Safety and efficacy of percutaneous microwave ablation for post-procedural hemostasis: a bi-central retrospective study focusing on safety and efficacy.

OBJECTIVES To review safety and efficacy of percutaneous microwave ablation (MWA) for post-procedural haemostasis. METHODS Institutional databases retrospective research identified 10 cases of iatrogenic bleeding who underwent percutaneous microwave ablation for post-procedural haemostasis. Ultrasound examination with Doppler and contrast enhancement identified a source of active bleeding prior to ablation; additionally they were used as guiding modality for antenna insertion whilst, post ablation, assessed the lack of active extravasation. Target locations included liver intercostal space spleen and thyroid gland. Technical success was defined as positioning of the antenna on the desired location. Treatment endpoint was considered the disappearance of active extravasation in both Doppler imaging and CEUS. RESULTS Technical success (i.e., positioning of the antenna on the desired location) was achieved in all cases. No complications were noted. All patients post microwave ablation remained hemodynamically stable with no need for transfusion and were discharged from the hospital the next morning. Imaging and clinical follow-up in all patients before exiting the hospital did not depict any sign of active extravasation or bleeding. CONCLUSION Our limited experience reports preliminary data showing that microwave ablation could be added in the armamentarium of percutaneous therapies for iatrogenic bleeding. More prospective studies with larger patient samples are necessary for verification of this technique as well as for drawing broader conclusions in order to evaluate the place of percutaneous ablation in the treatment algorithm of haemorrhage. ADVANCES IN KNOWLEDGE Percutaneous ablation might have a role in hemostasis in well selected cases.