title: Microwave Ablation for Twin-Reversed Arterial Perfusion Sequence: A Novel Application of Technology.
abstract: BACKGROUND
  Twin-reversed arterial perfusion sequence is a rare complication of monochorionic pregnancies that is characterized by the presence of an acardiac mass perfused by an apparently normal pump twin. The risk of death to the pump twin has led to a range of therapeutic interventions aimed at separating their vascular connection. We report a novel application of microwave ablation for vessel coagulation in the treatment of twin-reversed arterial perfusion sequence.
  
  
  METHODS
  Microwave ablation has been adopted by surgical subspecialties as a superior energy source for vessel and tissue ablation as it creates heat without a circuit and has less thermal spread. We describe the use of a 2.45-GHz microwave system using a 1.8-mm antenna to coagulate the intra-abdominal portion of umbilical vessels of the acardiac mass.
  
  
  RESULTS
  We report 6 cases of twin-reversed arterial perfusion sequence treated by microwave ablation. All patients were treated with microwave ablation with successful coagulation of intra-abdominal umbilical cord vessels of the acardiac mass with cessation of flow.
  
  
  CONCLUSIONS
  Microwave ablation is an excellent energy source for vessel coagulation due to its thermal properties and can be used effectively in the treatment of twin-reversed arterial perfusion sequence.
authors.affiliation: Charlotte Fetal Care Center, Carolinas Medical Center, Charlotte, N.C., USA.
authors.forename: Courtney D
authors.initials: CD
authors.lastname: Stephenson
authors.forename: Lorene A
authors.initials: LA
authors.lastname: Temming
authors.forename: Rebecca
authors.initials: R
authors.lastname: Pollack
authors.forename: David A
authors.initials: DA
authors.lastname: Iannitti
mesh_terms: D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D014470:Umbilical Cord / Q000000981:diagnostic imaging / Q000601:surgery*