Department of Anesthesiology

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Novel use of noninvasive high-intensity focused ultrasonography for intercostal nerve neurolysis in a swine model.

TitleNovel use of noninvasive high-intensity focused ultrasonography for intercostal nerve neurolysis in a swine model.
Publication TypeJournal Article
Year of Publication2014
AuthorsGulati A, Loh J, Gutta NB, Ezell PC, Monette S, Erinjeri JP, Maybody M, Solomon S
JournalReg Anesth Pain Med
Volume39
Issue1
Pagination26-30
Date Published2014 Jan-Feb
ISSN1532-8651
KeywordsAnimals, Catheter Ablation, High-Intensity Focused Ultrasound Ablation, Intercostal Nerves, Models, Animal, Nerve Block, Swine
Abstract

BACKGROUND: High-intensity focused ultrasound (HIFU) is a noninvasive thermal ablation technique. High-intensity focused ultrasound has been used in small-animal models to lesion neural tissue selectively. This study aimed to evaluate the efficacy of HIFU in a large-animal model for ablation of nerves similar in size to human nerves.

METHODS: Twelve acute magnetic resonance-guided HIFU ablation lesions were created in intercostal nerves in a swine model. In a second pig, as a control, 4 radiofrequency ablation and 4 alcohol lesions were performed on intercostal nerves under ultrasound guidance. Preprocedural and postprocedural magnetic resonance imaging was then performed to evaluate radiologically the lesion size created by HIFU. Animals were euthanized 1 hour postprocedure, and necropsy was performed to collect tissue samples for histopathologic analysis.

RESULTS: On gross and histological examination of the intercostal nerve, acute HIFU nerve lesions showed evidence of well-demarcated, acute, focally extensive thermal necrosis. Four intercostal nerves ablated with HIFU were sent for histopathologic analysis, with 2 of 4 lesions showing pathologic damage to the intercostal nerve. Similar results were shown with radiofrequency ablation technique, whereas the intercostal nerves appeared histologically intact with alcohol ablation.

CONCLUSIONS: High-intensity focused ultrasound may be used as a noninvasive neurolytic technique in swine. High-intensity focused ultrasound may have potential as a neuroablation technique for patients with chronic and cancer pain.

DOI10.1097/AAP.0000000000000028
Alternate JournalReg Anesth Pain Med
PubMed ID24317231