Dados do Trabalho

Título

Percutaneous ablations in musculoskeletal radiology: avoiding thermal injuries

Introdução e objetivo(s)

To provide an overview of thermal ablation techniques in musculoskeletal radiology, such as radiofrequency ablation (RFA) and cryoablation (CA); present a general overview of potential risks and complications associated with the procedures; discuss various methods and strategies available for protection during thermal ablations, and describe techniques to minimize heat diffusion to adjacent tissues.

Método(s)

A literature review was conducted using the PubMed database through a free search on the topic. Subsequently, case selection was performed on multimodality cases where ablative therapies were carried out using the Picture Archiving and Communication System (PACS) and the Search Reports system. In the obtained images, methods of thermoprotection were emphasized, and their representations in images were illustrated through graphical schemes for better understanding. For each set of cases, a brief explanation was developed to enhance comprehension of the techniques.

Discussão

In recent times, percutaneous or minimally invasive procedures have found successful applications in the treatment of various osteomuscular diseases making them a valuable alternative to traditional surgical interventions in both benign and malignant conditions. One of the primary advantages of percutaneous ablations is their minimal invasiveness, which leads to shorter recovery times and reduced post-procedural pain compared to surgery. These procedures include RFA, CA and microwave ablation, each tailored to the specific clinical scenario. However, despite their benefits, percutaneous ablations are not without their complications. Potential issues include infection, bleeding, and, most notably, thermal injury to surrounding structures. The latter risk highlights the importance of meticulous planning and precise execution of the procedure to minimize collateral damage. Protective methods include hydrodissection, pneumodissection, mechanical manipulation, joint distension, and heating or cooling of the skin. These techniques can be combined to ensure maximum protection and optimize clinical outcomes, reducing collateral damage.

Conclusões

Percutaneous ablations in musculoskeletal radiology represent a promising approach for the minimally invasive treatment of various conditions. However, these procedures come with the risk of thermal injury to the skin, blood vessels, and nerves, necessitating not only careful planning and execution of the ablation but also attention to the selection of materials and thermal protection measures.

Palavras Chave

Percutaneous ablations; thermal injury; thermal protection

Arquivos

Área

Sistema Musculoesquelético