A 71-year-old patient diagnosed with an HCC and portal hypertension in March 2026. Decision was made to treat the 2 lesions in segment II with microwave ablation guided by CAS-One IR. The system was chosen due to the challenging position of one lesion very close to the right ventricle. The planning and navigation helped ensure the optimum treatment to cover the lesion and the safety margins while keeping the treatment as safe as possible. AblaSure® was able to confirm full coverage of both lesions, and the patient was discharged the next day with no complications.
Name: Dr. Javier Armijo and Dr Marco Leyva Vásquez-Caicedo
Institution: Clinico San Carlos, Madrid, Spain
Patient age and sex: 71, Male
Patient initially diagnosed with chronic hepatopathy and portal hypertension due to alcohol abuse
HCC classified CHILD B8, MELD 13
In March 2026, MRI showed 2 lesions in segment II. One of 12mm LI-RADS 5, and one LI-RADS 4 of 10 mm. Other hypervascular lesions with no sign of washout in other lobes were classified as LR 3
MDT discussed surgery for the portal hypertension but decided on ablation for the lesions LR 4 and 5. Decision to use CAS-One IR due to the close proximity of the LR5 lesion from the right ventricle. The LR3 lesions will be monitored closely
Follow-up imaging 4 months post-ablation showed complete ablation of both lesions
No complications occurred, and the patient was discharged from the hospital the day after ablation
The 2 lesions in segment II were targeted with 2 different trajectories using the Medtronic Emprint® microwave
The lesion under the right ventricle was treated with 75W and 8 minutes to reduce the risks of injuring the pericardium
The second lesion was treated at 100W for 10 minutes due to its proximity to the hepatic vein
AblaSure showed complete coverage of both lesions