Microwave ablation for twin-reversed arterial perfusion sequence

Twin-reversed arterial perfusion (TRAP) sequence is a rare complication of monochorionic twin gestations characterised by an acardiac twin receiving retrograde perfusion from a structurally normal pump twin via abnormal vascular anastomoses. We report the case of a 20s gravida 2, para 1 woman who underwent ultrasound-guided percutaneous microwave ablation (MWA) at 25 weeks of gestation to interrupt flow to the intra-abdominal umbilical cord vessels of the acardiac twin. Successful cessation of blood flow was achieved. This case highlights the feasibility and clinical potential of MWA as an alternative to conventional modalities in the management of TRAP sequence.