Novel Use of Noninvasive High-Intensity Focused Ultrasonography for Intercostal Nerve Neurolysis in a Swine Model
| Autor: | Jeffrey Loh, Sebastien Monette, Joseph P. Erinjeri, N. Gutta, Paula C. Ezell, Amitabh Gulati, Majid Maybody, Stephen B. Solomon |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Swine Radiofrequency ablation medicine.medical_treatment High intensity focused Intercostal nerves Article law.invention Lesion law Animals Medicine Neurolysis medicine.diagnostic_test business.industry Nerve Block Magnetic resonance imaging General Medicine Ablation Surgery Anesthesiology and Pain Medicine Models Animal Catheter Ablation High-Intensity Focused Ultrasound Ablation Intercostal Nerves Radiology Ultrasonography medicine.symptom business |
| Zdroj: | Reg Anesth Pain Med |
| ISSN: | 1098-7339 |
| Popis: | Background High-intensity focused ultrasound (HIFU) is a noninvasive thermal ablation technique. High-intensity focused ultrasound has been used in small-animal models to lesion neural tissue selectively. This study aimed to evaluate the efficacy of HIFU in a large-animal model for ablation of nerves similar in size to human nerves. Methods Twelve acute magnetic resonance–guided HIFU ablation lesions were created in intercostal nerves in a swine model. In a second pig, as a control, 4 radiofrequency ablation and 4 alcohol lesions were performed on intercostal nerves under ultrasound guidance. Preprocedural and postprocedural magnetic resonance imaging was then performed to evaluate radiologically the lesion size created by HIFU. Animals were euthanized 1 hour postprocedure, and necropsy was performed to collect tissue samples for histopathologic analysis. Results On gross and histological examination of the intercostal nerve, acute HIFU nerve lesions showed evidence of well-demarcated, acute, focally extensive thermal necrosis. Four intercostal nerves ablated with HIFU were sent for histopathologic analysis, with 2 of 4 lesions showing pathologic damage to the intercostal nerve. Similar results were shown with radiofrequency ablation technique, whereas the intercostal nerves appeared histologically intact with alcohol ablation. Conclusions High-intensity focused ultrasound may be used as a noninvasive neurolytic technique in swine. High-intensity focused ultrasound may have potential as a neuroablation technique for patients with chronic and cancer pain. |
| Databáze: | OpenAIRE |
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