Thermal Protection During Percutaneous Thermal Ablation Procedures: Interest of Carbon Dioxide Dissection and Temperature Monitoring
- University Hospital of Strasbourg, Department of Radiology B (France)
Percutaneous image-guided thermal ablation of tumor is widely used, and thermal injury to collateral structures is a known complication of this technique. To avoid thermal damage to surrounding structures, several protection techniques have been reported. We report the use of a simple and effective protective technique combining carbon dioxide dissection and thermocouple: CO{sub 2} displaces the nontarget structures, and its low thermal conductivity provides excellent insulation; insertion of a thermocouple in contact with vulnerable structures achieves continuous thermal monitoring. We performed percutaneous thermal ablation of 37 tumors in 35 patients (4 laser, 10 radiofrequency, and 23 cryoablations) with protection of adjacent vulnerable structures by using CO{sub 2} dissection combined with continuous thermal monitoring with thermocouple. Tumor locations were various (19 intra-abdominal tumors including 4 livers and 9 kidneys, 18 musculoskeletal tumors including 11 spinal tumors). CO{sub 2} volume ranged from 10 ml (epidural space) to 1500 ml (abdominal). Repeated insufflations were performed if necessary, depending on the information given by the thermocouple and imaging control. Dissection with optimal thermal protection was achieved in all cases except two patients where adherences (one postoperative, one arachnoiditis) blocked proper gaseous distribution. No complication referred to this technique was noted. This safe, cost-effective, and simple method increases the safety and the success rate of percutaneous thermal ablation procedures. It also offers the potential to increase the number of tumors that can be treated via a percutaneous approach.
- OSTI ID:
- 21428537
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 32, Issue 3; Other Information: DOI: 10.1007/s00270-009-9524-8; Copyright (c) 2009 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2009 Springer Science+Business Media, LLC; ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
Similar Records
Interest of Electrostimulation of Peripheral Motor Nerves during Percutaneous Thermal Ablation
Prospective Analysis of the Safety and Efficacy of Percutaneous Cryoablation for pT1NxMx Biopsy-Proven Renal Cell Carcinoma