Benhur D Henz1, Paul A Friedman2, Charles J Bruce2, David R Holmes2, Mark Bower3, Malini Madhavan2, Christopher V DeSimone2, Douglas Wahnschaffe4, Steven Berhow4, Andrew J Danielsen5, Dorothy J Ladewig5, Susan B Mikell5, Susan B Johnson2, Scott H Suddendorf2, Tomas Kara6, Gregory A Worrell3, Samuel J Asirvatham7. 1. Instituto Brasília de Arritmia, Brasília, Brazil. 2. Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States. 3. Division of Neurology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States. 4. Access Point Technologies, Rogers, MN, United States. 5. Mayo Clinic, Rochester, MN, United States. 6. Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States; ICRC - Department of Cardiovascular Diseases, St Anne's University Hospital, Brno, CZ, United States. 7. Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States; Department of Pediatrics and Adolescent Medicine Mayo Clinic, Rochester, MN, United States. Electronic address: asirvatham.samuel@mayo.edu.
Abstract
BACKGROUND: Pharmacology frequently fails for the treatment of epilepsy. Although surgical techniques are effective, these procedures are highly invasive. We describe feasibility and efficacy of minimally invasive mapping and ablation for the treatment of epilepsy. METHODS: Mapping and radiofrequency ablations were performed via the venous system in eleven baboons and three dogs. RESULTS: Mapping in deep cerebral areas was obtained in all animals. High-frequency pacing was able to induce seizure activity of local cerebral tissue in 72% of our attempts. Cerebral activity could be seen during mapping. Ablative lesions were deployed at deep brain sites without steam pops or sudden impedance rise. Histologic analysis showed necrosis at the sites of ablation in all primates. CONCLUSION: Navigation through the cerebral venous system to map seizure activity is feasible. Radiofrequency energy can be delivered transvenously or transcortically to successfully ablate cortical tissue in this animal model using this innovative approach.
BACKGROUND: Pharmacology frequently fails for the treatment of epilepsy. Although surgical techniques are effective, these procedures are highly invasive. We describe feasibility and efficacy of minimally invasive mapping and ablation for the treatment of epilepsy. METHODS: Mapping and radiofrequency ablations were performed via the venous system in eleven baboons and three dogs. RESULTS: Mapping in deep cerebral areas was obtained in all animals. High-frequency pacing was able to induce seizure activity of local cerebral tissue in 72% of our attempts. Cerebral activity could be seen during mapping. Ablative lesions were deployed at deep brain sites without steam pops or sudden impedance rise. Histologic analysis showed necrosis at the sites of ablation in all primates. CONCLUSION: Navigation through the cerebral venous system to map seizure activity is feasible. Radiofrequency energy can be delivered transvenously or transcortically to successfully ablate cortical tissue in this animal model using this innovative approach.
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Authors: Prakriti Gaba; Christopher V DeSimone; Benhur D Henz; Paul A Friedman; Charles J Bruce; David R Holmes; Malini Madhavan; Krithika Vasudevan; Douglas Wahnschaffe; Steven Berhow; Andrew J Danielsen; Dorothy J Ladewig; Susan B Mikell; Susan B Johnson; Scott H Suddendorf; Tomas Kara; Gregory A Worrell; Samuel J Asirvatham Journal: J Neurol Neurophysiol Date: 2016-05-25
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