.2 ± 69.6 min, and average blood loss was 17.7 ± 55.6 ccs. The average length of intensive care unit (ICU) and hospital stays before discharge were 38.1 ± 62.7 h and 61.1 ± 87.2 h, respectively. There were 5 adverse events (AEs) attributable to SLA (5/100; 5%). After the procedure, 84.8% of patients were discharged home. There was 1 mortality within 30 d of the procedure (1/100; 1%), which was not attributable to SLA.

CONCLUSION:

SLA is a safe, minimally invasive procedure with favorable postprocedural ICU and hospital utilization profiles.

KEYWORDS:

Neuro-oncology; Safety; Stereotactic laser ablation

PMID:
31076762
DOI:
10.1093/neuros/nyz141

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