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Do Surgical Clips Interfere with Radiofrequency Thermal Ablation?

Daniel T. Boll1, Jonathan S. Lewin, Jeffrey L. Duerk and Elmar M. Merkle

1 All authors: Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106.



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  		Fig. 1. —Diagram shows experimental setup. Ex vivo liver specimen is placed on conductive grounding pad. Triple-cluster electrode is inserted perpendicular (a) and parallel (b) to grounding pad. Surgical clips are positioned in plane perpendicular to radiofrequency electrode at predefined locations. In this diagram, torus is placed on liver surface and symbolizes 20-mm radius from point of insertion. Additional clips are positioned within torus at 10 mm from point of insertion as well as outside torus, thus representing clip at 30 mm. In third arrangement (c), radiofrequency thermal ablation electrode is inserted parallel to grounding pad, whereas surgical clip plane represented by torus is now parallel and anterior to radiofrequency electrode track at predefined distance of 15 mm, with clips arranged in same configuration as in (a) and (b).

 


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  		Fig. 2A. —Growth of radiofrequency thermal lesion at various times of experimental setup. Photograph of liver surface shows radiofrequency-induced thermal lesion after 120 sec of energy delivery, which documents irregular extending of radiofrequency thermal ablation lesion toward surgical clip 10 mm away and additional satellite lesion surrounding 10-mm surgical clip (arrow).

 


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  		Fig. 2B. —Growth of radiofrequency thermal lesion at various times of experimental setup. Photograph of liver surface shows radiofrequency lesion with symmetric configuration after 5 min of ablation. No visual carbonization around first clip (arrow) is noted.

 

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