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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Image-Guided Cryoablation of the Spine in a Swine Model: Clinical, Radiological, and Pathological Findings with Light and Electron Microscopy

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Costa de Freitas, Ricardo Miguel [1] ; Andrade, Celi Santos [1] ; Mendes Pereira Caldas, Jose Guilherme [1] ; Tsunemi, Miriam Harumi [2] ; Ferreira, Lorraine Braga [3] ; Arana-Chavez, Victor Elias [3] ; Cury, Patricia Maluf [4]
Total Authors: 7
[1] Univ Sao Paulo, Fac Med, Inst Radiol, Intervent Radiol Unit, Dept Radiol, BR-05403900 Sao Paulo, SP - Brazil
[2] Univ Estadual Paulista, Biosci Inst, Dept Biostat, BR-18618970 Botucatu, SP - Brazil
[3] Univ Sao Paulo, Fac Odontol, Dept Oral Pathol, BR-05508900 Sao Paulo, SP - Brazil
[4] Fac Med Sao Jose do Rio Preto, Dept Pathol & Forens Med, BR-15090000 Sao Jose Do Rio Preto - Brazil
Total Affiliations: 4
Document type: Journal article
Source: CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY; v. 38, n. 5, p. 1261-1270, OCT 2015.
Web of Science Citations: 1

This study was designed to present the feasibility of an in vivo image-guided percutaneous cryoablation of the porcine vertebral body. The institutional animal care committee approved this study. Cone-beam computed tomography (CBCT)-guided vertebral cryoablations (n = 22) were performed in eight pigs with short, 2-min, single or double-freezing protocols. Protective measures to nerves included dioxide carbon (CO2) epidural injections and spinal canal temperature monitoring. Clinical, radiological, and pathological data with light (n = 20) or transmission electron (n = 2) microscopic analyses were evaluated after 6 days of clinical follow-up and euthanasia. CBCT/fluoroscopic-guided transpedicular vertebral body cryoprobe positioning and CO2 epidural injection were successful in all procedures. No major complications were observed in seven animals (87.5 %, n = 8). A minor complication was observed in one pig (12.5 %, n = 1). Logistic regression model analysis showed the cryoprobe-spinal canal (Cp-Sc) distance as the most efficient parameter to categorize spinal canal temperatures lower than 19 A degrees C (p < 0.004), with a significant Pearson's correlation test (p < 0.041) between the Cp-Sc distance and the lowest spinal canal temperatures. Ablation zones encompassed pedicles and the posterior wall of the vertebral bodies with an inflammatory rim, although no inflammatory infiltrate was depicted in the surrounding neural structures at light microscopy. Ultrastructural analyses evidenced myelin sheath disruption in some large nerve fibers, although neurological deficits were not observed. CBCT-guided vertebral cryoablation of the porcine spine is feasible under a combination of a short freezing protocol and protective measures to the surrounding nerves. Ultrastructural analyses may be helpful assess the early modifications of the nerve fibers. (AU)

FAPESP's process: 11/51222-8 - Evaluation of carbon dioxide thermal protection over neural structures of the spine canal of porcine models treated by computed tomography/fluoroscopy guided percutaneous vertebral cryoablation: radiological-anatomopathological correlation
Grantee:José Guilherme Mendes Pereira Caldas
Support Opportunities: Regular Research Grants
FAPESP's process: 12/00398-1 - White Matter Evaluation with Diffusion Magnetic Resonance Imaging Techniques at High Field Strength and Multiparametric Correlation with Volumetry and Phosphorus Spectroscopy in Patients with Epilepsy and Malformations of Cortical Development
Grantee:Celi Santos Andrade
Support Opportunities: Scholarships in Brazil - Post-Doctoral