Overview
Ablation refers to " destroying." Ablation therapy is a type of minimally invasive procedure that is used to get rid of aberrant tissue that can be manifested in different clinically abnormal conditions.
Ablation is most effective for tumors smaller than 3 cm in diameter. It may be used in conjunction with embolization for bigger tumors (1 to 2 inches or 3 to 5 cm wide). Because ablation frequently kills part of the normal tissue surrounding the tumor, it may not be suitable for treating cancers near major blood arteries, the diaphragm, or major bile ducts.
Ablation may be required for the following cases: A catheter or cardiac ablation: This is performed to treat a heart arrhythmia (irregular heartbeat). The goal is to restore normal heart rhythm by destroying regions of the heart that cause irregular heartbeats.
Endometrial ablation: Women who experience heavy menstrual bleeding may benefit from ablation of the endometrium (the lining of the uterus).
Ablation for cancer: Tumors of the kidneys, liver, and other organs can be treated with ablation techniques if surgery is not an option.
Alternate names
Radiofrequency ablation, cardiac ablation, catheter ablation
Body Location
Heart, liver, kidneys, lungs, thyroid, endometrium, and others.
How is it performed?
Some of the clinically approved methods that are widely performed are as follows:
Microwave ablation: Usually, a thin probe is inserted through a small incision in the skin guided by imaging tools, such as ultrasound, computed tomography (CT), or MRI (magnetic resonance imaging), to locate the area to be treated. The tip of the probe generates microwaves to destroy or ablate the tissue.
High-energy radiofrequency ablation: Same as the above technique. Radiofrequency (RF) is used instead of microwaves.
Thermal balloon ablation: A balloon is inserted at the desired anatomical location filled with fluid heated to approximately 88 degrees celsius to destroy undesired tissues.
Laser ablation: A beam of a laser can be used to treat skin discolorations, lesions, or abnormal growth.
Cryoablation: A probe or similar device supercooled to around -15-degrees celsius is inserted using a thin needle or applied to the tissue. Liquid nitrogen or argon is used to reach such low temperatures. The extremely cold gas flows through the organ causing ice crystals to form and rupture the tissue.
Preparation
Different radiological tests or blood tests may be required to analyze the condition of the heart and other disease-specific risk factors. On or before the day of the procedure following general preparations may be required.
The patients must accompany a person to take back home as they will not be able to drive or operate machinery for at least 24 hours after the procedure.
No eating or drinking is allowed after midnight the night before the procedure, except for a small amount of water if needed to take medications on the day of the procedure.
Patients who have diabetes and use insulin should consult the doctor to adjust or manage diabetic medication accordingly. Diabetes medication must be carried out such that one can take it after the procedure.
Any blood-thinning medications or antiplatelet medications must be stopped with appropriate permission.
Continue to take all other medications with minimal water before and after surgery in consultation with your primary care physician.
Procedure type
Minimally invasive procedure
Follow-up
A follow-up at regular intervals is suggested as per the condition and the clinician who performed the procedure. Sometimes a device called an “Event monitor” is provided to record any abnormal physiological response (aberrant heartbeat, dizziness, or pain)
Risks
The general procedural risks that rarely includes death are as follows:
- Bleeding or infection due to catheter or probe insertion.
- Damaged blood vessels in neighboring regions.
- Arrhythmias due to undesired destruction of an electrical circuit of the heart.
- Blood clots.
- Punctures or damage in the heart valves.
- Stroke or heart attack.
- Narrowing of the veins between the lungs and heart.
- Kidney damage from dye/radiation.
Recovery
As it is a minimally invasive procedure, most people can return home on the same day of the procedure or require an overnight stay at the hospital. They can return to normal activities within a few days after leaving the hospital. They need to follow certain guidelines at home for faster recovery:
Avoid heavy physical activity for a few days.
Avoid driving for 48 hours after the procedure.
They may have a small bruise from the catheter insertion. If it starts to bleed, consult the doctor immediately.
Ablation therapy does not guarantee a complete and non-recurrent recovery from the condition. The condition may recur depending on the case and the patient’s physical status. However, this newer technique has shown greater than 60-70% success on average in difficult cases.
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