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RFA machine

paindoctn

Full Member
7+ Year Member
Nov 23, 2013
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www.omegapaindoctor.com
  1. Attending Physician
Looking to buy an in-house RFA machine. Have done some research: Stryker is very expensive, Neurotherm - I used to work with it ~ 7yrs ago (needles were very nice, machine was glitchy, bad experience). Have narrowed my choices to Medronic Accurian and Boston Sci Cosman systems. Medronic Accurian system has been on the market for ~ 1 yr. Anyone with first hand experience with it? Any complaints? I know Cosman has been around for a long time.
2) Also, Medtronic Accurian brochure shows 18, 20, 22G (10mm) probes all having the same burn lesion sizes. Is it true? If that's the case, I'd love to go with the smallest size I can (22G vs 18G). I just want to give 10mg Valium PO 30 min PTProcedure. Don't want to torture lumbar RFA pts unnecessarily w/6 x 18G needles.
 
Last edited:

cowboydoc

Full Member
5+ Year Member
Jan 2, 2016
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813
166
  1. Attending Physician
Looking to buy an in-house RFA machine. Have done some research: Stryker is very expensive, Neurotherm - I used to work with it ~ 7yrs ago (needles were very nice, machine was glitchy, bad experience). Have narrowed my choices to Medronic Accurian and Boston Sci Cosman systems. Medronic Accurian system has been on the market for ~ 1 yr. Anyone with first hand experience with it? Any complaints? I know Cosman has been around for a long time.
2) Also, Medtronic Accurian brochure shows 18, 20, 22G (10mm) probes all having the same burn lesion sizes. Is it true? If that's the case, I'd love to go with the smallest size I can (22G vs 18G). I just want to give 10mg Valium PO 30 min PTProcedure. Don't want to torture lumbar RFA pts unnecessarily w/6 x 18G needles.
Have only seen the accuruian in a demo, but the lesion size claim doesn’t pass the smell test (and defies physics?)

I just ordered a new Stryker. Think the system got the generator for $18k, but leads are $1200 each, Venom needles are nearly $30 each.
 

myrandom2003

Member
15+ Year Member
Nov 4, 2004
828
276
316
  1. Attending Physician
Can get the Medtronic unit placed for “free” if you use about 10k worth rf supplies yearly for about 3 years.
Can also work out a deal if you do stim.

Medtronic can drive power individually to each probe which is nice. Also
Can add on cooledRf component if you ever want to and cost comes down.

I have demo’d all the units, which is what you should do, which means free supplies. And decide for yourself.

Put the demos on a day where you can stack 4-5 cases per company.




Sent from my iPhone using SDN
 
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paindoctn

Full Member
7+ Year Member
Nov 23, 2013
14
15
206
TN
www.omegapaindoctor.com
  1. Attending Physician
Can get the Medtronic unit placed for “free” if you use about 10k worth rf supplies yearly for about 3 years.
Can also work out a deal if you do stim.

Medtronic can drive power individually to each probe which is nice. Also
Can add on cooledRf component if you ever want to and cost comes down.

I have demo’d all the units, which is what you should do, which means free supplies. And decide for yourself.

Put the demos on a day where you can stack 4-5 cases per company.




Sent from my iPhone using SDN



myrandom2003, any problems w/ Medtronic overall from your experience? they've only been on the market for ~1yr.
 

myrandom2003

Member
15+ Year Member
Nov 4, 2004
828
276
316
  1. Attending Physician
myrandom2003, any problems w/ Medtronic overall from your experience? they've only been on the market for ~1yr.

Nope, it took a while to get so only used for 5 months. They have had rf machines for a long time in the interventional radiology realm. Also they have a cooled rf machine for a few years for vertebral Mets.

Same tech different packaging.


Sent from my iPhone using SDN
 

strike5858

Full Member
10+ Year Member
May 12, 2011
77
15
236
  1. Medical Student
Have any practices thought about passing on the extra cost of the venom needles to the patients.
ie having a standard option which is whatever the insurance covers and you get the regular needles but if you pay for the for venom needles we can use that?
 

Ligament

Interventional Pain Management
15+ Year Member
Jan 9, 2002
6,168
2,705
326
  1. Attending Physician
I've used the Neurotherm NT2000 on 1000+ of RF cases, almost zero problems except a firmware update where they limited max power, requiring a staggered start if doing a 4 level lesion. Otherwise, reliable machine. RF probes tend to break often, but I share them in a surgery center, where they get a lot of use and probably not very ginger handling with the autoclave. Also, we only have the non-nitinol probes in the ASC. The nitinol probes may be much more durable. RF cannulae are cheap.

I am using the Stryker unit now (newest version). And it is very good; gets up to temp fast, stable, easy user interface. The cannulae are $20 for non-venom and $30-$40 for venom; meaning if you do a 4 level venom case its $120 in disposable needles up front. Thats expensive. However, the overall equipment is good. Their probes are nitinol as as standard equipement, and seem very durable. Have only done a couple dozen cases on this machine so far.
 
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