Supplementary Material for: Microwave Ablation for Twin-Reversed Arterial Perfusion Sequence: A Novel Application of Technology

<b><i>Introduction:</i></b> 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. <b><i>Material and Methods:</i></b> 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. <b><i>Results:</i></b> 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. <b><i>Discussion:</i></b> 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.<b><i>引言：</i></b> 双胎反向动脉灌注序列征（Twin-reversed arterial perfusion sequence）是单绒毛膜双胎妊娠的一种罕见并发症，其特征为存在一个由外观正常的泵血双胎（pump twin）灌注的无心畸形团。泵血双胎的死亡风险促使学界开发了一系列旨在切断二者血管连接的治疗干预手段。我们报告了微波消融（microwave ablation）用于血管凝固以治疗双胎反向动脉灌注序列征的全新应用。<b><i>材料与方法：</i></b> 微波消融（microwave ablation）已被外科亚专科用作血管与组织消融的优质能量源，因其无需回路即可产热且热扩散范围更小。我们详述了采用配备1.8mm天线的2.45GHz微波系统，对无心畸形团的腹腔内脐血管进行凝固的操作。<b><i>结果：</i></b> 我们报告了6例接受微波消融治疗的双胎反向动脉灌注序列征病例。所有患者均接受了微波消融治疗，无心畸形团的腹腔内脐血管均成功凝固且血流停止。<b><i>讨论：</i></b> 微波消融凭借其热学特性，是用于血管凝固的优质能量源，可有效应用于双胎反向动脉灌注序列征的治疗。