In radiofrequency ablation, a radiofrequency generator produces alternating current. This generates intense heat (80 to 100 degrees Celsius) in a narrowly defined area. This allows doctors to precisely destroy small areas of tissue. The area destroyed by the heat is referred to as heat necrosis.
Special electrode needles (ablation probes) are used to introduce the current into the target area. The current is introduced into the body via the tip of the needle electrode and discharged again via wider electrodes on the thighs. The ions contained in the tissue fluid are moved in the target area. Due to the strong ion oscillation, heat is generated in the area of the ablation probe.
The electrodes contain sensors that measure the tissue temperature. The doctors monitor the insertion and positioning of the ablation probe using
In this way, they avoid accidentally destroying healthy tissue.
Depending on the size and shape of the electrodes, spherical tissue areas with a diameter of up to 7 cm can be destroyed. Tumors up to a maximum size of 4 cm are best treated.
In patients with cardiac arrhythmia and severe high blood pressure, the heart muscle tissue responsible or the nerves in the kidney causing the high blood pressure are sclerosed (artificially scarred) using a catheter.
Radiofrequency ablation can also be used in cardiology, for example in patients with high blood pressure © romaset | AdobeStock
Radiofrequency ablation is mainly used to destroy malignant liver tumors. These include
The best way to cure liver cancer is to surgically remove the tumor. However, this is not always possible, for example in the case of concomitant diseases or if the tumor has an unfavourable location and extent. In such cases, radiofrequency ablation is an option.
However, radiofrequency ablation can also be used for other tumors, for example in
The procedure is particularly successful in the treatment of benign bone tumors.
In addition to tumor treatment, radiofrequency ablation is also used in cardiology. Certain cardiac arrhythmias, such as tachycardia, are successfully treated with the procedure. Radiofrequency ablation can also help patients with severe chronic high blood pressure (hypertension).
Pain may occur due to the heat generated. For this reason, radiofrequency ablation is usually performed under general anesthesia. In some cases, the treatment is carried out under twilight sleep with the administration of painkillers.
The treatment is usually associated with an inpatient stay of several days. Depending on the size and location of the target tissue, the procedure takes around 1 to 3 hours.
The doctors insert the ablation probe percutaneously, i.e. through the skin, into the tissue and monitor the procedure using imaging techniques. The target area is then heated to the desired temperature for around 25 minutes using the applied current.
The method can be carried out several times in succession for a large number of tumors.
While the probe is being withdrawn, the puncture channel is also heated to prevent tumor cell spread.
The success of the procedure and the occurrence of possible complications are then checked using computer tomography.
As a rule, the patient can leave the clinic after 48 hours at the latest. After 6 to 8 weeks, the patient is checked again using computer tomography.
As part of tumor follow-up care, the patient must undergo further examinations at regular intervals.
As minimally invasive radiofrequency ablation is a very safe procedure, serious side effects rarely occur.
In 6 to 8 percent of all cases, minor complications occur that do not necessarily need to be treated. These include, for example
- Nausea or pain in the area of the ablation,
- slight bleeding or
- a collapsed lung (pneumothorax).
The lungs usually recover on their own.
Serious complications after radiofrequency ablation only affect 2 to 4 percent of patients. Infection of the destroyed tissue areas and the resulting abscesses are possible. Patients who are particularly at risk are therefore given antibiotics before and after radiofrequency ablation.
A pronounced lung collapse is rare and is treated with drainage (drainage of fluid).
Injury to vital organs or blood vessels caused by the ablation probe is a very serious complication. It requires immediate surgery. However, this risk is extremely low, as imaging techniques enable precise insertion and positioning of the probes.
If there are more than four or five tumors, the treatment of liver tumors using radiofrequency ablation is less suitable. Treatment is also limited for larger tumors. For tumors with a diameter of more than 5 cm, the tumor should first be reduced in size using other methods. Chemotherapy or radiotherapy are possible options.
Radiofrequency ablation is also less promising if several organs have tumors.
Radiofrequency ablation is also not suitable if the tumor is located close to vital structures such as blood vessels.
Other contraindications (i.e. reasons that speak against the treatment) are
As anaesthetics and painkillers are required during the procedure, any allergies must also be clarified beforehand.
