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Objective: To evaluate the long-term oncological and functional results of the ablative treatment of T1a kidney malignancies by percutaneous radiofrequency (RF)., Materials and Methods: Monocentric retrospective study including all patients treated for renal cell carcinoma (RCC) T1a by radiofrequency, in our center, from 2005 to 2009. All patients had a tumor biopsy before treatment. The primary endpoint was local recurrence. A total of 44 RCCs in 41 consecutive patients were treated (1 patient had 3 synchronous tumors and 1 patient had 2 tumors). There were 26 clear cell RCCs, 13 papillary RCCs and 5 chromophobe RCCs. The median age at diagnosis was 70 years [48-82]. The median American Society of Anesthesiologists (ASA) score was 2 [1-3] and the median glomerular filtration rate (GFR) was 64mL/min [26-109]. Furhman grade was defined for 39 tumors (Clear cell RCC and papillary RCC), of which 82% were grade 1-2. The median tumor size was 20mm [11-40], and the median RENAL score was 4 [4-6]. Complications were assessed according to the Clavien-Dindo classification. Overall survival, recurrence-free survival and metastasis-free survival were calculated using the Kaplan-Meier method., Results: Median follow-up was 90.5 months [17.8-145.3]. Three (7%) local recurrences were reported within a median of 26 months [12-93]. All were treated by a 2nd RF. The overall 10-year survival was 70% (95% CI [56-85]). The 10-year recurrence-free survival was 72% (95% CI [57-88]). The 10-year metastasis-free survival was 87% (95% CI [74-97]). The median GFR on the date of the last news was 51mL/min [16-98] (P=0.05). Post-RFA complications consisted in 5 (11.3%) Clavien-Dindo 1-2 complications. No high grade (Clavien ≥3)., Conclusion: Percutaneous radiofrequency for RCC T1a is an alternative. It appears to be safe with low morbidity, satisfaying long-term oncological and functional results, but a risk of reprocessing of 7%., Level of Evidence: 3., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Introduction: Elderly patients represent a growing part of our society for who treatment strategy for localized renal tumors has to be chosen knowing iatrogen effects and renal function morbidity. The aim was to analyze oncological and functional results of nephron sparing surgery (PN) versus radiofrequency ablation (RFA)., Materials and Methods: All patients aged more than 75 treated by partial nephrectomy or radiofrequency ablation between 2007 and 2014 in our centre were included. Patient and tumors data were compared and these criteria were analyzed: survival (overall and without recurrence) and loss of renal function (pre- and postoperative MDRD)., Results: In total, 100 patients were included (26 partial nephrectomies, group 1 and 74 radiofrequency ablation, group 2) with a 32-months medium follow-up. Medium age and tumor size were significantly different (respectively, 78 versus 81 years old, P=0.001, 38mm versus 29mm, P=0.003). Perioperative results showed no differences in complications. Transfusion rate and duration of hospital stay were significantly higher in the PN group. Median overall survival were 45 vs. 27 months (P=0.23) for PN and RFA and median recurrence-free survival were 28 vs. 10 months (P=0.34). On a multivariate analysis, operative technique (PN or RFA) were not significantly linked to survival (HR 2.37 [95% CI: 0.66-8.5]), P=0.19. Loss of renal function were 1.5±14mL/min/1.73m 2 for PN and 3±14mL/min/1.73m 2 for RFA (P=0.69)., Conclusion: Our study showed better perioperative results for RFA than for PN, without significant different survival. Loss of renal function were little and similar., Level of Evidence: 4., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Percutaneous lung thermo-ablation has steadily been developed over the past 15years. Main indications are early stage non-small cell lung carcinoma (NSCLC) for non-surgical patients and slow evolving localized metastatic disease, either spontaneous or following a general treatment. Radiofrequency, being the most evaluated technique, offers a local control rate of about 80-90% for tumors <3 cm in diameter. With excellent tolerance and very few complications, radiofrequency may be proposed for patients with a chronic disease. Other ablation techniques under investigation such as microwaves and cryotherapy could allow overcoming radiofrequency limits. Furthermore, stereotactic radiotherapy proposed for the same indications is efficient. Comparative studies are warranted to differentiate these techniques in terms of efficacy, tolerance and cost-effectiveness., (Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

This year, What's new in Interventional Dermatology will be dedicated to lasers and other interventional devices. Many articles have been published these past two years emphasizing how dynamic this field of dermatology is. However, most of published papers were case reports or open series. Thus, innovative approaches, prospective randomized trials and large retrospective studies were the main criteria of selection of the articles., (© 2016 Elsevier Masson SAS. Tous droits réservés.)

Background: Pulmonary vein (PV) isolation, using cryoballoon or radiofrequency ablation, is the cornerstone therapy for symptomatic paroxysmal atrial fibrillation (AF) refractory to antiarrhythmic drugs. One-third of the patients have recurrences, mainly due to PV reconnections., Aims: To describe the different locations of reconnection sites in patients who had previously undergone radiofrequency or cryoballoon ablation, and to compare the characteristics of the redo procedures in both instances., Methods: Demographic data and characteristics of the initial ablation (cryoballoon or radiofrequency) were collected. Number and localization of reconduction gaps, and redo characteristics were reviewed., Results: Seventy-four patients scheduled for a redo ablation of paroxysmal AF were included; 38 had been treated by radiofrequency ablation and 36 by cryoballoon ablation during the first procedure. For the initial ablation, procedural and fluoroscopy times were significantly shorter for cryoballoon ablation (147.8±52.6min vs. 226.6±64.3min [P<0.001] and 37.0±17.7min vs. 50.8±22.7min [P=0.005], respectively). Overall, an identical number of gaps was found during redo procedures of cryoballoon and radiofrequency ablations. However, a significantly higher number of gaps were located in the right superior PV for patients first ablated with radiofrequency (0.9±1.0 vs. 0.5±0.9; P=0.009). Gap localization displayed different patterns. Although not significant, redo procedures of cryoballoon ablation were slightly shorter and needed shorter durations of radiofrequency to achieve PV isolation., Conclusions: During redo procedures, gap localization pattern is different for patients first ablated with cryoballoon or radiofrequency ablation, and right superior PV reconnections occur more frequently after radiofrequency ablation. Redo ablation of a previous cryoballoon ablation appears to be easier., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Juxtaglomerular cell tumors are rare and benign tumors, occurring in young patients. The standard treatment is partial nephrectomy. We report the case of a young 22-year-old patient with a renin-secreting tumor diagnosed during an exploration of severe hypertension associated with hypokalemia that we treated by radiofrequency ablation., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

In the management of lung metastases originating from colorectal cancer, RFA is particularly indicated in case of major comorbidities contraindicating thoracic surgery or recurrent disease after previous ipsilateral resection. The most frequent complication of RFA is pneumothorax, requiring chest tube insertion in 5% of cases. Interestingly, this proportion is very close to the rate of local recurrence, suggesting a possible association. We report a case of RFA followed by intractable pneumothorax requiring surgical management, and leading to the diagnosis of residual tumour. This case report illustrates this association and questions its relevance., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objective: In present study, we are assessing the efficiency of endometrial ablation by radiofrequency (Novasure(®)) for the treatment of abnormal uterine bleeding., Material and Methods: A total of 90 patients underwent an endometrial ablation by radiofrequency for uterine bleeding between 2009 and 2012. For the postoperative follow-up, symptoms amelioration and eventual adverse-events were evaluated by a self-administered questionnaire given to all patients after the surgery., Result: Sixty-five patients (74%) responded to the questionnaire with an average of 17.5 months. Among them, endometrial bleeding decreased in 92% of the cases (IC 95%; 86-99). The amenorrhea rate was 55% (IC 95%; 43-67) and 36% of the patients presented a diminution of menstrual bleeding after treatment. Thirty-two patients (36%) presented dysmenorrhea before the radiofrequency and 78% of them experienced an amelioration of the symptoms after treatment (IC 95%; 64-93). In 19 patients (21%), the cause of uterine bleeding was adenomyosis, among them, bleeding decreased in 84% of the cases (IC 95%; 71-98) and dysmenorrhea in 70%. (IC 95%; 41-97). Finally, 84% of the patients were satisfied with the result of the treatment., Conclusion: Our findings suggest that endometrial radiofrequency is effective for the treatment of menometrorrhagia, dysmenorrhea and also adenomyosis., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Abstract: Radiofrequency is a thermal ablative technique that is most often used percuteanously under image guidance. Thermal damage is obtained through frictional heating of a high frequency current. The maximal volume of destruction obtained in one radiofrequency delivery is around 4cm and consequently, best indication for treatment are tumours below 3cm. When compared, radiofrequency and surgical removal for tumours below 25mm in diameter demonstrated a rate of incomplete resection/ablation of 6% and 7.3% respectively. Median survival after the first radiofrequency of a liver metastasis of CRC is reported to be 24 to 52 months with a 5 years overall survival of 18 to 44%. The median overall survival increases from 22 to 48 months depending on the use of radiofrequency ablation as rescue treatment after failure of others, or as a first line treatment. For patients with a single tumour, less than 4cm, the survival rates at 1, 3, and 5 years are respectively 97%, 84% and 40%, with a median survival of 50 months. Follow-up imaging requires to use contrast-enhanced CT or MRI, looking for local recurrences evidenced by local foci of enhancement at the periphery of the ablation zone. [Copyright &y& Elsevier]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The possibility of curing patients suffering from paroxysmal atrial fibrillation using a radiofrequency ablation treatment is a major change in the management of this arrhythmia. Pulmonary vein disconnection is efficient and safe after a learning curve of the operator. This pulmonary vein isolation is the first and mandatory step allowing disappearance of atrial fibrillation in 70% of the patients. Modification in fibrillatory substrate using linear lesions increases the rate success to 75% in chronic atrial fibrillation and to 82% in paroxysmal atrial fibrillation. The radiofrequency ablation of atrial fibrillation should be considered as a surgical treatment without an open heart, isolating structures and cutting tissues are technical improvements (new radiofrequency catheters) will probably facilitate in the future. Some comparative studies with medical treatment are currently evaluating their efficacy, safety and respective cost and they may lead to a considerable increase in the number of patients who could benefit from these curative treatments. [Copyright &y& Elsevier]

Abstract: Percutaneous ablation allows to treat tumours with temperature modifications. These non-invasive techniques are useful to treat metastatic lung tumours in patients with a slowly evolving disease, which requires multiple local treatment. Ablation is therefore proposed as a locoregional treatment because it has a minimal impact on the lung. Other advantages are its efficacy and a low morbidity. Limits may be the tumour size and its location. [Copyright &y& Elsevier]

Percutaneous radiofrequency ablation is a well known treatment for osteoid osteomas. But its use in treating chondroblastoma is not well established in literature. There have been few case reports of such treatment in recent radiology literature (Radiology 221(2):463–468, ; Eur Radiol 3:1–7, ). We report a case of chondroblastoma in proximal humerus in a 14 year old treated with percutaneous radiofrequency ablation. At 6 month follow up the patient was asymptomatic. A repeat CT showed evidence of healing including resolution of the tumeral calcification. Repeat biopsy at this time showed no evidence of tumour recurrence. This minimally invasive treatment is an effective alternative to surgical curettage and packing, and should be considered the treatment of choice for suitable lesions. [ABSTRACT FROM AUTHOR]

Abstract: The mainstay of treatment for atrial fibrillation (AF) remains pharmacological, however, catheter ablation, since an early attempt in 1994 has undergone many evolutions up to the present day whereby it has taken an increasing place in the management of this arrhythmia. In paroxysmal AF, the most recent studies report a success rate of more than 80% at 1 year of follow-up after a single procedure (free of symptoms without antiarrhythmic drugs). In persistent AF the technique continues to evolve with a success rates between 70% and 95% even if several long and complex procedures are often needed, which are not without risk, to achieve these results. With constant improvement in this field catheter ablation has become a valuable tool in the management strategy of AF. [Copyright &y& Elsevier]