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No device malfunctions or other noteworthy events occurred during the case.In response to reports of acute kidney injury associated with histotripsy, histosonics has incorporated the following warning into its labeling: "consider patient-specific risk factors for acute kidney injury (aki) and/or renal failure based on clinical history and procedural scenarios that could increase stress on kidney function, including but not limited to hydration status, planned treatment volume and expected use of imaging contrast agents.Consistent with other liver-directed therapies, treatments involving large treatment volumes or multiple treatment sessions may be associated with an increased risk of aki.Evaluate renal risk and monitor for signs of aki before and after treatment.".
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On (b)(6), 2026, a male patient with a history of hepatocellular carcinoma (hcc) received histotripsy treatment to a portal vein tumor thrombus in liver segment 6 for a total planned treatment volume (ptv) of 73.9 cc.The procedure involved overlapping histotripsy treatments of the portal vein thrombus.The treating physician reported that following treatment, imaging demonstrated resolution of the tumor thrombus, and the patient's bilirubin levels improved, consistent with a favorable local treatment response.On (b)(6), the patient presented to the hospital reporting that they were not feeling well.Laboratory evaluation demonstrated elevated serum creatinine of 4.6 mg/dl, and the patient was admitted for evaluation of acute kidney injury.The patient was managed conservatively, dialysis was not required, and serum creatinine began to decline during hospitalization with no further sequelae resulting in discharge on (b)(6).
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