Dr. Guttler’s comments:
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To decrease the amount of residual nodule tissue left after the first ablation there are two methods to help.
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The Artery Ablation. This is the first thing to do. The feeder artery can be ablated by inserting the tip of the electrode into the artery.The heat loss ( heat sink effect) from the artery can effect the power needed to ablate the nodule. When microbubbles occur the artery ablated. This is also a good way to reduce the chance of hemorrhage.
Image of a parathyroid adenoma with the feeder artery that can be RFA ablated before doing the ablation of the PTA.
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The marginal vein draining the nodule also causes heat sink.
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After puncturing the vein with the electrode and ablation is begun as soon as micobubbles occur the vein is ablated.
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Now you can continue to ablate the nodule with the lowest power in watts because you have prevented the vascular heat sink effect.
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