scholarly journals Ultrasound-guided thermal radiofrequency ablation to treat refractory knee and hip pain: Outcomes of a case series

2021 ◽  
Vol 28 ◽  
pp. 221049172110033
Author(s):  
Ismael Carneiro ◽  
Joana Silva ◽  
Tiago Lopes ◽  
José Luís Carvalho
Keyword(s):  
Radiofrequency Ablation ◽  
Pain Control ◽  
Case Series ◽  
Hip Pain ◽  
Ultrasound Guided ◽  
Symptomatic Knee ◽  
Pain Outcomes

A number of options are currently available to treat symptomatic knee and hip pain. Among them, there is the use of thermal radiofrequency ablation. It is a more recent technique and we still have a lack regarding safety and effectiveness. In this report, we briefly present a case series of patients with refractory knee and hip pain, treated with thermal radiofrequency ablation, where we discuss the results in safety and effectiveness, concerning not only the pain control, but also the return to participation in activities.

scholarly journals Endoscopic ultrasound-guided radiofrequency ablation of pancreatic neuroendocrine tumors: a case series

2020 ◽  
Vol 08 (12) ◽  
pp. E1754-E1758
Author(s):  
Germana de Nucci ◽  
Nicola Imperatore ◽  
Enzo Domenico Mandelli ◽  
Franca di Nuovo ◽  
Corrado d’Urbano ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasound ◽  
Therapeutic Option ◽  
Case Series ◽  
Pancreatic Head ◽  
Complete Disappearance ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ultrasound Guided ◽  
Effective Therapeutic Option

Abstract Background and study aims Surgery is the considered the therapeutic cornerstone for pancreatic neuroendocrine tumors (P-NETs), although burdened by high risk of significant adverse events. Recently, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has been described for P-NETs. We aimed to evaluate the effectiveness and safety of EUS-RFA for treatment of P-NETs. Patients and methods We prospectively included all consecutive patients with P-NET ≤ 20 mm who were treated with EUS-RFA and were followed-up for at least 12 months. Results Ten patients (5 males, mean age 78.6 years, mean body mass index 28.2) with 11 P-NETs (mean size 14.5 mm; range 9 – 20 mm) localized in the pancreatic head (3 lesions), pancreatic body (5 lesions), and tail (3 lesions) underwent complete EUS ablation with one session of RFA. Complete ablation of P-NET was reached using a single-session RFA with a mean of 2.3 treatment applications per session. At both 6 – and 12-months computed tomography scans, all the patients had complete disappearance of lesions with radiological normalization. Regarding safety, only two cases of mild abdominal pain were recorded in two subjects with pancreatic head lesion, which were effectively treated with analgesics. The mean duration of hospital stay was 4 days (range 3 – 7 days). Conclusions EUS-RFA is effective and safe in treating P-NETs. It may be considered an effective therapeutic option in the treatment of small P-NETs independently from their functional status.

scholarly journals Endoscopic Ultrasound-Guided Radiofrequency Ablation of the Pancreatic Tumors: A Promising Tool in Management of Pancreatic Tumors

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Kinesh Changela ◽  
Rashmee Patil ◽  
Sushil Duddempudi ◽  
Vinaya Gaduputi
Keyword(s):  
Radiofrequency Ablation ◽  
Endoscopic Ultrasound ◽  
Pancreatic Neoplasms ◽  
Pancreatic Neoplasm ◽  
Case Series ◽  
Human Case ◽  
Pancreatic Tumors ◽  
Ultrasound Guided ◽  
Technical Success Rate ◽  
Novel Technique

Objective. Radiofrequency ablation is a well-established antitumor treatment and is recognized as one of the least invasive therapeutic modalities for pancreatic neoplasm. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) delivery can be used to treat both pancreatic cancer and asymptomatic premalignant pancreatic neoplasms and may serve as a less invasive alternative to surgical resection. This is an appealing option that may result in less morbidity and mortality. The aim of this review was to summarize and evaluate the clinical and technical effectiveness of EUS-guided RFA of pancreatic neoplasms.Methods. A through literature review was performed to identify the studies describing this novel technique. In this review article, we have summarized human case series. The indications, techniques, limitations, and complications reported are discussed.Results. A total of six studies were included. Overall, a 100% technical success rate was reported in human studies. Complications related to endoscopic ultrasound-guided radiofrequency ablation delivery have been described; however, few cases have presented life-threatening outcomes.Conclusion. We believe that this novel technique can be a safe and effective alternative approach in the management of selected patients.

scholarly journals Analgesic evaluation of ultrasound-guided Pericapsular Nerve Group (PENG) block for emergency hip surgery in fragile patients: a case series

Arthroplasty ◽  
2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Tommaso Pagano ◽  
Fulvio Scarpato ◽  
Gianmaria Chicone ◽  
Domenico Carbone ◽  
Carlo Blandina Bussemi ◽  
...  
Keyword(s):  
Pain Control ◽  
Ultrasound Guidance ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Case Series ◽  
Hip Surgery ◽  
Ultrasound Guided ◽  
Analgesic Technique ◽  
Fascia Iliaca Block ◽  
Complications And Mortality

Abstract Background Emergency hip surgery is common especially in elderly patients. Very often we are faced with elderly and fragile patients with several comorbidities. In these cases a careful pain control is crucial to reduce length of stay, costs, postoperative complications and mortality. Currently the Fascia Iliaca Block (FIB) and the Femoral Nerve Block (FNB) are the main techniques used for this purpose. Cases presentation Recently, a new method has been described under ultrasound-guidance, the Pericapsular Nerve Group (PENG) block. In this case series we try to point out the importance of this novel, safe and effective ultrasound-guided locoregional analgesic technique as an alternative to FIB or FNB based on our clinical experience. Conclusion In this case series the PENG block has been proved to be safe and effective, but more and larger-sized studies are needed to better assess the method in future before it becomes an established analgesic technique for hip surgery.

scholarly journals Combined Ultrasound and Fluoroscopic Guidance for Radiofrequency Ablation of the Obturator Nerve for Intractable CancerAssociated Hip Pain

2014 ◽  
Vol 17;1 (1;17) ◽  
pp. E83-E87
Author(s):  
Gerald Matchett
Keyword(s):  
Radiofrequency Ablation ◽  
Femoral Head ◽  
Case Reports ◽  
Femoral Nerve ◽  
Case Series ◽  
Obturator Nerve ◽  
Hip Pain ◽  
Skeletal Metastases ◽  
Difficult Case ◽  
Fluoroscopic Guidance

Management of pain from skeletal metastases is notoriously difficult. Case reports and case series have described radiofrequency ablation of the obturator nerve branches to the femoral head for treatment of intractable hip pain. Ablation of the obturator branches to the femoral head is technically difficult because of bony and vascular anatomy, including close proximity of the femoral vessels. Here we present the case of a 79-year-old woman with intractable right hip pain and inability to ambulate secondary to metastatic non-small cell lung cancer in the femoral head and acetabulum, treated with thermal radiofrequency ablation of the obturator and femoral nerve branches to the femoral head. Ablation of the obturator nerve was done via anterior placement of the radiofrequency needle under combined ultrasound and fluoroscopic guidance, passing the radiofrequency needle between the femoral artery and femoral vein. Real-time ultrasound guidance was used to avoid vascular puncture. Thermal radiofrequency ablation resulted in sustained pain relief, and resumption in the ability of the patient to ambulate. From this case we suggest that an anterior approach to the obturator nerve branches to the femoral head may be technically feasible using combined ultrasound and fluoroscopic guidance to avoid vascular puncture. Key words: Obturator nerve, radiofrequency ablation, cancer associated pain

scholarly journals Endoscopic ultrasound-guided ethanol and radiofrequency ablation of pancreatic insulinomas: a systematic literature review

2021 ◽  
Vol 14 ◽  
pp. 175628482110421
Author(s):  
Ghassan El Sayed ◽  
Levente Frim ◽  
Jamie Franklin ◽  
Raymond McCrudden ◽  
Charles Gordon ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Radiofrequency Ablation ◽  
Endoscopic Ultrasound ◽  
Case Reports ◽  
Case Series ◽  
Clinical Success Rate ◽  
Ablation Techniques ◽  
Neuroendocrine Neoplasm ◽  
Efficacy And Safety ◽  
Ultrasound Guided

Background: Insulinoma is the most common neuroendocrine neoplasm of the pancreas, characterised by hypoglycaemic symptoms. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) and ethanol ablation (EUS-EA) are novel methods for treating insulinoma. We aimed to perform a systematic review to assess the efficacy and safety of EUS-guided ablation techniques for pancreatic insulinomas. Methods: We systematically searched for articles detailing EUS-guided ablations of insulinomas. We performed a qualitative analysis and summarised data on the efficacy and safety of EUS-RFA and EUS-EA techniques. Results: In total, we identified 35 case reports and case series describing 75 patients with insulinomas treatment with EUS-guided ablation. Twenty-seven patients were treated with EUS-RFA, 47 patients with EUS-EA, and 1 patient received EUS-EA and EUS-RFA in the same session. In total, 84 insulinomas were ablated (EUS-RFA: 31, EUS-EA: 53). Most insulinomas were in the head of the pancreas (40%). The clinical success rate for EUS-guided ablation techniques was 98.5%. The median glucose level was 1.95 (Q1-Q3: 1.69–2.13) mmol/L before ablation compared to 6.20 (Q1-Q3: 5.30–7.05) mmol/L after treatment. The median insulin and C-peptide levels before and after RFA/EA were 230 (Q1–Q2: 120–257) pmol/L and 41 (Q1–Q2 35–42) pmol/L; 2077 (Q1–Q2 1644–2459) pmol/L and 819 (Q1–Q2 696–1072) pmol/L, respectively. There were eleven adverse events: seven abdominal pain, two mild acute pancreatitis, one necrotising acute pancreatitis and one local hematoma. All patients recovered, and there were no periprocedural deaths. Conclusions: EUS-guided ablation of insulinoma seems to be a safe and effective treatment and is an alternative to surgical resection in selected cases.

scholarly journals ULTRASOUND-GUIDED CONTINUOUS RADIOFREQUENCY ABLATION OF PAINFUL RESIDUAL LIMB NEUROMA IN INDIVIDUALS WITH LIMB AMPUTATION- A RETROSPECTIVE CASE SERIES

2019 ◽  
Author(s):  
Shigong Guo ◽  
Ramy Mansour ◽  
David Henderson Slater
Keyword(s):  
Radiofrequency Ablation ◽  
Steroid Injection ◽  
Case Series ◽  
Limb Amputation ◽  
Residual Limb ◽  
Ultrasound Guided ◽  
Retrospective Case ◽  
Prosthetic Limb ◽  
Pain Scores ◽  
Retrospective Case Series

BACKGROUND: Residual limb neuromas are a significant cause of post-amputation pain. There is little knowledge concerning ultrasound-guided (US) radiofrequency ablation (RFA) as treatment. OBJECTIVE: To investigate US-guided RFA for neuroma associated pain in individuals with limb amputation. METHODOLOGY: The notes of nine consecutive patients were retrospectively reviewed. Information obtained included neuroma size and nerve, RFA duration/temperature, pain scores, analgesic requirements and ease/comfort of prosthetic use. Eight patients had lower-limb amputations and one had a trans-radial amputation.  All except one, underwent diagnostic US-guided steroid injection to confirm the neuroma as the source of pain, prior to RFA. RESULTS: Six patients reported significant reduction in pain scores (defined as at least 50% reduction) and an improvement in comfort/ease of wearing their prosthetic limb, with no adverse effects. Three of these six patients also reported a reduction in analgesic requirements. Of the three remaining patients – one had a large sciatic nerve neuroma that was eventually surgically excised, another had confounding pain from an adjacent bony spur, whilst the third patient did not receive a routine diagnostic steroid injection prior to RFA.   CONCLUSIONS: Our findings suggest that US-guided RFA is safe and effective for small to medium-sized residual limb neuroma associated pain in individuals with limb amputation. It can reduce pain and analgesic requirements, improve comfort/ease of wearing the prosthesis and potentially avoid surgical excision. We recommend patients should undergo a diagnostic steroid injection prior to RFA to confirm that the neuroma is the source of pain. LAYMAN’S ABSTRACTAfter amputation, many patients can get a neuroma which can cause significant pain leading to discomfort wearing the prosthetic limb. Ultrasound-guided radiofrequency ablation can successfully treat painful residual limb neuromas in individuals with limb amputation which in turn can reduce the patient’s pain medications and improve the comfort of wearing the prosthetic limb. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/33061/25509 How to Cite: Guo S, Mansour R, Henderson Slater D. Ultrasound-guided continuous radiofrequency ablation of painful residual limb neuroma in individuals with limb amputation- A retrospective case series. Canadian Prosthetics & Orthotics Journal. 2019; volume2, Issue1, No.4. https://doi.org/10.33137/cpoj.v2i1.33061 CORRESPONDING AUTHOR:Shigong Guo,LLM MSc(Orth Eng) MRCS, Specialty Registrar in Rehabilitation MedicineOxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, UK.Email: [email protected]

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