Abstracts

Rationale: Laser interstitial thermal therapy (LITT) is a minimally invasive surgical tool for the treatment of drug resistant epilepsy. LAANTERN is a multicenter registry that collects data on patients using the NeuroBlate system. Here we analyze all reported epilepsy procedures from LAANTERN and assess patient outcomes, clinical characteristics, and procedural data. Methods: LAANTERN is designed to capture data using the NeuroBlate system for standard of care procedures. Patients undergoing LITT were consented for enrollment into the LAANTERN registry. Data are collected and monitored regarding patient demographics, procedural data, adverse events, and outcomes. Results: Sixty epilepsy subjects are enrolled at ten centers in the U.S., with an average age of 35 (range 5-73; 18% pediatric <18 yrs.). Temporal lobe epilepsy (TLE) is the most common epilepsy localization. Other localizations include frontal lobe, parietal lobe, occipital lobe, insula, hypothalamus, and paraventricular nodular heterotopias. Twenty patients had a previous surgical intervention and 12 had previous intracranial EEG monitoring. Average age of seizure onset was 16 years. Most patients had one area ablated with a range of 1-3. Median blood loss was 5 mL (range 0-100 mL). The median number of burr holes was one (range 1-3) with 80.3% of procedures performed with one trajectory. The median length of stay was 1 day and 58 patients were discharged to home. Twenty-nine patients have reached one year of follow up. Eighteen (62%) are Engel I and 16 (55%) are ILAE 1/2. Contrarily, only two (6.9%) are Engel IV and one (3.4%) is ILAE 5. Those with good outcomes had MTLE, cortical dysplasia, and hypothalamic hamartoma. Four patients had four adverse events. Three of the patients reported headaches which resolved. One had an asymptomatic 3mm subdural hematoma. One patient had aphasia that was classified as mild within 15 days of the procedure.  Conclusions: Interim data in the largest prospective cohort of LITT in epilepsy patients reported to date indicate LITT to have a similar safety and efficacy compared to published literature. This multicenter and 'real world' cohort of patients with heterogenous disease etiology and previous surgical interventions provides some generalizability outside of single center studies.  Funding: Monteris Medical