MR-guided laser ablation

Visualase™ MRI-guided laser ablation

MR-guided laser ablation

Visualase™ MRI-guided laser ablation

Visualase™ is a minimally-invasive surgical option to ablate epileptic foci, brain tumors, and radiation necrosis.

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Indications, Safety, and Warnings

Description

Visualase™ is an MRI-guided laser ablation system used to perform laser interstitial thermal therapy (LITT), a minimally invasive surgical alternative to open craniotomy. LITT may benefit patients with brain tumors, radiation necrosis, or medically refractory focal epilepsy.

Visualase™ MRI-guided laser ablation system lets you monitor tissue ablation in real-time. It provides significant advantages to the patient:

  • Small catheter — 1.65 mm diameter
  • Requires a very small incision and 3.2 mm burr hole
  • Requires minimal sutures, typically a single stitch1,2
  • Most patients have little or no hair removed
  • Less scarring compared to open procedures
  • Most patients are discharged after a shorter stay compared to open procedures — typically one day3–8
  • Requires no ionizing radiation or large skull flap

How the Visualase™ ablation system works

The Visualase™ system delivers laser energy through a small catheter into unwanted soft tissue targets in the brain. When laser energy is absorbed by the target tissue, temperature rises and, over time, creates an irreversibly damaged thermal lesion.

A workflow that works with your hospital

The Visualase™ system supports a workflow that addresses the unique challenges of performing a procedure within the MRI bore.

A healthcare provider holds the Visualase™ anchor bolt.
A patient receives MRI-guided laser ablation.

Plan: The surgeon plans the approach using stereotactic planning software, and takes into account ablation coverage and catheter placement trajectory.

Laser placement: A small, flexible laser catheter is inserted in the target area. Visualase™ is compatible with many common stereotactic platforms so the surgeon and staff can stick to a workflow that is most familiar to them.

Transport to MRI: The patient is transported to the MRI in radiology, or an intraoperative MRI is brought to the patient.

MRI-guided laser ablation: A pre-ablation scan is obtained. The surgeon then selects the preferred thermal imaging planes, identifies temperature check points, and starts the ablation. As tissue heats up, the system displays the thermal damage progress.

Close: The laser applicator is removed and the small incision is typically closed with just one suture required.1,2 The patient is then moved to recovery and in many cases goes home the next day.3–8

Is a Visualase™ procedure right for your patient?

Our team is here to support you with the information you need to make the most informed decisions for your patient’s care. Medtronic U.S. clinician services can be contacted at 800‑328‑0810.

Ordering information

Visualase™ capital equipment kits

Item number Description
VTTS-15

Visualase™ 15 W thermal therapy system includes:

  • Visualase™ MRI head phantom (9735656)
  • Visualase™ MRI test bottle (9735657)
  • 4 Visualase™ infrared goggles (9735555)
  • Visualase™ 15 W system (9735542)
  • Visualase™ cooled laser applicator system (VCLAS) — 10 mm (9735560)
  • Visualase™ neuro accessories (9736536)
Item number Description
VERTEK-CRT-KIT Vertek™ biopsy kit with reducing tubes includes:
Item number Description
9733936

Vertek™ biopsy kit includes:

  • Double star adapter - Mayfield mount (960-535)
  • Vertek™ II articulating arm (9734252)
  • Biopsy guide (960-539)
  • 2.2 mm reducing tube (9733214)
  • Vertek™ probe (9733158)
  • Vertek™ biopsy tray (9733770)
  • 2.6 mm reducing tube (9733215)
  • 1.9 mm reducing tube (9733213)
9735998

Cranial reducing tube set includes:

  • 1.7 mm cranial reducing tube (9735732)
  • 3.2 mm cranial reducing tube (9735733)
  • 4.0 mm cranial reducing tube (9735734)

Visualase™ neurokits

Item number Description
NEUROKIT-T03

Visualase™ cooled laser applicator system (VCLAS) (9735559) — 3 mm tip includes:

  • Laser diffusing fiber with 3 mm tip
  • 1.65 mm cooling catheter
  • Pump tubing set
  • Drainage bag

Visualase™ neuro accessories (9736536) neuro accessory kit includes:

  • Anchor bolt
  • Stiffening stylet
  • Removal tool
Item number Description
NEUROKIT-T10

Visualase™ cooled laser applicator system (VCLAS) (9735560)— 10 mm tip includes:

  • Laser diffusing fiber with 10 mm tip
  • 1.65 mm cooling catheter
  • Pump tubing set
  • Drainage bag

Visualase™ neuro accessories (9736536) neuro accessory kit includes:

  • Anchor bolt
  • Stiffening stylet
  • Removal tool

Visualase™ MR stylet kits

Item number Description
VCLAS-STYLTKIT-T03

Visualase™ cooled laser applicator system (VCLAS) (9735559) — 3 mm tip includes:

  • Laser diffusing fiber with 3 mm tip
  • 1.65 mm cooling catheter
  • Pump tubing set
  • Drainage bag

Visualase™ MR stiffening stylet (9736538)
VCLAS-STYLTKIT-T10

Visualase™ cooled laser applicator system (VCLAS) (9735560) — 10 mm tip includes:

  • Laser diffusing fiber with 10 mm tip
  • 1.65 mm cooling catheter
  • Pump tubing set
  • Drainage bag

Visualase™ MR stiffening stylet (9736538)
VCLAS-STYLTKIT-T15

Visualase™ cooled laser applicator system (VCLAS) (9735561) — 15 mm tip includes:

  • Laser diffusing fiber with 15 mm tip
  • 1.85 mm cooling catheter
  • Pump tubing set
  • Drainage bag

Visualase™ MR stiffening stylet (9736538)

Visualase™ tools and accessories

Item number Description
9736536

Visualase™ neuro accessories includes:

  • Anchor bolt
  • Stiffening stylet
  • Removal tool
  • Sterilization & Storage Tray
9736537

Visualase™ anchor bolt tools includes:

  • Sterilization & Storage Tray
  • Anchor Bolt Driver Guide for Leksell® Coordinate Frame
  • Anchor Bolt Driver Guide for ROSA ONE® Brain
  • Anchor Bolt Driver Guide for Stealth Autoguide™
  • Anchor Bolt Driver Guide for CRW® Stereotactic System
9736538

Visualase™ MR stiffening stylet
9735998

Cranial reducing tube set for PAD insertion method includes:

  • 1.7 mm cranial reducing tube (9735732)
  • 3.2 mm cranial reducing tube (9735733)
  • 4.0 mm cranial reducing tube (9735734)

Related links

  1. Jethwa PR, Lee JH, Assina R, Keller IA, Danish SF. Treatment of a supratentorial primitive neuroectodermal tumor using magnetic resonance-guided laser-induced thermal therapy. J Neurosurg Pediatr. 2011;8(5):468–475. doi:10.3171/2011.8.PEDS11148.
  2. Torres-Reveron J, Tomasiewicz HC, Shetty A, Amankulor NM, Chiang VL. Stereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery. J Neurooncol. 2013;113(3):495–503. doi:10.1007/s11060-013-1142-2.
  3. Jethwa PR, Barrese JC, Gowda A, Shetty A, Danish SF. Magnetic resonance thermometry-guided laser-induced thermal therapy for intracranial neoplasms: initial experience. Neurosurgery. 2012;71(1 suppl operative):133–145. doi:10.1227/NEU.0b013e31826101d4.
  4. Kang JY, Wu C, Tracy J, et al. Laser interstitial thermal therapy for medically intractable mesial temporal lobe epilepsy. Epilepsia. 2016;57(2):325–334. doi:10.1111/ epi.13284.
  5. Lewis EC, Weil AG, Duchowny M, Bhatia S, Ragheb J, Miller I. MR-guided laser interstitial thermal therapy for pediatric drug-resistant lesional epilepsy. Epilepsia. 2015;56(10):1590–1598. doi:10.1111/epi.13106.
  6. Patel P, Patel NV, Danish SF. Intracranial MR-guided laser-induced thermal therapy: single-center experience with the Visualase thermal therapy system. J Neurosurg. 2016;125(4):853–860. doi:10.3171/2015.7.JNS15244.
  7. Wilfong AA, Curry DJ. Hypothalamic hamartomas: optimal approach to clinical evaluation and diagnosis. Epilepsia. 2013;54(suppl 9):109–114. doi:10.1111/epi.12454.
  8. Willie JT, Laxpati NG, Drane DL, et al. Real-time magnetic resonance-guided stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy. Neurosurgery. 2014;74(6):569–585. doi:10.1227/NEU.0000000000000343.