Development of an ultrasound-guided radiofrequency ablation technique in the equine cadaveric distal limb: histological findings and potential for treating chronic lameness.
Abstract: Radiofrequency (RF) relieves chronic pain in humans, but it is unexplored in horses affected by chronic lameness. This study aims to describe the technique and the histological effects of ultrasound (US)-guided radiofrequency ablation (RFA) of palmar digital nerves (PDNs) in horse's fetlock and pastern, . Unassigned: After assessing the US anatomy of lateral and medial PDNs in fetlock and pastern ( = 10 horses; 20 forelimbs), US-guided RFA was performed on these sites in cadaveric forelimbs ( = 10) applying four different settings with increasing invasiveness ( = 40 total treatments): 60°C, 6 min (GROUP LOW); 70°C, 4 min (GROUP MEDIUM); 90°C, 2 min (GROUP HIGH); 80°C, 8 min (GROUP VERY HIGH). Needle-tip-to-nerve proximity was assessed with US and methylene blue, injected through the port of the RF needle. Nerves were collected for microscopical assessment. Unassigned: Transverse palmaro-lateral and palmaro-medial US images of fetlock and pastern detected PDNs consistently, close to the palmar digital artery. With in-plane US technique, RFA was performed at target in 31/40 cases, with significantly higher number of failures in fetlock ( = 0.008). PDNs histology identified thermal injury/coagulation with axonal degeneration and collagen homogenation. Nuclear smearing of arterial leyomyocytes was also observed. Nerve coagulation was significantly associated with treatment ( = 0.03) and needle-tip-to-nerve proximity (US distance: = 0.009; blue distance: = 0.04). Unassigned: The PDNs were easily visualized and reached with the RF needle by US in-plane-guided technique. RFA produced axonal thermal damage and intensity-related coagulation effectiveness. To ensure effective nerve coagulation, it is crucial that the needle is accurately positioned in close proximity to the target nerve. Based on the histopathological findings, HIGH and VERY HIGH RFA treatments might be worth of being tested in clinical studies aimed at treating chronic lameness of the distal forelimb in horses.
Copyright © 2024 Amari, Rabbogliatti, Ravasio, Auletta, Brioschi, Riccaboni, Dell’Aere and Roccabianca.
Publication Date: 2024-08-23 PubMed ID: 39247124PubMed Central: PMC11377333DOI: 10.3389/fvets.2024.1437989Google Scholar: Lookup
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Summary
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This research article discusses a study where ultrasound-guided radiofrequency ablation (RFA) was developed and tested on the distal limbs of equine cadavers in order to explore potential treatment methods for chronic lameness in horses.
Objective and Methodology
- The study aimed to describe the technique and histological effects of ultrasound (US)-guided radiofrequency ablation (RFA) on the palmar digital nerves (PDNs) in the fetlock and pastern of equine limbs.
- The US anatomy of the medial and lateral PDNs was first assessed in 10 horses (20 forelimbs). US-guided RFA was then performed on cadaveric forelimbs using four different methods (or groups) with varying levels of invasiveness: GROUP LOW (60°C, 6 min), GROUP MEDIUM (70°C, 4 min), GROUP HIGH (90°C, 2 min), and GROUP VERY HIGH (80°C, 8 min).
Results
- Transverse US images of the fetlock and pastern consistently detected PDNs close to the palmar digital artery.
- The study encountered more failures in fetlock with a statistically significant divergence.
- The effects of RFA on the nerves showed thermal injury or coagulation, axonal degeneration, and collagen homogenation. Thermal treatment also resulted in nuclear smearing in the arterial leyomyocytes.
- The study reveals that the effectiveness of nerve coagulation was significantly associated with the type of treatment and the proximity of the needle-tip to the nerve.
Achievements and Further Research
- The study successfully visualized and treated PDNs using an US in-plane-guided technique with a RF needle
- The study demonstrated that RFA resulted in axonal thermal damage and varying levels of coagulation effectiveness, depending on the intensity.
- To ensure effective nerve coagulation, the study highlighted the importance of accurately positioning the needle close to the target nerve.
- Based on their findings, the researchers suggest that HIGH and VERY HIGH RFA treatments should be tested in clinical studies with the goal of potentially treating chronic lameness in horses’ distal forelimbs.
Cite This Article
APA
Amari M, Rabbogliatti V, Ravasio G, Auletta L, Brioschi FA, Riccaboni P, Dell'Aere S, Roccabianca P.
(2024).
Development of an ultrasound-guided radiofrequency ablation technique in the equine cadaveric distal limb: histological findings and potential for treating chronic lameness.
Front Vet Sci, 11, 1437989.
https://doi.org/10.3389/fvets.2024.1437989 Publication
Researcher Affiliations
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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