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Morphologic Analysis of Water-Cooled Bipolar Radiofrequency lesions on Egg White in Vitro

  • Kang, Sang-Soo (Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Park, Jung-Chan (Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Yoon, Young-Jun (Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Shin, Keun-Man (Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine)
  • Received : 2012.03.15
  • Accepted : 2012.06.05
  • Published : 2012.07.01

Abstract

Background: The aim of this study was to document the optimal spacing of two cannulae to form continuous strip lesions and maximal surface area by using water-cooled bipolar radiofrequency technology. Methods: Two water-cooled needle probes (15 cm length, 18-gauge probe with 6 mm electrode tip) were placed in a parallel position 10, 20, 24, 26, and 28 mm apart and submerged in egg white. Temperatures of the probes were raised from $35^{\circ}C$ to $90^{\circ}C$ and the progress of lesion formation was photographed every 1 minute with the increase of the tip temperature. Approximately 30 photographs were taken. The resultant surface areas of the lesions were measured with the digital image program. Results: Continuous strip lesions were formed when the cannulae were spaced 24 mm or less apart; monopolar lesions around each cannula resulted if they were spaced more than 26 mm apart. Maximal surface areas through the formation of continuous strip lesion were 221 $mm^2$, 375 $mm^2$, and 476 $mm^2$ in 10, 20, and 24 mm, respectively. Summations of maximal surface area of each monopolar lesions were 394 $mm^2$ and 103 $mm^2$ in 26 and 28 mm, respectively. Conclusions: Water-cooled bipolar Radiofrequency technology creates continuous "strip" lesions proportional in size to the distance between the probes till the distance between cannulae is 24 mm or less. Spacing the cannulae 24 mm apart and treating about $80^{\circ}C$ for 24 minutes maximizes the surface area of the lesion.

Keywords

References

  1. Nakada SY, Jerde TJ, Warner TF, Wright AS, Haemmerich D, Mahvi DM, et al. Bipolar radiofrequency ablation of the kidney: comparison with monopolar radiofrequency ablation. J Endourol 2003; 17: 927-33. https://doi.org/10.1089/089277903772036316
  2. Anfinsen OG, Kongsgaard E, Foerster A, Aass H, Amlie JP. Radiofrequency current ablation of porcine right atrium: increased lesion size with bipolar two catheter technique compared to unipolar application in vitro and in vivo. Pacing Clin Electrophysiol 1998; 21: 69-78. https://doi.org/10.1111/j.1540-8159.1998.tb01063.x
  3. Wang YG, Lu ZY, Zhao HY, Song YE, Li RL. A comparative study of radiofrequency ablation in unipolar and bipolar fashion. J Tongji Med Univ 1995; 15: 73-6. https://doi.org/10.1007/BF02887905
  4. Watanabe I, Masaki R, Min N, Oshikawa N, Okubo K, Sugimura H, et al. Cooled-tip ablation results in increased radiofrequency power delivery and lesion size in the canine heart: importance of catheter-tip temperature monitoring for prevention of popping and impedance rise. J Interv Card Electrophysiol 2002; 6: 9-16. https://doi.org/10.1023/A:1014140104777
  5. Ferrante FM, King LF, Roche EA, Kim PS, Aranda M, Delaney LR, et al. Radiofrequency sacroiliac joint denervation for sacroiliac syndrome. Reg Anesth Pain Med 2001; 26: 137-42. https://doi.org/10.1097/00115550-200103000-00008
  6. Gauci CA. Sacroiliac joint denervation. In: Handbook of clinical techniques in the management of chronic pain. Edited by Wedley JR, Gauci CA. Chur, Switzerland, Harwood Academic. 1994, pp 12-3.
  7. Ray CD. Percutaneous radiofrequency facet nerve blocks: treatment of the mechanical low back syndrome. Procedure technique series. Boston, MA, Radionics. 1982, pp 18-9.
  8. Pino CA, Hoeft MA, Hofsess C, Rathmell JP. Morphologic analysis of bipolar radiofrequency lesions: implications for treatment of the sacroiliac joint. Reg Anesth Pain Med 2005; 30: 335-8.
  9. Choi EM, Shin KM, Nam SK, Cheong IY. A study about size and shape of bipolar radiofrequency lesions. Korean J Anesthesiol 2008; 54: 197-200. https://doi.org/10.4097/kjae.2008.54.2.197
  10. Kang SS, Shin KM, Jung SM, Park JH, Hong SJ. Sequential bipolar radiofrequency lumbar sympathectomy in Raynaud's disease -A case report-. Korean J Anesthesiol 2010; 59: 286-9. https://doi.org/10.4097/kjae.2010.59.4.286
  11. Lorentzen T. A cooled needle electrode for radiofrequency tissue ablation: thermodynamic aspects of improved performance compared with conventional needle design. Acad Radiol 1996; 3: 556-63. https://doi.org/10.1016/S1076-6332(96)80219-4
  12. Sim WS, Lee AR. Radiofrequency lumbar medial branch denervation using bipolar probe in patient with facet joint syndrome. J Korean Pain Soc 2004; 17: 153-8. https://doi.org/10.3344/jkps.2004.17.2.153
  13. Lee KH, Yun SH, Kim HJ, Jung BH, Lim SY, Shin KM, et al. A comparison of the size and shape of radiofrequency lesions produced by different temperatures using straight and curved electrodes. Korean J Anesthesiol 2000; 39: 260-4. https://doi.org/10.4097/kjae.2000.39.2.260
  14. Lee KH, Kim KS, Lim SY, Hong SY, Won RS, Shin KM. Experimental radiofrequency lesion size utilizing Different parameters and neuropathologic correlation on the peripheral nerve. Korean J Anesthesiol 2002; 42: 368-82. https://doi.org/10.4097/kjae.2002.42.3.368
  15. Derby R, Lee CH. The efficacy of a two needle electrode technique in percutaneous radiofrequency rhizotomy: an investigational laboratory study in an animal model. Pain Physician 2006; 9: 207-13.

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