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Radiofrequency ablation

Last revised by Dr Francis Deng on 25 Nov 2021

Radiofrequency ablation (RFA) is a medical procedure that uses a high-frequency alternating current produced by a radiofrequency generator oscillating in a closed-loop circuit. This current heats a needle to over 60°C, which is used to cause intentional protein denaturation and tissue damage 1.

Applications

  • tumor ablation: established for the local destruction of liver, lung, and bone tumors, e.g. HCC and osteoid osteoma
  • cardiac arrhythmia: used in the treatment of an abnormally discharging focus within the heart
  • ablation neurotomy and pain management for specific nerve plexuses or Morton neuroma
  • varicose veins: an alternative to sclerotherapy, as the produced heat causes closure of the affected vein

Complications

  • thermal injuries to the adjacent structures: in liver tumor ablation, this means potential injury to the diaphragm, colon, gallbladder, or bile ducts, which may result in perforation, leakage of secretions, or stricture formation 2
  • pneumothorax and pleural effusion: in lung tumor ablation
  • hemorrhage: small vessels are more liable to hemorrhage more than large vessels which are rather protected by "heat sink" effect of flowing blood
  • infection is a relatively low risk of radiofrequency ablation
  • tumor seeding along the needle track
  • post-ablation syndrome: flu-like symptoms, including low-grade fever, chills, nausea, pain, and malaise. It is a self-limited condition that usually begins three days after ablation
  • dysfunction of a cardiac pacemaker or defibrillator due to the use of radiofrequency waves

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Cases and figures

  • Case 1: osteoid osteoma
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