Stereotactic radiosurgery as neuromodulation of refractory
angina: an initial case series

J 2025

Stereotactic radiosurgery as neuromodulation of refractory angina: an initial case series

CVEK, Jakub; Otakar JIRAVSKÝ; Lukas KNYBEL; Miroslav HUDEC; Radim SPACEK et al.

Základní údaje

Originální název

Stereotactic radiosurgery as neuromodulation of refractory angina: an initial case series

Autoři

CVEK, Jakub; Otakar JIRAVSKÝ; Lukas KNYBEL; Miroslav HUDEC; Radim SPACEK; Adrian REICHENBACH; Jan HECKO; Radek NEUWIRTH a Josef KAUTZNER

Vydání

Radiation Oncology, LONDON, BMC, 2025, 1748-717X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.200 v roce 2024

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/25:00140926

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Radiosurgery; Refractory angina

Štítky

14110211, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 2. 4. 2025 12:36, Mgr. Tereza Miškechová

Anotace

V originále

BackgroundThis intervention pilot case series assessed 40-Gy stereotactic radiosurgery (SRS) neuromodulation applied to the bilateral stellate ganglion (SG) as a bailout procedure for patients with refractory angina pectoris (RAP).Materials and methodsThe local institutional review board approved this feasibility study. In three patients with RAP, after repeated good response, symptoms were temporarily relieved after anaesthetic blockade of the left SG under ultrasound guidance. Radiosurgical neuromodulation with a dose of 40 Gy in one fraction was used for more permanent pain control. When RAP recurred after the initial SRS, right-sided procedures were considered after a confirmed positive response to right SG anesthetic block.ResultsNo acute or late radiation-related toxicities were observed. Two patients (67%) responded to bilateral SRS (follow-up: 60 and 48 months, respectively). From baseline to 24 months, their average prescribed nitrate package count decreased from 5.5 to 0 and remained low. Daily emergency nitrates declined from 20 to 30 to 1-2 applications, and walking distance improved from 10 to 20 m to 200-400 m and remained stable. Quality of life as measured with the EQ-5D and all domains of the Seattle Angina Questionnaire improved. The third patient received only unilateral SRS, had a temporary improvement for 6 months before a return to baseline, and died after 42 months of follow-up.ConclusionsBilateral radiosurgical neuromodulation at 40 Gy appears to be feasible, safe, and effective as a bailout procedure for RAP.

Citovat

CVEK, Jakub; Otakar JIRAVSKÝ; Lukas KNYBEL; Miroslav HUDEC; Radim SPACEK; Adrian REICHENBACH; Jan HECKO; Radek NEUWIRTH a Josef KAUTZNER. Stereotactic radiosurgery as neuromodulation of refractory angina: an initial case series. Radiation Oncology. LONDON: BMC, 2025, roč. 20, č. 1, s. 1-10. ISSN 1748-717X. Dostupné z: https://doi.org/10.1186/s13014-025-02608-9.

@article{2488537,
   author = {Cvek, Jakub and Jiravský, Otakar and Knybel, Lukas and Hudec, Miroslav and Spacek, Radim and Reichenbach, Adrian and Hecko, Jan and Neuwirth, Radek and Kautzner, Josef},
   article_location = {LONDON},
   article_number = {1},
   doi = {https://doi.org/10.1186/s13014-025-02608-9},
   keywords = {Radiosurgery; Refractory angina},
   language = {eng},
   issn = {1748-717X},
   journal = {Radiation Oncology},
   title = {Stereotactic radiosurgery as neuromodulation of refractory angina: an initial case series},
   url = {https://ro-journal.biomedcentral.com/articles/10.1186/s13014-025-02608-9},
   volume = {20},
   year = {2025}
}

TY  - JOUR
ID  - 2488537
AU  - Cvek, Jakub - Jiravský, Otakar - Knybel, Lukas - Hudec, Miroslav - Spacek, Radim - Reichenbach, Adrian - Hecko, Jan - Neuwirth, Radek - Kautzner, Josef
PY  - 2025
TI  - Stereotactic radiosurgery as neuromodulation of refractory angina: an initial case series
JF  - Radiation Oncology
VL  - 20
IS  - 1
SP  - 1-10
EP  - 1-10
PB  - BMC
SN  - 1748717X
KW  - Radiosurgery
KW  - Refractory angina
UR  - https://ro-journal.biomedcentral.com/articles/10.1186/s13014-025-02608-9
N2  - BackgroundThis intervention pilot case series assessed 40-Gy stereotactic radiosurgery (SRS) neuromodulation applied to the bilateral stellate ganglion (SG) as a bailout procedure for patients with refractory angina pectoris (RAP).Materials and methodsThe local institutional review board approved this feasibility study. In three patients with RAP, after repeated good response, symptoms were temporarily relieved after anaesthetic blockade of the left SG under ultrasound guidance. Radiosurgical neuromodulation with a dose of 40 Gy in one fraction was used for more permanent pain control. When RAP recurred after the initial SRS, right-sided procedures were considered after a confirmed positive response to right SG anesthetic block.ResultsNo acute or late radiation-related toxicities were observed. Two patients (67%) responded to bilateral SRS (follow-up: 60 and 48 months, respectively). From baseline to 24 months, their average prescribed nitrate package count decreased from 5.5 to 0 and remained low. Daily emergency nitrates declined from 20 to 30 to 1-2 applications, and walking distance improved from 10 to 20 m to 200-400 m and remained stable. Quality of life as measured with the EQ-5D and all domains of the Seattle Angina Questionnaire improved. The third patient received only unilateral SRS, had a temporary improvement for 6 months before a return to baseline, and died after 42 months of follow-up.ConclusionsBilateral radiosurgical neuromodulation at 40 Gy appears to be feasible, safe, and effective as a bailout procedure for RAP.
ER  -

CVEK, Jakub; Otakar JIRAVSKÝ; Lukas KNYBEL; Miroslav HUDEC; Radim SPACEK; Adrian REICHENBACH; Jan HECKO; Radek NEUWIRTH a Josef KAUTZNER. Stereotactic radiosurgery as neuromodulation of refractory angina: an initial case series. \textit{Radiation Oncology}. LONDON: BMC, 2025, roč.~20, č.~1, s.~1-10. ISSN~1748-717X. Dostupné z: https://doi.org/10.1186/s13014-025-02608-9.

Přehled o publikaci