Abstracts

Rationale: Procedural and safety experiences with the NeuroBlate system for use in epilepsy patients has not been previously described.  NeuroBlate is a laser interstitial thermal therapy (LITT) tool used for intracranial conditions, commonly epilepsy and tumors.  LITT is a minimally invasive technique increasingly being considered as a treatment option to minimize patient morbidity while maintaining efficacy as well as a treatment option for otherwise inoperable localizations.  Here we analyze early interim patient demographic, procedure, and safety results for patients treated with LITT for epilepsy. Methods: LAANTERN is a multi-center registry designed to prospectively capture data from up to 1000 patients undergoing LITT as standard of care procedures. Patients undergoing LITT were consented for enrollment into the LAANTERN registry. Data are collected regarding patient demographics, procedural data, and adverse events.   128 patients are enrolled in the registry, of which 16 had LITT specifically for epilepsy. Results: 16 subjects with an indicated diagnosis of epilepsy were enrolled at 4 centers.  8 men and women each were enrolled, with an average age of 40 (range 10-72).  The average length of epilepsy prior to ablation was 7.19 +/- 8.39 years.  9 patients had mesial temporal lobe epilepsy (of which 7 had a history of mesial temporal sclerosis), 4 had focal cortical dysplasia, and 3 had other epilepsy foci.  12/14 had one lesion and 2/14 had two lesions present.  One patient had previously undergone an anterior temporal lobectomy.  9 patients had objective, but mild neurological symptoms prior to LITT.  9/13 patients were offered resection as well while 2/13 had no other surgical options.  4/15 patients had a biopsy conducted during the procedure to provide a pathologic diagnosis.  10/16 had one lesion ablated and 4/16 had two lesions ablated through 1 or 2 burr holes, respectively.  11/13 had one trajectory while 2/13 had two trajectories.  5/13 had superficial lesions while 4/13 had deep lesions.  Ablations were performed in the temporal lobe (7), frontal lobe (2), and parietal lobe (2).  Of interest, one Side Fire treatment approach was done for a hippocampal lesion.  Average lesion volume was 5.5 +/- 1.2 cm3.  The average ICU time was 25.4 +/- 16.7 hours and average discharge time post ablation was 28.7 +/- 16.5 hours.  All patients were discharged home. One patient with MTLE had two separate adverse events that were unrelated to LITT or the surgical procedure.  This patient had hyponatremia on POD#8 that resolved with medical treatment and a seizure cluster on POD#19 after tapering off anti-seizure medications. A new seizure medication was prescribed.  No other patient had adverse events.  There were no new neurological deficits after surgery in any patient. Conclusions: Early study results indicate LITT to be a safe treatment consideration for multiple types of epilepsy and most typically require short hospitalizations. Funding: The LAANTERN registry is sponsored by Monteris Medical.