[go: up one dir, main page]

WO2025132371A1 - Method of using an ablation probe or probes to create an ablation zone in tissue - Google Patents

Method of using an ablation probe or probes to create an ablation zone in tissue Download PDF

Info

Publication number
WO2025132371A1
WO2025132371A1 PCT/EP2024/086812 EP2024086812W WO2025132371A1 WO 2025132371 A1 WO2025132371 A1 WO 2025132371A1 EP 2024086812 W EP2024086812 W EP 2024086812W WO 2025132371 A1 WO2025132371 A1 WO 2025132371A1
Authority
WO
WIPO (PCT)
Prior art keywords
treatment area
probes
ablation
electrode
ablation probe
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/EP2024/086812
Other languages
French (fr)
Inventor
Calin Druma
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medtronic Europe Sarl
Original Assignee
Medtronic Europe Sarl
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Medtronic Europe Sarl filed Critical Medtronic Europe Sarl
Publication of WO2025132371A1 publication Critical patent/WO2025132371A1/en
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/148—Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00339—Spine, e.g. intervertebral disc
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00875—Resistance or impedance

Definitions

  • the present technology is generally relative to a method to facilitate adjustment of the size of an ablation zone at a treatment area using a radio frequency (RF) ablation probe or probes.
  • RF radio frequency
  • RF ablation probes have been used for treating the spinal metastases.
  • Advantages of the use of the cooled RF ablation probes, in comparison to non-cooled RF ablation probes include increased lesion size, lower charring potential, and less skin bums than non-cooled version.
  • One of the disadvantages of RF ablation, whether cooled or uncooled, is that such ablation requires electrical and thermal conductive tissue in order to penetrate deep into the spinal metastases and kill the diseased tissue.
  • the method of the present disclosure affords use an ablation probe or probes to create an ablation zone via efficient transfer of RF energy to a treatment area.
  • the method of the present disclosure can determine a bioimpedance of a treatment area, and then determine a preferrable RF ablation probe or probes from a selection thereof. Impedance matching between the source (the ablation probe or probes) and the load impendence (the treatment area) and/or burst RF signals can serve in efficiently transferring power from the RF ablation probe to the treatment area to correspondingly facilitate adjustment of the size of an ablation zone created thereby without charring.
  • the present disclosure provides a method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method including inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area ; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; energizing a first electrode provided on one of the first tip portion and the second tip portion; receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion; measuring an impedance of the treatment area between the first tip portion and the second tip portion; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of
  • the present disclosure provides a method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method including inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; measuring an impedance of the treatment area between the first tip portion and the second tip portion using energy transferred between the first ping probe and the second ping probe; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at
  • the present disclosure provides a method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method comprising; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to a measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at least one electrode using an RF generator connected thereto; and lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
  • RF radio frequency
  • a preferred ablation probe or probes is/are selected from a selection of ablation probes based on impedance matching of the properties thereof to a measured impedance of the treatment area, and/or a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes is determined according the measured impedance of the treatment area. Via such impedance matching and/or such scheduled sequences, efficient transfer of RF power from the ablation probe or probes to the treatment area can be maximized.
  • the techniques of this disclosure generally relate to a method of using an ablation probe or probes to facilitate adjustment of the size of an ablation zone at a treatment area.
  • FIG. 1 is a top plan view of a first vertebrae including placement of a first ping probe and a second ping probe in position adjacent to a treatment area surrounding a tumor;
  • FIG. 2 is a top plan view of a second vertebrae, similar to first vertebrae of FIG. 1 , including placement of a single ping probe in position through portions of a tumor and a treatment area surrounding the tumor;
  • FIG. 3 is a top plan view of a third vertebrae, different from the first vertebrae of FIG. 1 and the second vertebrae of FIG. 2, including placement of a single ping probe in position through portions of a tumor and a treatment area surrounding the tumor;
  • FIG. 4 is a graphical representation of a continuous alternating current signal
  • FIG. 5 is a graphical representation of an intermittent continuous alternating current signal with burst intervals and pause intervals
  • FIG. 6 is a graphical representation of power delivered via an intermittent alternating current signal with burst intervals of constant magnitude and pause intervals.
  • FIG. 7 is a graphical representation of power delivered via an intermittent alternating current signal with burst intervals of increasing magnitude and pause intervals.
  • a method according to the present disclosure generally provides for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area using a radio frequency (RF) ablation probe or probes. Creation of the ablation zone using the ablation probe or probes facilitates treatment via necrosis of diseased tissue in the treatment area.
  • the method can serve in adjusting the size of the ablation zone by efficiently transferring power from the RF ablation probe or probes to the treatment area without charring. To illustrate, the method can serve in maximizing the transfer of power from the RF ablation probe or probes to facilitate maximization of the size of the ablation zone.
  • the method according to the present disclosure can afford selection of a preferred ablation probe or probes to facilitate efficient transfer of power (and for example, maximize the power transfer) from the RF ablation probe or probes to the treatment area via impedance matching.
  • Impedance refers to opposition to alternating current (AC) signals, and includes resistance and reactive components.
  • bioimpedance specifically refers to opposition to AC signals in bodily tissue and correspondingly includes resistance and reactive components of the tissue.
  • the resistance and reactive components of the bioimpedance can be different for different tissues of a patient, and the differences in the bioimpedance can be especially acute between diseased and healthy tissue.
  • Measuring the bioimpedance of a treatment area including tissue to be ablated can be advantageous. By performing such measurements to evaluate the bioimpedance of the treatment area, a preferred RF ablation probe or probes can be selected that are matched to the bioimpedance of the tissues to be ablated. Impedance matching can serve in efficiently transferring power (and in some instances, maximize power transfer) from the RF ablation probe or probes, and the power transfer can facilitate penetration of the AC signals from the RF ablation probe or probes into the treatment area.
  • Impedance matching of the measured bioimpedance to a preferrable ablation probe or probes can be accomplished via calculation of the complex conjugate of the load impedance (the treatment area).
  • the complex conjugate of the load can then be used to select corresponding properties of the source (the preferred ablation probe or probes).
  • the preferred ablation probe or probes By selecting the preferred ablation probe or probes based on the complex conjugate of the bioimpedance of the treatment area, a phase difference between the voltage and current in the treatment area can be reduced to zero or close to zero, and such a phase difference reduction can facilitate the efficient transfer of power (and in some instances, maximize power transfer) thereto and minimizes signal reflections therefrom.
  • a selection of RF ablation probe or probes can have different configurations (including being cooled, being uncooled, having different dimensions of the at least one electrode, and/or having different placement of the at least one electrode), and be powered by RF generators that facilitate application of AC signals at various frequencies and various amplitudes afforded by the different configurations of the RF ablation probe or probes to the treatment area.
  • the preferred RF ablation probe or probes and the frequency and the amplitude of the AC signals from the RF generator can be selected based on the properties thereof that correspond to the complex conjugate of the measured bioimpedance of the treatment area to afford the best impedance match to maximize the transfer of power to the treatment area.
  • the efficiency of the ablation afforded by the use of the preferred RF ablation probe or probes can be correspondingly increased.
  • the increased efficiency can create the ablation zone (encompassing all or portions of the treatment area) having a maximized size without charring.
  • measurement probes such as, for example, diagnosis ping RF probes 10 and 12 can be used.
  • an exemplary vertebrae 20 is provided.
  • the vertebrae 20 includes a vertebral body 22 that includes a treatment area 24 occupying a portion of the interior thereof.
  • the treatment area 24 corresponds to tissue that is to be ablated, and can encompasses all or portions of a tumor (or diseased area) T.
  • the diagnosis ping RF probes 10 and 12 can be positioned relative to the tumor T and the corresponding treatment area 24.
  • the treatment area 24 can be reached via one or more approaches thereto, including anterior, anterior-lateral, posterior, posterior-lateral, and/or lateral approaches. As depicted in FIG. 1 , the treatment area 24 is reached from posterior trans-pedicle approaches.
  • one or more osteointroducers can be used.
  • the osteointroducers can be configured as cannulas having passageways extending therethrough.
  • a first of osteointroducers can be inserted through a first pedicle 26 and into the vertebral body 22 such that a tip thereof is positioned into and/or adjacent a first side Si of the treatment area 24, and a second of the osteointroducers can be inserted through a second pedicle 28 and into the vertebral body 22 such that a tip thereof is positioned into and/or adjacent a second side S 2 of the treatment area 24.
  • the first side Si and the second side S 2 of the treatment area 24 can be opposite from one another, and the first and second osteointroducers can be inserted via linear and/or rotational movement thereof, and can be used to create access channels 30 and 32 to the treatment area 24.
  • the diagnosis ping RF probe 10 can be inserted through the channel 30 for positioning of a first tip portion 34 of the diagnosis ping probe 10 into and/or adjacent the first side Si of the treatment area 24, and the diagnosis ping RF probe 12 can be inserted through the channel 32 for positioning of a second tip portion 36 of the diagnosis ping probe 12 into and/or adjacent the second side S 2 of the treatment area 24.
  • Each of the first tip portion 34 and the second tip portion 36 can each include a first transmitting electrode and a second receiving electrode.
  • the first transmitting electrode of the first tip portion 34 can be energized, and the second receiving electrode of the second tip portion 36 can receive the RF energy transmitted across the treatment area 24 from the first transmitting electrode of the first tip portion 34; and/or the first transmitting electrode of the second tip portion 36 can be energized, and the second receiving electrode of the first tip portion 34 can receive the RF energy transmitted across the treatment area 24 from the first transmitting electrode of the second tip portion 36.
  • a single diagnosis ping RF probe 38 (similar to the diagnosis ping RF probes 10 and 12) and a receiving/ground pad (not shown) can be used.
  • the single diagnosis ping RF probe 38 can be inserted using an osteointroducers (not shown). The single diagnosis ping RF probe 38, as depicted in FIGS.
  • the ground/receiving pad (not shown) can be positioned on skin of the patient opposite from the single diagnosis ping RF probe 38 and across a portion the treatment area 24, so that the receiving pad can receive the RF energy transmitted across the portion of the treatment area 24 from the single diagnosis ping RF probe 38.
  • the RF energy received by the second receiving electrode of the first tip portion 34, the second receiving electrode of the second tip portion 36, and/or the receiving/ground pad can be used in measuring the bioimpedance of the treatment area 24.
  • the measured bioimpedance can be used to select a preferred RF ablation probe or probes based on the properties that can affords the best impedance match to the measured bioimpedance of the treatment area to facilitate maximation of the transfer of power thereto.
  • the transfer of power to the treatment area 24 can maximized using the AC signals applied by the preferred RF ablation probe or probes.
  • maximizing the transfer of power to the treatment area 24 serves to correspondingly increase efficiency of the ablation afforded by use of the preferred RF ablation probe or probes.
  • an ablation zone A (encompassing all or portions of the treatment area 24), as depicted in FIGS. 1-3, created by the preferred RF ablation probe or probes can have a maximized size without charring.
  • Measuring the impedance also affords a determination whether or not ablation is even possible, and whether or not the treatment area 24 requires wetting to afford such ablation.
  • the discussion above presumes that the measured bioimpedance of the treatment area 24 would allow ablation thereof.
  • the treatment area 24 may be dry resulting in a high bioimpedance measured by the diagnosis ping RF probes 10 and 12 and/or the receiving/ground pad. Ablation of the treatment area 24 if it is too dry can increase the potential for unwanted charring.
  • the treatment area 24 can be removed using a surgical instrument or instruments (such as a curet).
  • the treatment area 24 can be wetted with the wetting solution, and thereafter, the bioimpedance of the treatment area 24 can be measured using the diagnosis ping RF probes 10 and 12 and/or the receiving/ground pad. If the measured bioimpedance is suitably decreased after the wetting of the treatment area 24, the preferred RF ablation probe or probes can be used to ablate all or portions of the treatment area 24 as described above. If the measured bioimpedance is not suitably decreased after the wetting of the treatment area 24, it may not be possible to use ablation, and the treatment area 24 can be removed using a surgical instrument or instruments.
  • the method according to the present disclosure can afford delivering uninterrupted continuous AC signals (FIG. 4) from the preferred RF ablation probe or probes to create the ablation zone around all or portions of the treatment area 24.
  • the method according to the present disclosure in part, can be used to increase the penetration of the RF energy into the treatment area 24 to create the corresponding ablation zone A around all or portions of the treatment area 24 by delivering intermittent AC signals (FIG. 5).
  • the AC signals can be delivered intermittently as a scheduled sequence of burst intervals and pause intervals (FIG. 5).
  • the burst intervals of the AC signals can be at constant maximum energy (FIG. 6), or at increasing maximum energy (FIG. 7) and the increasing energy can increase linearly, exponentially, or variably.
  • the burst intervals of the AC signals afford increased penetration of thermal energy (generated by the AC signals) that penetrates deeper into the treatment area 24 via build-up of thermal inertia conducted thereinto. And increasing the energy of the burst intervals of AC signals can aid the deeper penetration into the treatment area 24 by building up of the thermal inertia in an additive or compounding manner. The deeper penetration of the thermal energy into the treatment area 24 serves to increase the size of the ablation zone A.
  • the timing of the burst intervals of the AC signals can be used with the impedance matching can service in efficiently transferring power (and in some instance, maximize power transfer) to the treatment area 24.
  • the RF ablation probe or probes can be used to raise the temperature of the treatment area 24 to facilitate the ablation thereof.
  • the RF ablation probe or probes can be used to raise temperatures of the treatment area 24 to 90 to 95 °C.
  • the burst intervals of AC signals can be used to raise the temperature of the treatment area 24 via a quick increase of energy (e.g., between 20 to 50 °C/min.) or gradual increase of energy (e.g., up to 20 °C/min) to a predetermined burst level plateau without charring of the treatment area 24.
  • the scheduled sequence of the burst intervals and the pause intervals can be modulated using feedback provided by an optional temperature monitor (attached to or provided adjacent the ablation probe or probes) to prevent the treatment area 24 from overheating.
  • Such modulation can serve to raise the temperature of the treatment area 24 to 90 to 95 °C without exceeding 95 °C.
  • a method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes comprising; inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area ; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; energizing a first electrode provided on one of the first tip portion and the second tip portion; receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion; measuring an impedance of the treatment area between the first tip portion and the second tip portion; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause
  • selecting of the preferred ablation probe or probes includes selecting different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of at least one electrode, and/or having different placement of the at least one electrode.
  • a method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes comprising; inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area ; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; measuring an impedance of the treatment area between the first tip portion and the second tip portion using energy transferred between the first ping probe and the second ping probe; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at least one electrode using an RF generator connected
  • the measuring of the impedance of the treatment area comprises energizing a first electrode provided on one of the first tip portion and the second tip; and receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion.
  • selecting of the ablation probe or probes includes selecting different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of the at least one electrode, and/or having different placement of the at least one electrode.
  • lesioning of the treatment area comprises energizing and deenergizing the at least one electrode of the ablation probe or probes according to the scheduled sequence of the burst intervals and the pause intervals using the RF generator.
  • a method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes comprising; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to a measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at least one electrode using an RF generator connected thereto; and lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
  • RF radio frequency
  • the impedance matching is performed by determining a complex conjugate of the measured impedance. 17. The method of example 16, wherein the selecting of the preferred ablation probe or probes via the impedance matching, and operation of the RF generator at a selected frequency and a selected amplitude facilitates the efficient transfer of power the treatment area.
  • selecting of the ablation probe or probes includes selecting different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of the at least one electrode, and/or having different placement of the at least one electrode.
  • a system for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body comprising a a radio frequency (RF) ablation probe or probes, wherein the radio frequency (RF) ablation probe or probes are configured for: inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; energizing a first electrode provided on one of the first tip portion and the second tip portion; receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion; and measuring an impedance of the treatment area between the first tip portion and the second tip portion; wherein the ablation probe or probes are selected based on an impedance matching of the properties thereof to the measured impedance of the treatment area, and configured to apply a determined scheduled sequence of
  • a system for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body comprising a radio frequency (RF) ablation probe or probes and an RF generator, wherein the radio frequency (RF) ablation probe or probes are configured for:; inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area ; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; measuring an impedance of the treatment area between the first tip portion and the second tip portion using energy transferred between the first ping probe and the second ping probe; wherein the ablation probe or probes are selected based on an impedance matching of the properties thereof to the measured impedance of the treatment area, and configured to apply a scheduled sequence of burst intervals and pause intervals according to the measured impedance of the treatment area; wherein the ablation probe or probes are further configured for
  • a system for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body comprising a radio frequency (RF) ablation probe or probes and an RF generator, wherein the radio frequency (RF) ablation probe or probes are configured to be; selected from a selection of ablation probes based via impedance matching of the properties thereof to a measured impedance of the treatment area, and wherein the radio frequency (RF) ablation probe or probes are configured to apply a determined scheduled sequence of burst intervals and pause intervals according to the measured impedance of the treatment area; wherein the ablation probe or probes are further configured for energizing at least one electrode using the RF generator connected thereto; and for lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Otolaryngology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Plasma & Fusion (AREA)
  • General Health & Medical Sciences (AREA)
  • Neurosurgery (AREA)
  • Neurology (AREA)
  • Surgical Instruments (AREA)

Abstract

Systems and methods for lesioning of diseased tissue are provided. The method forms an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes. To perform the lesioning, a preferred ablation probe or probes is/are selected from a selection of ablation probes based on impedance matching of the properties thereof to a measured impedance of the treatment area, and/or a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes is determined according the measured impedance of the treatment area. Via such impedance matching and/or such scheduled sequences, efficient transfer of RF power from the ablation probe or probes to the treatment area can be maximized.

Description

METHOD OF USING AN ABLATION PROBE OR PROBES TO CREATE AN ABLATION ZONE IN TISSUE
FIELD
[0001] The present technology is generally relative to a method to facilitate adjustment of the size of an ablation zone at a treatment area using a radio frequency (RF) ablation probe or probes.
BACKGROUND
[0002] Spinal metastases are a common cause of severe pain among patients with cancer. And tumor ablation can be used for the palliative treatment of such painful spinal metastases. Cooled radio frequency (RF) or microwave ablation probes have been used for treating the spinal metastases. Advantages of the use of the cooled RF ablation probes, in comparison to non-cooled RF ablation probes include increased lesion size, lower charring potential, and less skin bums than non-cooled version. One of the disadvantages of RF ablation, whether cooled or uncooled, is that such ablation requires electrical and thermal conductive tissue in order to penetrate deep into the spinal metastases and kill the diseased tissue. High tissue impedance often results in impedance-driven cutoffs and/or charring that can eventually result in possible failure of the procedure. Therefore, there is a need for a method for using an ablation probe or probes to efficiently transfer power to a treatment area to correspondingly facilitate adjustment of the size of an ablation zone without charring.
SUMMARY
[0003] The method of the present disclosure affords use an ablation probe or probes to create an ablation zone via efficient transfer of RF energy to a treatment area. In part, the method of the present disclosure can determine a bioimpedance of a treatment area, and then determine a preferrable RF ablation probe or probes from a selection thereof. Impedance matching between the source (the ablation probe or probes) and the load impendence (the treatment area) and/or burst RF signals can serve in efficiently transferring power from the RF ablation probe to the treatment area to correspondingly facilitate adjustment of the size of an ablation zone created thereby without charring.
[0004] In one aspect, the present disclosure provides a method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method including inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area ; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; energizing a first electrode provided on one of the first tip portion and the second tip portion; receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion; measuring an impedance of the treatment area between the first tip portion and the second tip portion; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according the measured impedance of the treatment area; and lesioning of the treatment area to form the ablation zone using the preferred ablation probe or probes and/or the scheduled sequence of the bust intervals and the pause intervals via efficient transfer of RF power to the treatment area as facilitated thereby.
[0005] In another aspect, the present disclosure provides a method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method including inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; measuring an impedance of the treatment area between the first tip portion and the second tip portion using energy transferred between the first ping probe and the second ping probe; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at least one electrode using an RF generator connected thereto; and lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
[0006] In yet another aspect, the present disclosure provides a method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method comprising; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to a measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at least one electrode using an RF generator connected thereto; and lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
[0007] Systems and methods for lesioning of diseased tissue are provided. The method forms an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes. To perform the lesioning, a preferred ablation probe or probes is/are selected from a selection of ablation probes based on impedance matching of the properties thereof to a measured impedance of the treatment area, and/or a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes is determined according the measured impedance of the treatment area. Via such impedance matching and/or such scheduled sequences, efficient transfer of RF power from the ablation probe or probes to the treatment area can be maximized. The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the techniques described in this disclosure will be apparent from the description and drawings, and from the claims.
BRIEF DESCRIPTION OF DRAWINGS
[0008] The techniques of this disclosure generally relate to a method of using an ablation probe or probes to facilitate adjustment of the size of an ablation zone at a treatment area.
[0009] FIG. 1 is a top plan view of a first vertebrae including placement of a first ping probe and a second ping probe in position adjacent to a treatment area surrounding a tumor;
[0010] FIG. 2 is a top plan view of a second vertebrae, similar to first vertebrae of FIG. 1 , including placement of a single ping probe in position through portions of a tumor and a treatment area surrounding the tumor;
[0011] FIG. 3 is a top plan view of a third vertebrae, different from the first vertebrae of FIG. 1 and the second vertebrae of FIG. 2, including placement of a single ping probe in position through portions of a tumor and a treatment area surrounding the tumor;
[0012] FIG. 4 is a graphical representation of a continuous alternating current signal;
[0013] FIG. 5 is a graphical representation of an intermittent continuous alternating current signal with burst intervals and pause intervals;
[0014] FIG. 6 is a graphical representation of power delivered via an intermittent alternating current signal with burst intervals of constant magnitude and pause intervals; and
[0015] FIG. 7 is a graphical representation of power delivered via an intermittent alternating current signal with burst intervals of increasing magnitude and pause intervals.
DETAILED DESCRIPTION [0016] A method according to the present disclosure generally provides for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area using a radio frequency (RF) ablation probe or probes. Creation of the ablation zone using the ablation probe or probes facilitates treatment via necrosis of diseased tissue in the treatment area. As discussed below, the method can serve in adjusting the size of the ablation zone by efficiently transferring power from the RF ablation probe or probes to the treatment area without charring. To illustrate, the method can serve in maximizing the transfer of power from the RF ablation probe or probes to facilitate maximization of the size of the ablation zone.
[0017] In part, the method according to the present disclosure can afford selection of a preferred ablation probe or probes to facilitate efficient transfer of power (and for example, maximize the power transfer) from the RF ablation probe or probes to the treatment area via impedance matching. Impedance refers to opposition to alternating current (AC) signals, and includes resistance and reactive components. And bioimpedance specifically refers to opposition to AC signals in bodily tissue and correspondingly includes resistance and reactive components of the tissue. The resistance and reactive components of the bioimpedance can be different for different tissues of a patient, and the differences in the bioimpedance can be especially acute between diseased and healthy tissue.
[0018] Measuring the bioimpedance of a treatment area including tissue to be ablated can be advantageous. By performing such measurements to evaluate the bioimpedance of the treatment area, a preferred RF ablation probe or probes can be selected that are matched to the bioimpedance of the tissues to be ablated. Impedance matching can serve in efficiently transferring power (and in some instances, maximize power transfer) from the RF ablation probe or probes, and the power transfer can facilitate penetration of the AC signals from the RF ablation probe or probes into the treatment area.
[0019] Impedance matching of the measured bioimpedance to a preferrable ablation probe or probes can be accomplished via calculation of the complex conjugate of the load impedance (the treatment area). The complex conjugate of the load can then be used to select corresponding properties of the source (the preferred ablation probe or probes). By selecting the preferred ablation probe or probes based on the complex conjugate of the bioimpedance of the treatment area, a phase difference between the voltage and current in the treatment area can be reduced to zero or close to zero, and such a phase difference reduction can facilitate the efficient transfer of power (and in some instances, maximize power transfer) thereto and minimizes signal reflections therefrom.
[0020] To illustrate, a selection of RF ablation probe or probes can have different configurations (including being cooled, being uncooled, having different dimensions of the at least one electrode, and/or having different placement of the at least one electrode), and be powered by RF generators that facilitate application of AC signals at various frequencies and various amplitudes afforded by the different configurations of the RF ablation probe or probes to the treatment area. The preferred RF ablation probe or probes and the frequency and the amplitude of the AC signals from the RF generator can be selected based on the properties thereof that correspond to the complex conjugate of the measured bioimpedance of the treatment area to afford the best impedance match to maximize the transfer of power to the treatment area. With the transfer of power to the treatment area maximized, the efficiency of the ablation afforded by the use of the preferred RF ablation probe or probes can be correspondingly increased. The increased efficiency can create the ablation zone (encompassing all or portions of the treatment area) having a maximized size without charring.
[0021] During use of the apparatus and method of the present disclosure, measurement probes such as, for example, diagnosis ping RF probes 10 and 12 can be used. As depicted in FIG. 1 , an exemplary vertebrae 20 is provided. The vertebrae 20 includes a vertebral body 22 that includes a treatment area 24 occupying a portion of the interior thereof. The treatment area 24 corresponds to tissue that is to be ablated, and can encompasses all or portions of a tumor (or diseased area) T. As depicted in FIG. 1 , the diagnosis ping RF probes 10 and 12 can be positioned relative to the tumor T and the corresponding treatment area 24. FIGS. 2 and 3 depict different locations of the tumor T and the corresponding treatment area 24, and the diagnosis RF ping probes 10 and 12 can also be positioned relative to these different locations of the tumor T and the corresponding treatment area 24. The treatment area 24 can be reached via one or more approaches thereto, including anterior, anterior-lateral, posterior, posterior-lateral, and/or lateral approaches. As depicted in FIG. 1 , the treatment area 24 is reached from posterior trans-pedicle approaches.
[0022] To gain access to the treatment area 24, one or more osteointroducers (not shown) can be used. The osteointroducers can be configured as cannulas having passageways extending therethrough. A first of osteointroducers can be inserted through a first pedicle 26 and into the vertebral body 22 such that a tip thereof is positioned into and/or adjacent a first side Si of the treatment area 24, and a second of the osteointroducers can be inserted through a second pedicle 28 and into the vertebral body 22 such that a tip thereof is positioned into and/or adjacent a second side S2 of the treatment area 24. As depicted in FIG. 1 , the first side Si and the second side S2 of the treatment area 24 can be opposite from one another, and the first and second osteointroducers can be inserted via linear and/or rotational movement thereof, and can be used to create access channels 30 and 32 to the treatment area 24.
[0023] After the access channels 30 and 32 are formed, the diagnosis ping RF probe 10 can be inserted through the channel 30 for positioning of a first tip portion 34 of the diagnosis ping probe 10 into and/or adjacent the first side Si of the treatment area 24, and the diagnosis ping RF probe 12 can be inserted through the channel 32 for positioning of a second tip portion 36 of the diagnosis ping probe 12 into and/or adjacent the second side S2 of the treatment area 24. Each of the first tip portion 34 and the second tip portion 36 can each include a first transmitting electrode and a second receiving electrode.
[0024] Thus, when the first tip portion 34 and the second tip portion 36 are positioned in and/or adjacent the first side Si and the second side S2 of the tumor, the first transmitting electrode of the first tip portion 34 can be energized, and the second receiving electrode of the second tip portion 36 can receive the RF energy transmitted across the treatment area 24 from the first transmitting electrode of the first tip portion 34; and/or the first transmitting electrode of the second tip portion 36 can be energized, and the second receiving electrode of the first tip portion 34 can receive the RF energy transmitted across the treatment area 24 from the first transmitting electrode of the second tip portion 36.
[0025] Instead of using both of the diagnosis ping RF probes 10 and 12, a single diagnosis ping RF probe 38 (similar to the diagnosis ping RF probes 10 and 12) and a receiving/ground pad (not shown) can be used. Like the diagnosis ping RF probes 10 and 12, the single diagnosis ping RF probe 38 can be inserted using an osteointroducers (not shown). The single diagnosis ping RF probe 38, as depicted in FIGS. 2 and 3, can be inserted through portions of the tumor T and the corresponding treatment area 24, and the ground/receiving pad (not shown) can be positioned on skin of the patient opposite from the single diagnosis ping RF probe 38 and across a portion the treatment area 24, so that the receiving pad can receive the RF energy transmitted across the portion of the treatment area 24 from the single diagnosis ping RF probe 38. [0026] The RF energy received by the second receiving electrode of the first tip portion 34, the second receiving electrode of the second tip portion 36, and/or the receiving/ground pad can be used in measuring the bioimpedance of the treatment area 24. As discussed above, the measured bioimpedance can be used to select a preferred RF ablation probe or probes based on the properties that can affords the best impedance match to the measured bioimpedance of the treatment area to facilitate maximation of the transfer of power thereto. By matching the impedance of the load (the measured bioimpedance of the treatment area) to the source (the preferred RF ablation probe or probes), as discussed above, the transfer of power to the treatment area 24 can maximized using the AC signals applied by the preferred RF ablation probe or probes. And maximizing the transfer of power to the treatment area 24 serves to correspondingly increase efficiency of the ablation afforded by use of the preferred RF ablation probe or probes. With such increased efficiency, an ablation zone A (encompassing all or portions of the treatment area 24), as depicted in FIGS. 1-3, created by the preferred RF ablation probe or probes can have a maximized size without charring.
[0027] Measuring the impedance also affords a determination whether or not ablation is even possible, and whether or not the treatment area 24 requires wetting to afford such ablation. The discussion above presumes that the measured bioimpedance of the treatment area 24 would allow ablation thereof. However, the treatment area 24 may be dry resulting in a high bioimpedance measured by the diagnosis ping RF probes 10 and 12 and/or the receiving/ground pad. Ablation of the treatment area 24 if it is too dry can increase the potential for unwanted charring. Thus, when a high bioimpedance is measured, it may not be possible to ablate the treatment area 24 or it may possible to wet the treatment area 24 with a wetting solution to decrease the bioimpedance thereof. If it is not possible to use ablation, the treatment area 24 can be removed using a surgical instrument or instruments (such as a curet).
[0028] If wetting is possible, the treatment area 24 can be wetted with the wetting solution, and thereafter, the bioimpedance of the treatment area 24 can be measured using the diagnosis ping RF probes 10 and 12 and/or the receiving/ground pad. If the measured bioimpedance is suitably decreased after the wetting of the treatment area 24, the preferred RF ablation probe or probes can be used to ablate all or portions of the treatment area 24 as described above. If the measured bioimpedance is not suitably decreased after the wetting of the treatment area 24, it may not be possible to use ablation, and the treatment area 24 can be removed using a surgical instrument or instruments.
[0029] When ablation of the treatment area 24 is possible as discussed above, the method according to the present disclosure, in part, can afford delivering uninterrupted continuous AC signals (FIG. 4) from the preferred RF ablation probe or probes to create the ablation zone around all or portions of the treatment area 24. Alternatively, the method according to the present disclosure, in part, can be used to increase the penetration of the RF energy into the treatment area 24 to create the corresponding ablation zone A around all or portions of the treatment area 24 by delivering intermittent AC signals (FIG. 5). Instead of being delivered by the preferred RF ablation probe or probes as uninterrupted continuous signals (FIG. 4), the AC signals can be delivered intermittently as a scheduled sequence of burst intervals and pause intervals (FIG. 5). The burst intervals of the AC signals can be at constant maximum energy (FIG. 6), or at increasing maximum energy (FIG. 7) and the increasing energy can increase linearly, exponentially, or variably. [0030] The burst intervals of the AC signals afford increased penetration of thermal energy (generated by the AC signals) that penetrates deeper into the treatment area 24 via build-up of thermal inertia conducted thereinto. And increasing the energy of the burst intervals of AC signals can aid the deeper penetration into the treatment area 24 by building up of the thermal inertia in an additive or compounding manner. The deeper penetration of the thermal energy into the treatment area 24 serves to increase the size of the ablation zone A. And, it is possible to tailor the scheduled sequence of the burst intervals of the AC signals in order to achieve a desired thermal dose to the treatment area 24. Moreover, using the burst intervals of AC signals may obviate the need for using a cooled ablation probe or probes because the burst intervals decrease the potential for charring in comparison to the constant application of the AC signals. Additionally, the timing of the burst intervals of the AC signals can be used with the impedance matching can service in efficiently transferring power (and in some instance, maximize power transfer) to the treatment area 24.
[0031] Using the method of the present disclosure, the RF ablation probe or probes can be used to raise the temperature of the treatment area 24 to facilitate the ablation thereof. For example, the RF ablation probe or probes can be used to raise temperatures of the treatment area 24 to 90 to 95 °C. To illustrate, the burst intervals of AC signals can be used to raise the temperature of the treatment area 24 via a quick increase of energy (e.g., between 20 to 50 °C/min.) or gradual increase of energy (e.g., up to 20 °C/min) to a predetermined burst level plateau without charring of the treatment area 24. In doing so, the scheduled sequence of the burst intervals and the pause intervals can be modulated using feedback provided by an optional temperature monitor (attached to or provided adjacent the ablation probe or probes) to prevent the treatment area 24 from overheating. Such modulation can serve to raise the temperature of the treatment area 24 to 90 to 95 °C without exceeding 95 °C.
[0032] It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and the accompanying drawings. It should also be understood that, depending on the example, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the techniques). In addition, while certain aspect of this disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the techniques of this disclosure may be performed by a combination of units or modules associated with, for example, a medical device.
[0033] Systems configured to perform the methods described herein including the RF ablation probe or probes are also disclosed.
[0034] In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-Engl ish equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open- ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.
[0035] The following examples are disclosed:
1 . A method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method comprising; inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area ; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; energizing a first electrode provided on one of the first tip portion and the second tip portion; receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion; measuring an impedance of the treatment area between the first tip portion and the second tip portion; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according the measured impedance of the treatment area; and lesioning of the treatment area to form the ablation zone using the preferred ablation probe or probes and/or the scheduled sequence of the bust intervals and the pause intervals via efficient transfer of RF power to the treatment area as facilitated thereby.
2. The method of example 1 , wherein the impedance matching is performed by determining a complex conjugate of the measured impedance.
3. The method of example 2, wherein the selecting of the preferred ablation probe or probes via the impedance matching, and operation of an RF generator at a selected frequency and a selected amplitude facilitates the efficient transfer of power to the treatment area.
4. The method of example 3, wherein the selecting of the preferred ablation probe or probes includes selecting different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of at least one electrode, and/or having different placement of the at least one electrode.
5. The method of example 4, wherein the lesioning of the treatment area comprises energizing the at least one electrode using the RF generator connected to the preferred ablation probe or probes.
6. The method of example 1 , wherein the determining of the scheduled sequence of the burst intervals and the pause intervals, and operation of an RF generator connected to the ablation probe or probes facilitates the efficient transfer of power to the treatment area.
7. The method of example 6, wherein the lesioning of the treatment area comprises energizing and deenergizing at least one electrode of the ablation probe or probes according to the scheduled sequence of the burst intervals and the pause intervals using the RF generator.
8. A method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method comprising; inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area ; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; measuring an impedance of the treatment area between the first tip portion and the second tip portion using energy transferred between the first ping probe and the second ping probe; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at least one electrode using an RF generator connected thereto; and lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
9. The method of example 8, wherein the measuring of the impedance of the treatment area comprises energizing a first electrode provided on one of the first tip portion and the second tip; and receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion.
10. The method of example 8, wherein the impedance matching is performed by determining a complex conjugate of the measured impedance.
11 . The method of example 10, wherein the selecting of the preferred ablation probe or probes via the impedance matching, and operation of the RF generator at a selected frequency and a selected amplitude facilitates the efficient transfer of power from the at least one electrode to the treatment area.
12. The method of example 11 , wherein the selecting of the ablation probe or probes includes selecting different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of the at least one electrode, and/or having different placement of the at least one electrode.
13. The method of example 8, wherein the determining of the scheduled sequence of the burst intervals and the pause intervals, and operation of the RF generator connected to the ablation probe or probes facilitates the efficient transfer of power from the at least one electrode to the treatment area.
14. The method of example 13, wherein the lesioning of the treatment area comprises energizing and deenergizing the at least one electrode of the ablation probe or probes according to the scheduled sequence of the burst intervals and the pause intervals using the RF generator.
15. A method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method comprising; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to a measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at least one electrode using an RF generator connected thereto; and lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
16. The method of example 15, wherein the impedance matching is performed by determining a complex conjugate of the measured impedance. 17. The method of example 16, wherein the selecting of the preferred ablation probe or probes via the impedance matching, and operation of the RF generator at a selected frequency and a selected amplitude facilitates the efficient transfer of power the treatment area.
18. The method of example 17, wherein the selecting of the ablation probe or probes includes selecting different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of the at least one electrode, and/or having different placement of the at least one electrode.
19. The method of example 15, wherein the determining of the scheduled sequence of the burst intervals and the pause intervals, and operation of the RF generator connected to the ablation probe or probes facilitates the efficient transfer of power from the at least one electrode to the treatment area.
20. The method of example 19, wherein the lesioning of the treatment area comprises energizing and deenergizing the at least one electrode of the ablation probe or probes according to the scheduled sequence of the burst intervals and the pause intervals using the RF generator.
21 . A system for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body, comprising a a radio frequency (RF) ablation probe or probes, wherein the radio frequency (RF) ablation probe or probes are configured for: inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; energizing a first electrode provided on one of the first tip portion and the second tip portion; receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion; and measuring an impedance of the treatment area between the first tip portion and the second tip portion; wherein the ablation probe or probes are selected based on an impedance matching of the properties thereof to the measured impedance of the treatment area, and configured to apply a determined scheduled sequence of burst intervals and pause intervals according the measured impedance of the treatment area; wherein the ablation probe or probes are further configured for lesioning of the treatment area to form the ablation zone and/or the scheduled sequence of the bust intervals and the pause intervals via efficient transfer of RF power to the treatment area as facilitated thereby.
22. The system of example 21 , wherein the impedance matching is performed by determining a complex conjugate of the measured impedance.
23. The system of any of the examples 21 or 22, wherein the system further comprises an RF generator.
24.. The system of example 23, wherein selecting of the ablation probe or probes via the impedance matching, and an operation of the RF generator at a selected frequency and a selected amplitude are configured to facilitate the efficient transfer of power to the treatment area.
25. The method system of any of the examples 23 or 24, wherein the lesioning of the treatment area comprises energizing the at least one electrode using the RF generator connected to the preferred ablation probe or probes.
26. The system of any of the examples 21 to 25, wherein the ablation probe or probes are selected based on different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of at least one electrode, and/or having different placement of the at least one electrode. 27. The system of any of the examples 21 to 26, wherein the determining of the scheduled sequence of the burst intervals and the pause intervals, and operation of an RF generator connected to the ablation probe or probes facilitates the efficient transfer of power to the treatment area.
28. A system for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body, comprising a radio frequency (RF) ablation probe or probes and an RF generator, wherein the radio frequency (RF) ablation probe or probes are configured for:; inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area ; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; measuring an impedance of the treatment area between the first tip portion and the second tip portion using energy transferred between the first ping probe and the second ping probe; wherein the ablation probe or probes are selected based on an impedance matching of the properties thereof to the measured impedance of the treatment area, and configured to apply a scheduled sequence of burst intervals and pause intervals according to the measured impedance of the treatment area; wherein the ablation probe or probes are further configured for energizing at least one electrode via the RF generator connected thereto; and for lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
29. A system for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body, comprising a radio frequency (RF) ablation probe or probes and an RF generator, wherein the radio frequency (RF) ablation probe or probes are configured to be; selected from a selection of ablation probes based via impedance matching of the properties thereof to a measured impedance of the treatment area, and wherein the radio frequency (RF) ablation probe or probes are configured to apply a determined scheduled sequence of burst intervals and pause intervals according to the measured impedance of the treatment area; wherein the ablation probe or probes are further configured for energizing at least one electrode using the RF generator connected thereto; and for lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
30. The system of example 29, wherein the impedance matching is performed by determining a complex conjugate of the measured impedance.
31 . The system of any of the examples 29 or 30, wherein the selected ablation probe or probes are selected via the impedance matching, and operation of the RF generator at a selected frequency and a selected amplitude facilitates the efficient transfer of power the treatment area.
32. The system of any of the examples 29 to 31 , wherein the selected ablation probe or probes are selected based on different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of the at least one electrode, and/or having different placement of the at least one electrode.
33. The system of any of the examples 29 to 32, wherein the determined scheduled sequence of the burst intervals and the pause intervals, and operation of the RF generator connected to the ablation probe or probes facilitates the efficient transfer of power from the at least one electrode to the treatment area. The system of any of the examples 29 or 30, wherein the radio frequency (RF) ablation probe or probes are configured for lesioning of the treatment area comprising energizing and deenergizing the at least one electrode of the ablation probe or probes according to the scheduled sequence of the burst intervals and the pause intervals using the RF generator.

Claims

1 . A method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method comprising; inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; energizing a first electrode provided on one of the first tip portion and the second tip portion; receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion; measuring an impedance of the treatment area between the first tip portion and the second tip portion; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according the measured impedance of the treatment area; and lesioning of the treatment area to form the ablation zone using the preferred ablation probe or probes and/or the scheduled sequence of the bust intervals and the pause intervals via efficient transfer of RF power to the treatment area as facilitated thereby.
2. The method of claim 1 , wherein the impedance matching is performed by determining a complex conjugate of the measured impedance.
3. The method of claim 2, wherein the selecting of the preferred ablation probe or probes via the impedance matching, and operation of an RF generator at a selected frequency and a selected amplitude facilitates the efficient transfer of power to the treatment area.
4. The method of claim 3, wherein the selecting of the preferred ablation probe or probes includes selecting different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of at least one electrode, and/or having different placement of the at least one electrode, specifically, wherein the lesioning of the treatment area comprises energizing the at least one electrode using the RF generator connected to the preferred ablation probe or probes.
5. The method of any of the preceding claims, wherein the determining of the scheduled sequence of the burst intervals and the pause intervals, and operation of an RF generator connected to the ablation probe or probes facilitates the efficient transfer of power to the treatment area.
6. The method of any of the preceding claims, wherein the lesioning of the treatment area comprises energizing and deenergizing at least one electrode of the ablation probe or probes according to the scheduled sequence of the burst intervals and the pause intervals using the RF generator.
7. A method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method comprising; inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area ; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; measuring an impedance of the treatment area between the first tip portion and the second tip portion using energy transferred between the first ping probe and the second ping probe; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to the measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at least one electrode using an RF generator connected thereto; and lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
8. The method of claim 7, wherein the measuring of the impedance of the treatment area comprises energizing a first electrode provided on one of the first tip portion and the second tip; and receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion, specifically, wherein the impedance matching is performed by determining a complex conjugate of the measured impedance.
9. The method of any of the claims 7 or 8, wherein the selecting of the preferred ablation probe or probes via the impedance matching, and operation of the RF generator at a selected frequency and a selected amplitude facilitates the efficient transfer of power from the at least one electrode to the treatment area.
10. The method of claim 9, wherein the selecting of the ablation probe or probes includes selecting different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of the at least one electrode, and/or having different placement of the at least one electrode.
11. The method of any of the claims 8 to 10, wherein the determining of the scheduled sequence of the burst intervals and the pause intervals, and operation of the RF generator connected to the ablation probe or probes facilitates the efficient transfer of power from the at least one electrode to the treatment area, specifically, wherein the lesioning of the treatment area comprises energizing and deenergizing the at least one electrode of the ablation probe or probes according to the scheduled sequence of the burst intervals and the pause intervals using the RF generator.
12. A method for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body using a radio frequency (RF) ablation probe or probes, the method comprising; at least one of selecting a preferred ablation probe or probes from a selection of ablation probes based via impedance matching of the properties thereof to a measured impedance of the treatment area, and determining a scheduled sequence of burst intervals and pause intervals to be applied by an ablation probe or probes according to the measured impedance of the treatment area; energizing at least one electrode using an RF generator connected thereto; and lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
13. The method of claim 12, wherein the impedance matching is performed by determining a complex conjugate of the measured impedance.
14. The method of any of the claims 12 or 13, wherein the selecting of the preferred ablation probe or probes via the impedance matching, and operation of the RF generator at a selected frequency and a selected amplitude facilitates the efficient transfer of power the treatment area.
15. The method of any of the claims 12 to 14, wherein the selecting of the ablation probe or probes includes selecting different properties thereof to facilitate the impedance matching including being cooled, being uncooled, having different dimensions of the at least one electrode, and/or having different placement of the at least one electrode.
16. The method of any of the claims 12 to 15, wherein the determining of the scheduled sequence of the burst intervals and the pause intervals, and operation of the RF generator connected to the ablation probe or probes facilitates the efficient transfer of power from the at least one electrode to the treatment area.
17. The method of any of the claims 12 to 16, wherein the lesioning of the treatment area comprises energizing and deenergizing the at least one electrode of the ablation probe or probes according to the scheduled sequence of the burst intervals and the pause intervals using the RF generator.
18. A system for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body, comprising a a radio frequency (RF) ablation probe or probes, wherein the radio frequency (RF) ablation probe or probes are configured for: inserting a first ping probe into the vertebral body and positioning a first tip portion thereof adjacent a first side of the treatment area; inserting a second ping probe into the vertebral body and positioning a second tip portion thereof adjacent a second side of the treatment area; energizing a first electrode provided on one of the first tip portion and the second tip portion; receiving energy from the first electrode across the treatment area at a second electrode provided on the other of the first tip portion and the second tip portion; and measuring an impedance of the treatment area between the first tip portion and the second tip portion; wherein the ablation probe or probes are selected based on an impedance matching of the properties thereof to the measured impedance of the treatment area, and configured to apply a determined scheduled sequence of burst intervals and pause intervals according the measured impedance of the treatment area; wherein the ablation probe or probes are further configured for lesioning of the treatment area to form the ablation zone and/or the scheduled sequence of the bust intervals and the pause intervals via efficient transfer of RF power to the treatment area as facilitated thereby.
19. The system of claim 18, wherein the system further comprises an RF generator, specifically, wherein selecting of the ablation probe or probes via the impedance matching, and an operation of the RF generator at a selected frequency and a selected amplitude are configured to facilitate the efficient transfer of power to the treatment area.
20. A system for lesioning of diseased tissue to form an ablation zone encompassing all or portions of a treatment area in a vertebral body, comprising a radio frequency (RF) ablation probe or probes and an RF generator, wherein the radio frequency (RF) ablation probe or probes are configured to be; selected from a selection of ablation probes based via impedance matching of the properties thereof to a measured impedance of the treatment area, and wherein the radio frequency (RF) ablation probe or probes are configured to apply a determined scheduled sequence of burst intervals and pause intervals according to the measured impedance of the treatment area; wherein the ablation probe or probes are further configured for energizing at least one electrode using the RF generator connected thereto; and for lesioning of the treatment area to form the ablation zone using the at least one electrode via efficient transfer of RF power from the at least one electrode to the treatment area as facilitated by the impedance matching and/or the scheduled sequence of the burst intervals and the pause intervals.
PCT/EP2024/086812 2023-12-19 2024-12-17 Method of using an ablation probe or probes to create an ablation zone in tissue Pending WO2025132371A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202363612178P 2023-12-19 2023-12-19
US63/612,178 2023-12-19

Publications (1)

Publication Number Publication Date
WO2025132371A1 true WO2025132371A1 (en) 2025-06-26

Family

ID=94216830

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2024/086812 Pending WO2025132371A1 (en) 2023-12-19 2024-12-17 Method of using an ablation probe or probes to create an ablation zone in tissue

Country Status (1)

Country Link
WO (1) WO2025132371A1 (en)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008014465A2 (en) * 2006-07-28 2008-01-31 Jnj Technology Holdings, Llc Ablation apparatus and system to limit nerve conduction
US20140031715A1 (en) * 2012-07-30 2014-01-30 Michael David SHERAR Coil electrode apparatus for thermal therapy for treating bone tissue
US20150320480A1 (en) * 2014-05-06 2015-11-12 Chenes Llc Electrosurgical generator
US20190083159A1 (en) * 2016-03-04 2019-03-21 Creo Medical Limited Electrosurgical instrument having multiple treatment modalities
US20210038280A1 (en) * 2019-08-08 2021-02-11 John Pikramenos Electrosurgical generator for optimizing power output
US20230126626A1 (en) * 2021-10-26 2023-04-27 DIXI Neurolab, Inc. Configurable multi-polar rf ablation probe

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008014465A2 (en) * 2006-07-28 2008-01-31 Jnj Technology Holdings, Llc Ablation apparatus and system to limit nerve conduction
US20140031715A1 (en) * 2012-07-30 2014-01-30 Michael David SHERAR Coil electrode apparatus for thermal therapy for treating bone tissue
US20150320480A1 (en) * 2014-05-06 2015-11-12 Chenes Llc Electrosurgical generator
US20190083159A1 (en) * 2016-03-04 2019-03-21 Creo Medical Limited Electrosurgical instrument having multiple treatment modalities
US20210038280A1 (en) * 2019-08-08 2021-02-11 John Pikramenos Electrosurgical generator for optimizing power output
US20230126626A1 (en) * 2021-10-26 2023-04-27 DIXI Neurolab, Inc. Configurable multi-polar rf ablation probe

Similar Documents

Publication Publication Date Title
US11617614B2 (en) Multi-probe system using bipolar probes and methods of using the same
EP2101668B1 (en) Tissue ablation using pulse modulated radio frequency energy
US8795270B2 (en) System and method for ablating tissue
EP2965784B1 (en) Tissue ablation system with phase-controlled channels
US6139546A (en) Linear power control with digital phase lock
EP2293733B1 (en) System for performing electrosurgical procedures
EP2449990B1 (en) Multichannel ablation with frequency differentiation
US20140296840A1 (en) Impedance matching in a microwave electrosurgical system
JP6122239B2 (en) Dual antenna assembly with user controlled phase shift
US20100145424A1 (en) Method for Treatment of an Intervertebral Disc
JP2022037870A (en) Blending ire and rf ablation using sine wave generator
EP1639956B1 (en) Arrangement for therapy of tumours
WO2025132371A1 (en) Method of using an ablation probe or probes to create an ablation zone in tissue
KR20230005947A (en) Needle Array Devices and Related Methods
US20250186111A1 (en) Probe, system, and method for forming a lesion in a target tissue
AU2019312205B2 (en) Dispersive return pad with phase change material for active thermal management during an ablation procedure
EP3902489B1 (en) System for measuring heat transfer due to local tissue perfusion prior to an ablation procedure

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 24834336

Country of ref document: EP

Kind code of ref document: A1