title: Pilot clinical study of a novel minimally invasive bipolar microneedle radiofrequency device.
abstract: OBJECTIVE
  Noninvasive bipolar and monopolar radiofrequency (RF) deep dermal heating devices have previously been described. A novel minimally invasive RF device employing a bipolar microneedle electrode system is introduced and its resultant thermal effects on human skin in vivo were characterized for the first time.
  
  
  METHODS
  An investigational 35 W RF device was configured to operate in bipolar mode delivering energy directly within the dermis using 5 microneedle electrode pairs with real-time feedback of tissue temperature for treatment control. Superficial cooling was achieved using a Peltier device. A range of pulse durations between 1 and 25 seconds, and lesion temperatures between 60 and 80 degrees C were tested in vivo on 15 human subjects. Thermal effects were assessed histologically using either hematoxylin & eosin (H&E) or nitroblue-tetrazoliumchloride (NBTC) staining. Treatment effects and adverse events were also monitored clinically.
  
  
  RESULTS
  The investigational bipolar RF device delivered controlled heating within dermal tissue. Histological staining with H&E revealed the presence of zones of denatured collagen within the reticular dermis. Lesions were generated at preselected temperatures between 60 and 80 degrees C. Fractional lesions separated by zones of sparing as well as contiguous lesion patterns were demonstrated. Histological staining with H&E and NBTC revealed sparing of adnexal structures and adipose tissue. No major adverse events were observed.
  
  
  CONCLUSIONS
  A novel fractional RF device utilizing a minimally invasive bipolar microneedle delivery system for the treatment of human tissue was developed. Treatment of 15 human subjects illustrated the controlled creation of dermally located thermal coagulation zones, herein known as radiofrequency thermal zones. We discovered that varying the pulse length allowed for fractional sparing of dermal tissue. To our knowledge, this is the first report to describe use of a direct real-time temperature and impedance feedback system to control energy delivery during deep dermal heating.
authors.affiliation: Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Basil M
authors.initials: BM
authors.lastname: Hantash
authors.forename: Bradley
authors.initials: B
authors.lastname: Renton
authors.forename: R Laurence
authors.initials: RL
authors.lastname: Berkowitz
authors.forename: Braden C
authors.initials: BC
authors.lastname: Stridde
authors.forename: James
authors.initials: J
authors.lastname: Newman
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000295:instrumentation*; D003357:Cosmetic Techniques; D062109:Dermatologic Surgical Procedures; D004564:Electrocoagulation / Q000295:instrumentation*; D004566:Electrodes; D004867:Equipment Design; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D009339:Needles; D010865:Pilot Projects