Laser Interstitial Thermal Therapy for Cavernous Malformations: A Systematic Review.

LITT cavernous malformation laser interstitial thermal therapy neurosurgery systematic review

Journal

Frontiers in surgery
ISSN: 2296-875X
Titre abrégé: Front Surg
Pays: Switzerland
ID NLM: 101645127

Informations de publication

Date de publication:
2022
Historique:
received: 01 03 2022
accepted: 27 04 2022
entrez: 1 6 2022
pubmed: 2 6 2022
medline: 2 6 2022
Statut: epublish

Résumé

Microsurgical resection of intracranial cavernous malformations (CM) is regarded as the standard treatment, but in recent years, there has been a trend toward minimally invasive procedures like ablation of such lesions by using laser interstitial thermal therapy (LITT). A systematic search using keywords 'laser interstitial thermal therapy' OR 'LITT' AND 'cavernoma' OR 'cavernous angiomas' OR 'cavernous malformations' was conducted in MEDLINE (PubMed), Scopus, Embase, and Cochrane electronic bibliographic databases and studies reporting the outcome of LITT procedure on intracranial CM were included. The demographic data, symptoms of patients, location and size of the lesion, and surgical outcome were extracted from the articles. Six studies, reporting the outcome of 33 patients were included in this review. In 26 patients, CM was identified as the epileptogenic foci and in others, CM was the source of headache or focal neurological deficits. LITT led to a satisfactory outcome in all patients except for three who achieved improvement in symptoms after the open resection of the lesion. Most of the post-operative complications were transient and resolved at the time of the last follow up. Cyst formation at the previous ablated CM site was reported as the long-term complication of LITT in one case. LITT can provide a comparable outcome to the open resection of CMs, by having less invasiveness, even in deep and eloquent area lesions, and complications that are often temporary and disappear gradually. However, technical issues, such as thermal monitoring during the procedure, are considered a challenge for this procedure in CMs. Further studies with a larger population are needed to report this method's long-term outcome and complications on CMs.

Sections du résumé

Background UNASSIGNED
Microsurgical resection of intracranial cavernous malformations (CM) is regarded as the standard treatment, but in recent years, there has been a trend toward minimally invasive procedures like ablation of such lesions by using laser interstitial thermal therapy (LITT).
Methods UNASSIGNED
A systematic search using keywords 'laser interstitial thermal therapy' OR 'LITT' AND 'cavernoma' OR 'cavernous angiomas' OR 'cavernous malformations' was conducted in MEDLINE (PubMed), Scopus, Embase, and Cochrane electronic bibliographic databases and studies reporting the outcome of LITT procedure on intracranial CM were included. The demographic data, symptoms of patients, location and size of the lesion, and surgical outcome were extracted from the articles.
Result UNASSIGNED
Six studies, reporting the outcome of 33 patients were included in this review. In 26 patients, CM was identified as the epileptogenic foci and in others, CM was the source of headache or focal neurological deficits. LITT led to a satisfactory outcome in all patients except for three who achieved improvement in symptoms after the open resection of the lesion. Most of the post-operative complications were transient and resolved at the time of the last follow up. Cyst formation at the previous ablated CM site was reported as the long-term complication of LITT in one case.
Conclusion UNASSIGNED
LITT can provide a comparable outcome to the open resection of CMs, by having less invasiveness, even in deep and eloquent area lesions, and complications that are often temporary and disappear gradually. However, technical issues, such as thermal monitoring during the procedure, are considered a challenge for this procedure in CMs. Further studies with a larger population are needed to report this method's long-term outcome and complications on CMs.

Identifiants

pubmed: 35647010
doi: 10.3389/fsurg.2022.887329
pmc: PMC9136030
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

887329

Informations de copyright

Copyright © 2022 Yousefi, Sabahi, Malcolm, Adada, and Borghei-Razavi.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Omid Yousefi (O)

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Mohammadmahdi Sabahi (M)

Neurosurgery Research Group (NRG), Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.

James Malcolm (J)

Department of Neurosurgery, Emory University, Atlanta, GA, United States.

Badih Adada (B)

Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, United States.

Hamid Borghei-Razavi (H)

Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, United States.

Classifications MeSH