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Journal of the American College of... Aug 2021Atrial fibrillation (AF), the most common sustained arrhythmia observed in clinical practice, is a chronic and progressive disorder characterized by exacerbations and... (Review)
Review
Atrial fibrillation (AF), the most common sustained arrhythmia observed in clinical practice, is a chronic and progressive disorder characterized by exacerbations and remissions. Guidelines recommend antiarrhythmic drugs as the initial therapy for the maintenance of sinus rhythm; however, antiarrhythmic drugs have modest efficacy to maintain sinus rhythm and can be associated with significant adverse effects. An initial treatment strategy of cryoballoon catheter ablation in patients with treatment-naïve AF has been shown to significantly improve arrhythmia outcomes (freedom from any, or symptomatic atrial tachyarrhythmia), produce clinically meaningful improvements in patient-reported outcomes (symptoms and quality of life), and significantly reduce subsequent health care resource use (hospitalization), and it does not increase the risk of serious or any adverse events compared with initial antiarrhythmic drug therapy. These findings are relevant to inform patients, providers, and health care systems regarding the initial choice of rhythm-control therapy in patients with treatment-naïve AF.
Topics: Atrial Fibrillation; Cryosurgery; Decision Making, Shared; Humans; Patient Selection; Quality of Life
PubMed: 34446164
DOI: 10.1016/j.jacc.2021.06.038 -
Frontiers in Immunology 2023With the rapid advancement of imaging equipment and minimally invasive technology, cryoablation technology is being used more frequently in minimally invasive treatment... (Review)
Review
With the rapid advancement of imaging equipment and minimally invasive technology, cryoablation technology is being used more frequently in minimally invasive treatment of tumors, primarily for patients with early tumors who voluntarily consent to ablation as well as those with advanced tumors that cannot be surgically removed or cannot be tolerated. Cryoablation is more effective and secure for target lesions than other thermal ablation methods like microwave and radiofrequency ablation (RFA). The study also discovered that cryoablation, in addition to causing tumor tissue necrosis and apoptosis, can facilitate the release of tumor-derived autoantigens into the bloodstream and activate the host immune system to elicit beneficial anti-tumor immunological responses against primary. This may result in regression of the primary tumor and distant metastasis. The additional effect called " Accompanying effects ". It is the basis of combined ablation and immunotherapy for tumor. At present, there is a lot of research on the mechanism of immune response induced by cryoablation. Trying to solve the question: how positively induce immune response. In this review, we focus on: 1. the immune effects induced by cryoablation. 2. the effect and mechanism of tumor immunotherapy combined with cryoablation. 3.The clinical research of this combination therapy in the treatment of tumors.
Topics: Humans; Cryosurgery; Neoplasms; Radiofrequency Ablation; Immunity; Immunotherapy
PubMed: 36761748
DOI: 10.3389/fimmu.2023.1094009 -
The European Respiratory Journal Nov 2022In patients with interstitial lung diseases (ILD), histopathological input is often required to obtain a diagnosis. Surgical lung biopsy (SLB) is considered the...
BACKGROUND
In patients with interstitial lung diseases (ILD), histopathological input is often required to obtain a diagnosis. Surgical lung biopsy (SLB) is considered the reference standard, but many patients are clinically unfit to undergo this invasive procedure, and adverse events, length of hospitalisation and costs are considerable. This European Respiratory Society (ERS) guideline provides evidence-based clinical practice recommendations for the role of transbronchial lung cryobiopsy (TBLC) in obtaining tissue-based diagnosis in patients with undiagnosed ILD.
METHODS
The ERS Task Force consisted of clinical experts in the field of ILD and/or TBLC and methodological experts. Four PICO (Patient, Intervention, Comparator, Outcomes) questions and two narrative questions were formulated. Systematic literature searches were performed in MEDLINE and Embase (up to June 2021). GRADE (Grading, Recommendation, Assessment, Development and Evaluation) methodology was applied.
RESULTS
In patients with undiagnosed ILD and an indication to obtain histopathological data: 1) TBLC is suggested as a replacement test in patients considered eligible to undergo SLB, 2) TBLC is suggested in patients not considered eligible to undergo SLB, 3) SLB is suggested as an add-on test in patients with a non-informative TBLC, 4) no recommendation is made for or against a second TBLC in patients with a non-informative TBLC and 5) TBLC operators should undergo training, but no recommendation is made for the type of training required.
CONCLUSIONS
TBLC provides important diagnostic information in patients with undiagnosed ILD. Diagnostic yield is lower compared to SLB, at reduced serious adverse events and length of hospitalisation. Certainty of the evidence is mostly "very low".
Topics: Humans; Biopsy; Bronchoscopy; Cryosurgery; Lung; Lung Diseases, Interstitial
PubMed: 35710261
DOI: 10.1183/13993003.00425-2022 -
Europace : European Pacing,... Jan 2018
Review
Topics: Atrial Fibrillation; Cardiac Catheterization; Catheter Ablation; Consensus; Cryosurgery; Humans; Risk Factors; Treatment Outcome
PubMed: 29016840
DOI: 10.1093/europace/eux274 -
American Family Physician Dec 2012Cutaneous cryosurgery refers to localized application of freezing temperatures to achieve destruction of skin lesions. It can be used to treat a broad range of benign...
Cutaneous cryosurgery refers to localized application of freezing temperatures to achieve destruction of skin lesions. It can be used to treat a broad range of benign and premalignant skin conditions, and certain malignant skin conditions, with high cure rates. Cellular destruction is accomplished by delivery of the cryogen via dipstick, probe, or spray techniques. It is widely used in primary care because of its safety, effectiveness, low cost, ease of use, good cosmetic results, and lack of need for anesthesia. Cryosurgery is as effective as alternative therapies for most cases of molluscum contagiosum, dermatofibromas, keloids, and plantar or genital warts. It is a more effective cure for common warts than salicylic acid or observation. Cryosurgery is generally the treatment of choice for actinic keratosis. Contraindications to cryosurgery include cryofibrinogenemia, cryoglobulinemia, Raynaud disease, agammaglobulinemia, and multiple myeloma. Complications from cryosurgery include hypopigmentation and alopecia, and can be avoided by limiting freeze times to less than 30 seconds. Referral to a dermatologist should be considered in cases of diagnostic uncertainty or for treatment of skin cancer, which requires larger amounts of tissue destruction, resulting in higher complication rates.
Topics: Condylomata Acuminata; Cryosurgery; Histiocytoma, Benign Fibrous; Humans; Keloid; Keratosis, Actinic; Molluscum Contagiosum; Practice Guidelines as Topic; Skin Diseases; Skin Neoplasms; Treatment Outcome; United States; Warts; Wound Healing
PubMed: 23316984
DOI: No ID Found -
Australian Family Physician 2017Cryosurgery is an effective, simple and inexpensive treatment used extensively in general practice and dermatology. It is used most commonly for actinic keratoses and...
BACKGROUND
Cryosurgery is an effective, simple and inexpensive treatment used extensively in general practice and dermatology. It is used most commonly for actinic keratoses and warts; however, a large number of benign, premalignant and malignant skin diseases can also be treated.
OBJECTIVE
The objective of this article is to help readers improve their cryosurgery technique.
DISCUSSION
Application of the cryogenic agent (most commonly liquid nitrogen) to the skin induces rapid freezing followed by slow thawing. This produces cell injury, vascular stasis and occlusion, and inflammation. The quantity of cryogen delivered onto the skin (dose), technique, duration of thawing and amount of surrounding tissue frozen are dependent on the body region and type of lesion. If clinical diagnosis is not possible, either a skin biopsy or referral to a dermatologist is recommended. We strongly discourage blind treatment of undiagnosed skin lesions.
Topics: Contraindications; Cryosurgery; Humans; Nitrogen; Skin; Skin Diseases
PubMed: 28472571
DOI: No ID Found -
Veterinary Medicine and Science Mar 2022Eyelid mass removal and cryotherapy application using only local anaesthesia and restraint may benefit patients with high anaesthesia risks.
BACKGROUND
Eyelid mass removal and cryotherapy application using only local anaesthesia and restraint may benefit patients with high anaesthesia risks.
OBJECTIVE
To evaluate and validate cryosurgery application using the CryoPen XL on palpebral masses under local anaesthesia for patients not suitable for general anaesthesia.
METHODS
Thirty patients underwent the procedure between November 2015 and April 2020. The procedure steps were as follows: skin preparation and local anaesthesia of the affected eyelid; debulking by resection and/or squeezing out the inspissated material; cryosurgery and post-operative care using topical medication, antibiotics and anti-inflammatory ointment. The medical records of the patients who underwent the operation were evaluated. Moreover, a telephonic survey with the pet owners was performed to determine recurrence, time to recurrence, survivability and side effects.
RESULTS
Among the 30 owners, 29 responded to the survey. Ten (10/38, 26.3%) masses recurred with an average time to recurrence of 6.0 months. The estimated average depths for all, non-recurred, and recurred masses were 1.89, 1.88 and 1.90 mm, respectively. The average recurrence rate and time to recurrence were higher and earlier, respectively, than previously reported values. However, no patient presented intra- or post-operative complications.
CONCLUSION
These findings suggest that local anaesthesia and cryosurgery using the CryoPen XL can be used in patients with eyelid masses who are not suitable for general anaesthesia. Compared with the surgical eyelid mass removal and blepharoplasty procedure, the reported procedure is time- and cost-effective, with the additional benefit of not requiring general anaesthesia.
Topics: Anesthesia, Local; Animals; Cryosurgery; Dog Diseases; Dogs; Eyelid Diseases; Eyelids; Recurrence
PubMed: 34919349
DOI: 10.1002/vms3.688 -
Technology in Cancer Research &... 2023Breast cancer (BC) is the most frequently diagnosed malignancy among women. In the past two decades, new technologies and BC screening have led to the diagnosis of... (Review)
Review
Breast cancer (BC) is the most frequently diagnosed malignancy among women. In the past two decades, new technologies and BC screening have led to the diagnosis of smaller and earlier-stage BC (ESBC). Therefore, percutaneous minimally invasive techniques (PMIT) were adopted to treat patients unfit for surgery, women who refuse it, or elderly patients with comorbidities that could make surgery a difficult and life-threatening treatment. The target of PMIT is small-size ESBC with the scope of obtaining similar efficacy as surgery. Minimally invasive treatments are convenient alternatives with promising effectiveness, lower morbidity, less cost, less scarring and pain, and more satisfying cosmetic results. Ablative techniques used in BC are cryoablation, radiofrequency ablation, microwave ablation, high-intensity focused ultrasound (US), and laser ablation. The aim of our study is to discuss the current status of percutaneous management of BC, evaluate the clinical outcomes of PMIT in BC, and analyze future perspectives regarding ablation therapy in BC.
Topics: Humans; Female; Aged; Breast Neoplasms; Cryosurgery; Ablation Techniques; Laser Therapy; High-Intensity Focused Ultrasound Ablation; Catheter Ablation
PubMed: 36916200
DOI: 10.1177/15330338231157193 -
Theranostics 2022With rapid advances in modern imaging, minimally invasive ablative procedures have emerged as popular alternatives to surgical removal of tumors. Tumor ablation... (Review)
Review
With rapid advances in modern imaging, minimally invasive ablative procedures have emerged as popular alternatives to surgical removal of tumors. Tumor ablation modalities currently offered in clinical practice include microwave ablation, radiofrequency ablation, cryoablation, high-intensity focused ultrasound, and irreversible electroporation. Cryoablation, a non-heat-based method of ablation, is increasingly being used for treating various solid tumors. Accumulated comparative data of cryoablation versus heat-based ablation techniques (e.g., radiofrequency and microwave ablation) shows superior tumor response and quicker recovery time. Evolving research has demonstrated that nanocarriers may serves as excellent catalysts for the cryoablation therapy, imaging guidance, and the co-delivery of therapeutics for minimally invasive, precise, and complete treatment of cancer with immune modulation. This review article focuses on the current status of cryoablation in clinical practice, considers opportunities for enhancing therapeutic outcomes from cryoablation, and discusses new research in the field, including theranostic nanoparticles-mediated cryotherapy and combinational cryo-based immunotherapies.
Topics: Ablation Techniques; Catheter Ablation; Cryosurgery; Humans; Nanoparticles; Neoplasms
PubMed: 35265206
DOI: 10.7150/thno.67530 -
Frontiers in Immunology 2022The use of cryoablation, a minimally-invasive image-guided technique to target and kill cancer cells, continues to gain traction within the medical field and with... (Review)
Review
The use of cryoablation, a minimally-invasive image-guided technique to target and kill cancer cells, continues to gain traction within the medical field and with patients. This includes the use of cryoablation for the treatment of small breast cancers and focal sites of metastatic disease. In comparison to open surgical approaches, length of hospital stay and recovery time are decreased with the use of cryoablation. Research studies have also found that cryoablation may actually enhance tumor susceptibility to immunotherapy agents. Immunotherapy enhances a person's own immune system to identify and attack cancer cells. It is proposed that after cryoablation there is increased expression of tumor specific antigens which the body can recognize as foreign invaders and with the combination of immunotherapy, result in an even more robust and efficient attack on the cancer cells. In this review we aim to highlight some of the recent advances in cryoablation which support the potential for cryoablation to induce these tumor-specific immune responses and thus supporting the use of combining cryoablation and immunotherapy for the treatment of breast cancer.
Topics: Humans; Female; Cryosurgery; Breast Neoplasms; Treatment Outcome; Immunotherapy; Catheter Ablation; Immunologic Factors
PubMed: 36389815
DOI: 10.3389/fimmu.2022.1026475