Cryoablation Therapy Cools Phantom Limb Pain
Interview with J. David Prologo, MD
Over 200,000 limb amputations are performed every year. Many amputees are patients suffering from diabetes, while others are veterans who have incurred devastating wounds during combat.
When a limb is amputated from the body, the neural pathway is interrupted, forcing the brain to reorganize its signals. Typically, this causes phantom limb sensations to occur, which can be a source of significant pain. Up to this point, there has been no blanket treatment to manage these varying effects that develop following an amputation.
“In the absence of a good treatment, what actually happens specifically for veterans…is management of the phantom limb pain using opioids, [which is accompanied by the risks and benefits of] opioid administration, including potential dependence and inability to work and reintegrate into society,” said J. David Prologo, MD, an assistant professor in the Department of Radiology and Imaging Sciences at Emory University School of Medicine in Atlanta, Georgia.
However, interventional radiologists have been developing a promising new treatment—cryoablation therapy—that could offer another option to effectively managing this patient group. Using an image-guided, minimally invasive technique, a small probe is inserted through the skin to target the specific site of scar tissue in the residual limb, which is typically the source of the phantom pain.
“The procedure itself is comparable to other thermal ablation techniques like cooled radiofrequency ablation [C-RFA] or even pulse radiofrequency ablation, in that we use needles to target our region of interest,” Dr. Prologo told Practical Pain Management. However, while those techniques use heat on the target to destroy the lesion, cryoablation instead uses “cold blasts” of pressurized Argon gas to cause a drop in temperature surrounding the probe tip.