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

• Published in: Neurosurgery Vol. 86; no. 4; pp. 538 - 547
• Main Authors: Rennert, Robert C, Khan, Usman, Bartek, Jiri, Tatter, Stephen B, Field, Melvin, Toyota, Brian, Fecci, Peter E, Judy, Kevin, Mohammadi, Alireza M, Landazuri, Patrick, Sloan, Andrew E, Kim, Albert H, Leuthardt, Eric C, Chen, Clark C
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01-04-2020; Copyright by the Congress of Neurological Surgeons; Wolters Kluwer Health, Inc
• Subjects: Ablation; Ablation (Surgery); Care and treatment; Lasers; Medicin och hälsovetenskap; Methods; Nervous system; Nervous system tumors; Neurosurgery; Patient outcomes; Robotic surgery; Surgery; United States; Stereotactic laser ablation; Neuro-oncology; Safety
• ISSN: 0148-396X; 1524-4040; 1524-4040
• 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.