Download PDF
Semin intervent Radiol 2022; 39(02): 157-161
DOI: 10.1055/s-0042-1745795
Review Article

Thermal Protection Strategies and Neuromonitoring during Ablation

Alan Alper Sag
1   Division of Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina
,
Aatif M. Husain
2   Department of Neurology, Duke University Medical Center, Durham, North Carolina
3   Department of Veterans Affairs Medical Center, Neurodiagnostic Center, Durham, North Carolina
› Author Affiliations Funding No funding was received for any portion of this work.
› Further Information
Also available at
    Permissions and Reprints

Abstract

Advanced interventional pain management approaches seek to lesion neural targets to achieve desirable analgesia; however, equally important is preservation of motor and sensory function for regional bystander nerves. The topic of neuroprotection is also relevant for thermal ablation of metastatic bone tumors in the vicinity of neural structures. This report aims to provide an IR-directed framework of thermoprotective techniques available during thermal ablation.

Keywords

interventional radiology - cancer pain - pain management - analgesia - thermal ablation


Publication History

Article published online:
30 June 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Buy X, Tok C-H, Szwarc D, Bierry G, Gangi A. Thermal protection during percutaneous thermal ablation procedures: interest of carbon dioxide dissection and temperature monitoring. Cardiovasc Intervent Radiol 2009; 32 (03) 529-534
    CrossrefPubMedGoogle Scholar
  • 2 Tsoumakidou G, Garnon J, Ramamurthy N, Buy X, Gangi A. Interest of electrostimulation of peripheral motor nerves during percutaneous thermal ablation. Cardiovasc Intervent Radiol 2013; 36 (06) 1624-1628
    CrossrefPubMedGoogle Scholar
  • 3 Diehn FE, Neeman Z, Hvizda JL, Wood BJ. Remote thermometry to avoid complications in radiofrequency ablation. J Vasc Interv Radiol 2003; 14 (12) 1569-1576
    CrossrefPubMedGoogle Scholar
  • 4 Yamane T, Tateishi A, Cho S. et al. The effects of hyperthermia on the spinal cord. Spine 1992; 17 (11) 1386-1391
    CrossrefPubMedGoogle Scholar
  • 5 Dupuy DE, Hong R, Oliver B, Goldberg SN. Radiofrequency ablation of spinal tumors: temperature distribution in the spinal canal. AJR Am J Roentgenol 2000; 175 (05) 1263-1266
    CrossrefPubMedGoogle Scholar
  • 6 Sugarbaker PH, Sugarbaker C, Stephens AD, Chang D. Radiofrequency hyperthermia in the palliative treatment of mucinous carcinomatosis of appendiceal origin: optimizing and monitoring heat delivery in western patients. Int J Hyperthermia 2000; 16 (05) 429-441
    CrossrefPubMedGoogle Scholar
  • 7 Tsoumakidou G, Koch G, Caudrelier J. et al. Image-guided spinal ablation: a review. Cardiovasc Intervent Radiol 2016; 39 (09) 1229-1238
    CrossrefPubMedGoogle Scholar
  • 8 Baust JG, Gage AA, Bjerklund Johansen TE, Baust JM. Mechanisms of cryoablation: clinical consequences on malignant tumors. Cryobiology 2014; 68 (01) 1-11
    CrossrefPubMedGoogle Scholar
  • 9 Klossner DP, Robilotto AT, Clarke DM. et al. Cryosurgical technique: assessment of the fundamental variables using human prostate cancer model systems. Cryobiology 2007; 55 (03) 189-199
    CrossrefPubMedGoogle Scholar
  • 10 Ilfeld BM, Preciado J, Trescot AM. Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves. Expert Rev Med Devices 2016; 13 (08) 713-725
    CrossrefPubMedGoogle Scholar
  • 11 Filippiadis D, Efthymiou E, Tsochatzis A, Kelekis A, Prologo JD. Percutaneous cryoanalgesia for pain palliation: current status and future trends. Diagn Interv Imaging 2021; 102 (05) 273-278
    CrossrefPubMedGoogle Scholar
  • 12 Nuwer MR, Emerson RG, Galloway G. et al; American Association of Neuromuscular and Electrodiagnostic Medicine. Evidence-based guideline update: intraoperative spinal monitoring with somatosensory and transcranial electrical motor evoked potentials*. J Clin Neurophysiol 2012; 29 (01) 101-108
    CrossrefPubMedGoogle Scholar
  • 13 MacDonald DB, Dong C, Quatrale R. et al. Recommendations of the International Society of Intraoperative Neurophysiology for intraoperative somatosensory evoked potentials. Clin Neurophysiol 2019; 130 (01) 161-179
    CrossrefPubMedGoogle Scholar
  • 14 Legatt AD, Emerson RG, Epstein CM. et al. ACNS guideline: transcranial electrical stimulation motor evoked potential monitoring. J Clin Neurophysiol 2016; 33 (01) 42-50
    CrossrefPubMedGoogle Scholar
  • 15 MacDonald DB. Overview on criteria for MEP monitoring. J Clin Neurophysiol 2017; 34 (01) 4-11
    CrossrefPubMedGoogle Scholar
  • 16 Nair DG. Intraoperative mapping of roots, plexuses, and nerves. J Clin Neurophysiol 2013; 30 (06) 613-619
    CrossrefPubMedGoogle Scholar
  • 17 Cofano F, Zenga F, Mammi M. et al. Intraoperative neurophysiological monitoring during spinal surgery: technical review in open and minimally invasive approaches. Neurosurg Rev 2019; 42 (02) 297-307
    CrossrefPubMedGoogle Scholar
  • 18 Maybody M, Tang PQ, Moskowitz CS, Hsu M, Yarmohammadi H, Boas FE. Pneumodissection for skin protection in image-guided cryoablation of superficial musculoskeletal tumours. Eur Radiol 2017; 27 (03) 1202-1210
    CrossrefPubMedGoogle Scholar