Radiofrequency ablation Parathyroid Adenoma

Alternative to surgery?

Xinyang Li, et al Endocrine Practice Article July 23 2021.

DR.Guttler’s comments:

  1. 25 patients who were treated with RFA for pHPT in this report.

  2. 21/25 had normal PTH at 6 months.

  3. Minor complications of neck pain and one case of transient voice change.

  4. The used hydrodissection to set a 5 mm barrier between the PTA and vital structures. They injected 10-30 ml normal saline in order to avoid thermal injury of critical structures by forming a liquid isolation zone greater than 5 mm between the parathyroid

    and adjacent structures.

  5. I do not use saline as it is an conductor of electricity. I use dextrose instead.

  6. RFA was performed using the moving-shot technique and trans-

    isthmic approach.

  7. The RFA power was 3-7 Watts.

  8. If a transient hyperechoic zone did not form at

    the electrode tip within 5–10 s, the radiofrequency power was gradually increased.

  9. Failed response occurred with a larger size adenoma and if multiple glands were involved.

  10. Ideal size for RF ablation is around 1 cm.

  11. Very small PTAs <0.6 cm are also more difficult to ablate.

  12. The procedure takes about 5 minutes.

If you have a parathyroid adenoma and are interested in eeing if RFA is for you call me at 310-393-8860 or email to

Ask for Alicia


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