Cooled RF suprascapular nerve

[Timeoutofmind]

I have had a few people with good relief with the block, and marginal relief with the thermal RF (90 degress, 90seconds, two lesions)

Was thinking of offering them cooled RF, or even switching to cooled right off the bat for all. They are 90+ year old, non-operative candidates with severe disease so I feel bad just telling them nothing else to offer.

I guess my concern is that the cooled lesion is much bigger and possibly destroying the suprascapular artery. I am not sure what the consequences of this would be as its a pretty big vessel?

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[Agast]

I'm not sure your single peripheral RFA procedure would cover the cost of the $650 cooled RF probe...?

 

[DODOCSS]

facility/hosp

 

[dhcofc]

my concern is that the cooled lesion is much bigger and possibly destroying the suprascapular artery

My understanding of RF lesions is that blood vessels are carrying enough cooler (37 degree vs 80 degree) blood through them that the vessel does not get irreversibly damaged. I’ve never seen evidence that a blood vessel stops being a functional vessel after RFA because of the heat exchange with blood cooler than the hot tissue around it. I wouldn’t worry about vessel damage with a RF lesion.

 

[pastafan]

When you did thermal how many volts did it take to get muscle twitch?

 

[Orin]

Is anyone sending folks for embolizations? The data there are interesting

 

[No_Pain_No_Gain]

Could consider peripheral nerve stimulation for these patients as well.

 

[deleted993114]

My understanding of RF lesions is that blood vessels are carrying enough cooler (37 degree vs 80 degree) blood through them that the vessel does not get irreversibly damaged. I’ve never seen evidence that a blood vessel stops being a functional vessel after RFA because of the heat exchange with blood cooler than the hot tissue around it. I wouldn’t worry about vessel damage with a RF lesion.

I have done suprascapular cryo for many years with great results. The problem is that insurance now considers it experimental.

Be careful of rf in myelinated nerves.