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Singal A, Ballard JR, Rudie EN, Cressman ENK, Iaizzo PA. A Review of Therapeutic Ablation Modalities. J Med Device 2016. [DOI: 10.1115/1.4033876] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Understanding basic science and technical aspects is essential for scientists and engineers to develop and enhance ablative modalities, and for clinicians to effectively apply therapeutic ablative techniques. An overview of ablative modalities, anatomical locations, and indications for which ablations are performed is presented. Specifically, basic concepts, parameter selection, and underlying biophysics of tissue injury of five currently used therapeutic ablative modalities are reviewed: radiofrequency ablation (RFA), cryoablation (CRA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), and chemical ablation (CHA) (ablative agents: acetic acid, ethanol, hypertonic sodium chloride, and urea). Each ablative modality could be refined for expanding applications, either independently or in combination, for future therapeutic use.
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Affiliation(s)
- Ashish Singal
- Department of Biomedical Engineering, University of Minnesota, 420 Delaware Street SE, B172 Mayo Building, MMC 195, Minneapolis, MN 55455 e-mail:
| | - John R. Ballard
- Medical Devices Center, University of Minnesota, 420 Delaware Street SE, G217 Mayo Building, MMC 95, Minneapolis, MN 55455 e-mail:
| | - Eric N. Rudie
- Rudie Consulting LLC, 18466 Gladstone Boulevard, Maple Grove, MN 55311 e-mail:
| | - Erik N. K. Cressman
- Department of Interventional Radiology, MD Anderson Cancer Center, FCT 14.6012 Unit 1471, 1400 Pressler Street, Houston, TX 77030 e-mail:
| | - Paul A. Iaizzo
- Mem. ASME Department of Surgery, University of Minnesota, 420 Delaware Street SE, B172 Mayo, MMC 195, Minneapolis, MN 55455 e-mail:
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Abstract
Menorrhagia is defined as a 'complaint of heavy cyclical menstrual bleeding occurring over several consecutive cycles'. Objectively it is a total menstrual blood loss equal to or greater than 80 ml per menstruation. It is estimated that approximately 30% of women complain of menorrhagia. Excessive bleeding is the main presenting complaint in women referred to gynecologists and it accounts for two-thirds of all hysterectomies, and most of endoscopic endometrial destructive surgery. Thus, menorrhagia is an important healthcare problem. Its etiology, investigation, medical and surgical management are described. In approximately 50% of cases of menorrhagia no pathology is found at hysterectomy. Abnormal levels of prostaglandins or the fibrinolytic system in the endometrium have been implicated. Effective medical treatments suitable for long-term use include intrauterine progestogens, antifibrinolytic agents (tranexamic acid) and nonsteroidal anti-inflammatory agents (mefenamic acid). Over the past decade there has been increasing use of endometrial destructive techniques as an alternative to hysterectomy. Their further refinement and the advent of fibroid embolization has increased the options available to women.
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Affiliation(s)
- M K Oehler
- Department of Obstetrics & Gynecology, Westmead Hospital, University of Sydney, Westmead, NSW, Australia.
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