• RFA is the use of high-frequency electrical current to heat a specific volume of tissue to temperatures high enough to cause destruction of undesired malignant cells.
• RFA is a very potent and precise technique to obliterate soft tissue tumors while minimizing damage of surrounding tissue.
• Indicated for the thermal coagulation necrosis of soft tissues, including partial or complete ablation of nonresectable lung lesions.
• Operative team should be capable of handling any and all complications quickly.
• Ideal location to perform RF Ablation of lung tumors is in an operating room equiped with guidance.
• Thoracoscopic assitance beneficial - safety to nearby vital structures during ablation.
• Lower lobe tumors (ventilation movement of the diaphragm during ablation changes the geometry of the proximity of the lower lobe tumor to the diaphragm drastically.
• Lifting of the deflated lower lobe off of the diaphragm and sometimes with takedown of the inferior pulmonary ligament in cases where the tumor is located in the lower lobe, is beneficial during ablation to protect the diaphram.
• Moving lung away from nearby vital structures (diaphragm, heart, trachea, aorta, esophagus, etc.) affords tremendous amount of safety during ablation.

RFA is a procedure in which an electrical generator originates alternating current delivered at high frequency (460,000 Hz) by a needle electrode. Ions in the tissue follow the alternating current delivered by the needle. The ionic agitation causes frictional heating resulting in protein denaturation and desiccation. Target tissue necrosis is achieved as the tissue gradually desiccates and eventually loses its ability to conduct current. A rise in impedance occurs as the lesion becomes more resistant to current flow. Tissue necrosis is completed once the tissue impedance reaches a clinically relevant level. When system achieves Roll-Off™ there is a reduction in power concurrent with an increase in impedance, signaling the clinical endpoint. The term Roll-Off refers to a precipitous decrease in current/rise in impedance, which has been shown to be a significant predictor of local control after RFA.

Roll-Off might not occur if the electrode is bathed in blood which would continue to conduct electricity even after local tumor ablation and tissue dessication had occurred.

An advanced RFA system includes a 200 watt generator and a 4.0cm electrode designed to improve efficiency. Theoretically, the 4.0cm needle will enable the ablation of 49% more volume with a single deployment than a 3.5cm needle. In addition, the new CoAccess™ electrode is designed to allow pre-treatment biopsy to be performed through the same percutaneous channel used for RFA.

• LeVeen® Needle Electrode or LeVeen CoAccess™ Electrode System

LeVeen Electrode
Indications: The LeVeen Electrode is intended to be used in conjunction with a Boston Scientific Medi-tech radiofrequency (RF) generator for the thermal coagulation necrosis of soft tissues, including partial or complete ablation of non-resectable liver lesions.

• RF 3000 Radio Frequency Generator