Avoiding Complications in Bone and Soft Tissue Ablation.
As with percutaneous ablation of tumors in the liver, lungs, and kidneys, ablation of bone and non-visceral soft tissue tumors carries risk, primarily from collateral damage to vital structures in proximity to the target tumor. Certain risks are of particular interest when ablating bone and non-visceral soft tissue tumors, namely neural or skin injury, bowel injury, fracture, and gas embolism from damaged applicators. Ablation of large volume tumors also carries special risk. Many techniques may be employed by the interventional radiologist to minimize complications when treating tumors in the musculoskeletal system. These methods include those to depict, displace, or monitor critical structures. Thus, measures to provide thermoprotection may be active, such as careful ablation applicator placement and use of various displacement techniques, as well as passive, including employment of direct temperature, radiographic, or neurophysiologic monitoring techniques. Cementoplasty should be considered in certain skeletal locations at risk of fracture. Patients treated with large volume tumors should be monitored for renal dysfunction and properly hydrated. Finally, ablation applicators should be cautiously placed in the constrained environment of intact bone.
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. kurup.anil@mayo.edu.
A Nicholas
AN
Kurup
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Grant D
GD
Schmit
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Jonathan M
JM
Morris
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Thomas D
TD
Atwell
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
John J
JJ
Schmitz
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Adam J
AJ
Weisbrod
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
David A
DA
Woodrum
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Patrick W
PW
Eiken
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Matthew R
MR
Callstrom
D001859:Bone Neoplasms / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D050723:Fractures, Bone / Q000517:prevention & control; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D012983:Soft Tissue Neoplasms / Q000601:surgery*
Ablation; Bone tumors; Cryoablation; Musculoskeletal; Radiofrequency ablation