Laser Ablation of Abnormal Neurological Tissue Using Robotic Neuroblate System (LAANTERN): Procedural Safety and Hospitalization

Neurosurgery. 2020 Apr 1;86(4):538-547. doi: 10.1093/neuros/nyz141.

Abstract

Background: Stereotactic laser ablation (SLA) has demonstrated potential utility for a spectrum of difficult to treat neurosurgical pathologies in multiple small and/or retrospective single-institutional series. Here, we present the safety profile of SLA of intracranial lesions from the Laser Ablation of Abnormal Neurological Tissue using Robotic NeuroBlate System (LAANTERN; Monteris Medical) multi-institutional, international prospective observational registry.

Objective: To determine the procedural safety of SLA for intracranial lesions.

Methods: Prospective procedural safety and hospitalization data from the first 100 treated LAANTERN patients was collected and analyzed.

Results: Mean age and baseline Karnofsky Performance Status (KPS) were 51(± 17) yr and 83(± 15), respectively. In total, 81.2% of patients had undergone prior surgical or radiation treatment. Most patients had a single lesion (79%) ablated through 1 burr hole (1.2 ± 0.7 per patient), immediately following a lesion biopsy. In total, >90% of the lesion was ablated in 72% of treated lesions. Average total procedural time was 188.2 ± 69.6 min, and average blood loss was 17.7 ± 55.6 ccs. The average length of intensive care unit (ICU) and hospital stays before discharge were 38.1 ± 62.7 h and 61.1 ± 87.2 h, respectively. There were 5 adverse events (AEs) attributable to SLA (5/100; 5%). After the procedure, 84.8% of patients were discharged home. There was 1 mortality within 30 d of the procedure (1/100; 1%), which was not attributable to SLA.

Conclusion: SLA is a safe, minimally invasive procedure with favorable postprocedural ICU and hospital utilization profiles.

Trial registration: ClinicalTrials.gov NCT02392078.

Keywords: Neuro-oncology; Safety; Stereotactic laser ablation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Diseases / surgery*
  • Child
  • Female
  • Hospitalization
  • Humans
  • Laser Therapy / adverse effects*
  • Laser Therapy / instrumentation
  • Laser Therapy / methods*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / instrumentation
  • Minimally Invasive Surgical Procedures / methods
  • Registries
  • Robotic Surgical Procedures / adverse effects*
  • Robotic Surgical Procedures / instrumentation
  • Robotic Surgical Procedures / methods*
  • Stereotaxic Techniques / adverse effects
  • Stereotaxic Techniques / instrumentation
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02392078