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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

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

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Autor(es):
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]
Número total de Autores: 7
Afiliação do(s) autor(es):
[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
Número total de Afiliações: 4
Tipo de documento: Artigo Científico
Fonte: CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY; v. 38, n. 5, p. 1261-1270, OCT 2015.
Citações Web of Science: 1
Resumo

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)

Processo FAPESP: 12/00398-1 - Avaliação da Substância Branca com Técnicas de Difusão por Ressonância Magnética de Alto Campo e Correlação Multiparamétrica com Volumetria e Espectroscopia de Fósforo em Pacientes com Epilepsia e Malformações do Desenvolvimento Cortical
Beneficiário:Celi Santos Andrade
Linha de fomento: Bolsas no Brasil - Pós-Doutorado
Processo FAPESP: 11/51222-8 - Efeito térmico protetor do gás carbônico sobre a medula espinhal de modelos suínos tratados por crioablação percutânea vertebral guiada por fluoroscopia/tomografia computadorizada: correlação radiológico-anatomopatológica
Beneficiário:José Guilherme Mendes Pereira Caldas
Linha de fomento: Auxílio à Pesquisa - Regular