Guo Yuan How

Tan Tock Seng Hospital

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Uei Pua

Tan Tock Seng Hospital

Zhiwen Joseph Lo

Nanyang Technological University

Michelle Si Min Chim

Tan Tock Seng Hospital

Lawrence Han Hwee Quek

Nanyang Technological University

Eleni Georgiadi

National and Kapodistrian University of Athens

Alexis Kelekis

National and Kapodistrian University of Athens

Wcg Peh

Khoo Teck Puat Hospital

Kheng Song Leow

Woodlands Health Campus

Enming Yong

Tan Tock Seng Hospital

Ivan Kuang Hsin Huang

Tan Tock Seng Hospital

Cooperative Institutions

Tan Tock Seng Hospital

National University of Singapore

National and Kapodistrian University of Athens

University General Hospital Attikon

Nanyang Technological University

Khoo Teck Puat Hospital

Shandong First Medical University

Shandong Provincial QianFoShan Hospital

Woodlands Health Campus

Agency for Science, Technology and Research

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Comparative Study of Ablation Zone of EMPRINT HP Microwave Device with Contemporary 2.4 GHz Microwave Devices in an Ex Vivo Porcine Liver Model

Diagnostics (2023)

Terrence Chi Hong Hui Guo Yuan How Michelle Si Min Chim Uei Pua

(1) Background: Percutaneous microwave ablation (MWA) is an accepted treatment of non-operative liver cancer. This study compares the ablation zones of four commercially available 2.45 GHz MWA systems (Emprint, Eco, Neuwave, and Solero) in an ex vivo porcine liver model. (2) Methods: Ex vivo porcine livers (n = 85) were obtained. Two ablation time setting protocols were evaluated, the manufacturer’s recommended maximum time and a 3 min time, performed at the manufacturer-recommended maximum power setting. A total of 236 ablation samples were created with 32 (13.6%) samples rejected. A total of 204 samples were included in the statistical analysis. (3) Results: For single-probe protocols, Emprint achieved ablation zones with the largest SAD. Significant differences were found in all comparisons for the 3 min time setting and for all comparisons at the 10 min time setting except versus Neuwave LK15 and Eco. Emprint produced ablation zones that were also significantly more spherical (highest SI) than the single-probe ablations from all other manufacturers. No statistical differences were found for ablation shape or SAD between the single-probe protocols for Emprint and the three-probe protocols for Neuwave. (4) Conclusions: The new Emprint HP system achieved large and spherical ablation zones relative to other 2.45 GHz MWA systems.

Microwave ablation

Ablation zone

Ex vivo

Microwave power

10.3390/diagnostics13162702

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Citations (4)

Trends of Interventional Radiology procedures during the Covid-19 pandemic: The first 27 weeks in the eye of the storm

Research Square (Research Square) (2020)

Guo Yuan How Uei Pua

Abstract Objectives While the Novel Coronavirus (COVID-19) pandemic looks to persist, institutions promote delaying procedures. Understanding trends and demands of interventional radiology (IR) procedures in the infected and COVID-free populations are needed in long-term planning. We detail IR procedure trends in the first 27 weeks of the pandemic and compare with the pre-pandemic era. Methods In this IRB approved retrospective electronic case review, all IR patients in our institution from 1 January to 9 July 2020, the same period in 2019 pre-pandemic and the Severe Acute Respiratory Syndrome (SARS-CoV) outbreak were included. IR procedures were classified using Interventional Radiology – Procedure Acuity Scale (IR-PAS) and category of IR procedures. Along with descriptive frequencies, the Mann-Whitney U test and Chi-square test of independence were performed. Results During the pandemic, 3655 IR procedures were performed compared to 3851 procedures pre-pandemic. No statistically significant difference in weekly IR caseloads across IR-PAS tiers between both periods (p = .088) and category of procedure (p = .054) were noted. General intervention procedures remained the largest proportion and musculoskeletal procedures the minority, in both periods. More general intervention radiology and oncology procedures were performed during the Covid-19 pandemic compared to the SARS-CoV outbreak. Thirty-four (0.93%) IR procedures were performed on 30 COVID-19 patients. There was no IR procedure-related COVID-19 cross-transmission. Conclusions Demand for IR procedures among COVID-free patients remains high, and IR procedures involving COVID-19 represents a fraction of the IR caseload. A sustainable model in providing timely IR services to COVID-free patients needs to be considered.

Pandemic

10.21203/rs.3.rs-53608/v1

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Citations (0)

Irreversible electroporation of the pancreas – A decade on

Journal of interventional medicine (2022)

Daniel Yuxuan Ong Guo Yuan How Uei Pua

Irreversible electroporation (IRE) employs the use of an electric field to cause irreversible permeability of the cell membrane, inducing apoptosis. The use of IRE for locally advanced pancreatic cancer (LAPC) was first described in 2012. The crucial advantage of IRE compared with other devices employing thermal ablation is the safety around vital structures such as vessels and ducts. This makes it an attractive option for use in the pancreas due to the close proximity of multiple major vascular structures, biliary ducts, and adjacent gastrointestinal organs. Over the past decade, IRE has established itself as a useful treatment adjunct and may soon become the standard of care, particularly for LAPC. This article will explore the current evidence and provide a concise summary of pertinent issues, including patient selection, preoperative management, clinical outcomes, radiological response and future prospects of IRE in pancreatic cancer.

Irreversible Electroporation

Thermal ablation

10.1016/j.jimed.2022.10.001

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Citations (2)

Percutaneous Ablation of Metastatic Lymph Nodes: An Insight from the Comparison of Efficacy and Safety Between Cryoablation and Radiofrequency Ablation

CardioVascular and Interventional Radiology (2022)

Dimitrios Filippiadis Uei Pua Eleni Georgiadi Lawrence Han Hwee Quek Alexis Kelekis

Cryoablation

10.1007/s00270-022-03191-2

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Citations (2)

Trends of interventional radiology procedures during the COVID-19 pandemic: the first 27 weeks in the eye of the storm

Insights into Imaging (2020)

Guo Yuan How Uei Pua

While the Novel Coronavirus (COVID-19) pandemic looks to persist, institutions promote delaying procedures. Understanding trends and demands of interventional radiology (IR) procedures in the infected and COVID-free populations are needed in long-term planning. We detail IR procedure trends in the first 27 weeks of the pandemic and compare with the pre-pandemic era.In this IRB approved retrospective electronic case review, all IR patients in our institution from 1 January to 9 July 2020, the same period in 2019 pre-pandemic and the Severe Acute Respiratory Syndrome (SARS-CoV) outbreak were included. IR procedures were classified using Interventional Radiology-Procedure Acuity Scale (IR-PAS) and category of IR procedures. Along with descriptive frequencies, the Mann-Whitney U test and Chi-square test of independence were performed.During the pandemic, 3655 IR procedures were performed compared to 3851 procedures pre-pandemic. No statistically significant difference in weekly IR caseloads across IR-PAS tiers between both periods (p = .088) and category of procedure (p = .054) were noted. General intervention procedures remained the largest proportion and musculoskeletal procedures the minority, in both periods. More general intervention radiology and oncology procedures were performed during the COVID-19 pandemic compared to the SARS-CoV outbreak. Thirty-four (0.93%) IR procedures were performed on 30 COVID-19 patients. There was no IR procedure-related COVID-19 cross-transmission.Demand for IR procedures among COVID-free patients remains high, and IR procedures involving COVID-19 represents a fraction of the IR caseload. A sustainable model in providing timely IR services to COVID-free patients needs to be considered.

Interventional radiology

Pandemic

Neuroradiology

2019-20 coronavirus outbreak

Coronavirus Infections

10.1186/s13244-020-00938-8

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Citations (8)

Case report: Deep vein arterialization for limb salvage in a patient with subacute limb ischemia

Vascular (2024)

Michelle Si Min Chim Guo Yuan How Qian Tai Hong Zhiwen Joseph Lo Uei Pua

Background Successful revascularization of the lower extremity is key to avoiding amputation in patients with subacute limb ischemia. Percutaneous deep vein arterialization (DVA) is a novel endovascular technique which allows the shunting of blood through an arteriovenous fistula and native vein into the lower limb, typically employed in no-option chronic limb-threatening ischemia. Method We present a case illustrating the unconventional use of DVA for limb salvage in a patient presenting with subacute limb ischemia refractive to surgical treatment, endovascular revascularization, and medical therapy. Result and Conclusion The arteriovenous anastomosis allowed for the reconstitution of arterial inflow to the patient’s foot, thereby avoiding major limb amputation. Conclusion The conventional knowledge that DVA neo-conduits require maturation limiting its role in the treatment of subacute limb ischemia is challenged. However, further research is needed to establish its role and effectiveness for subacute limb ischemia.

Critical limb ischemia

Limb ischemia

10.1177/17085381241257316

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Citations (0)

Intravascular ultrasound correlation of unenhanced magnetic resonance venography in the context of pelvic deep venous disease

Journal of Vascular Surgery Venous and Lymphatic Disorders (2022)

Guo Yuan How Lawrence Han Hwee Quek Ivan Kuang Hsin Huang Zhiwen Joseph Lo Enming Yong

Intravascular Ultrasound

Venography

10.1016/j.jvsv.2022.04.008

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Citations (3)

Impact and the delivery of loco-regional treatment for hepatocellular carcinoma during the COVID-19 pandemic

Journal of interventional medicine (2022)

Guo Yuan How Uei Pua

Hepatocellular carcinoma (HCC) is the second most lethal tumour, with therapies broadly divided into curative and palliative intent. Unfortunately, the majority of HCCs were found to be unresectable at diagnosis. Advances in novel loco-regional therapies have given patients with unresectable HCC a vital chance for disease control and survival. However, the COVID-19 pandemic has greatly shaped and impacted treatment protocols and delivery for HCC patients. This review article aims to describe the impact of the COVID-19 pandemic on the delivery of loco-regional treatment modalities for HCC and compare treatment trends between the pre -pandemic and pandemic eras. Treatment of HCC involves complex collaboration between clinical professionals within their local and global healthcare institutions. The COVID-19 pandemic has had a profound impact on the treatment of HCC. The delivery of loco-regional treatment for HCC will need to adapt to each healthcare system's unique structure.

Pandemic

Modalities

Treatment modality

Curative treatment

Health care delivery

10.1016/j.jimed.2022.09.004

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Citations (0)

Diagnostic Algorithm of Tuberculosis

Medical radiology (2022)

Guo Yuan How Kheng Song Leow Say Tat Ooi Wcg Peh

10.1007/978-3-031-07040-2_15

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Citations (2)