This section describes safety outcomes from the published literature that the Committee considered as part of the evidence about this procedure. For more detailed information on the evidence, see the overview.
5.1 Pneumothorax (within 24 hours of the procedure) was reported in 9% (11/130) of procedures in the case series of 80 patients (130 lesions) with pulmonary metastases. Of these, 6 were categorised as 'mild' (treated conservatively), 4 were categorised as 'moderate' (managed with manual or catheter evacuation), and 1 was categorised as 'severe' (needing chest tube). Pneumothorax was reported in 32% (18/56) of patients after ablation in a case series of 56 patients with primary or metastatic disease (timing unclear). Of these patients 44% (8/18) needed chest tube insertion.
5.2 Haemothorax (within 30 days of the procedure) was reported in 3% (2/69) of patients in the case series of 69 patients with primary and metastatic pulmonary malignancies.
5.3 Bronchocutaneous fistula (diagnosed 12 hours after the procedure) was reported in a case report of a patient with adenocarcinoma: the fistula was no longer present at 2‑month follow-up.
5.4 Abscess in a cavity resulting from the treatment was reported in 1 patient 6 months after the procedure in the case series of 50 patients with primary or metastatic disease. The patient developed haemoptysis and died 8 months after the procedure.
5.5 Needle tip fracture was reported in 1 patient in a case series of 23 patients and microwave antenna breakage was reported in a patient in a case report.
5.6 The specialist advisers listed anecdotal adverse events as pleural seeding, pulmonary haemorrhage, thermal damage to other structures in the lung and pain caused by burns to the chest wall.