Outcomes of Magnetic Resonance-guided Laser Interstitial Thermal Therapy for Epileptogenic Cavernous Malformations: A Multicenter Study
Abstract number :
3.491
Submission category :
9. Surgery / 9A. Adult
Year :
2024
Submission ID :
1553
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Nathan Shlobin, MD MBA – Department of Neurosurgery, Columbia University Irving Medical Center
Adrian Jimenez, MD – Department of Neurosurgery, Columbia University Irving Medical Center
W. Elorm Yevudza Jr., BA – Department of Neurosurgery, Columbia University Irving Medical Center
Salil Bhole, BS – Department of Neurosurgery, Washington University in St. Louis
Jon Willie, MD PhD – Department of Neurosurgery, Washington University in St. Louis
Daniel Couture, MD – Department of Neurosurgery, Wake Forest Baptist Health
Adrian Laxton, MD – Department of Neurosurgery, Wake Forest Baptist Health
Kevin Hines, MD – Department of Neurological Surgery, Thomas Jefferson University Hospital
Chengyuan Wu, MD MSBmE – Department of Neurological Surgery, Thomas Jefferson University Hospital
H. isaac Chen, MD – Department of Neurosurgery, University of Pennsylvania
Thomas Lisko, BS – Department of Neurosurgery, University of Minnesota
Robert McGovern III, MD – University of Minnesota Medical Center
Guy McKhann, MD – Columbia University Irving Medical Center
Brett Youngerman, MD MS – Department of Neurosurgery, Columbia University Irving Medical Center
Rationale: Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is an emerging minimally invasive alternative to open resection for cavernous malformations (CMs). However, literature regarding the outcomes of MRgLITT for epileptogenic CMs is limited to small, single-center series. This multicenter study aimed to characterize the efficacy and safety of MRgLITT for epileptogenic CMs.
Methods: In this multicenter retrospective cohort study, of 24 patients with epileptogenic CMs consecutively treated with MRgLITT at 6 institutions between 2015 and 2023, 19 patients with at least one-year follow-up were included. Patient characteristics, seizure outcomes and adverse events are reported.
Results: A total of 73.7% (14/19) patients were male. The median time from epilepsy diagnosis to treatment was 13 years (range: 1-42 years). MRgLITT was targeted to the left side in 63.2% (12/19) and temporal lobe in 68.4% (13/19). Engel I seizure freedom was achieved in 57.8% (11/19) at one year, all of whom were also seizure free (57.8%, 11/19) at last follow-up (median: 2.24 years). Engel I or II outcomes were achieved in 68.4% (13/19) at 1 year and 73.7% (14/19) at last follow-up. Antiseizure medication use was reduced in 47.4% (9/19) at last follow-up. Hemorrhage was seen in 15.8% perioperatively and 0% postoperatively. In total, 21.1% (4/19) had postoperative neurological deficits, including 10.5% (2/19) with permanent deficits.
Conclusions: This study represents the largest cohort of patients with epileptogenic CMs undergoing MRgLITT. MRgLITT is a promising treatment option for these patients.
Funding: No funding was received.
Surgery