RESUMEN
PURPOSE: To evaluate the efficacy and safety of cryoablation for venous malformations. MATERIALS AND METHODS: A total of 12 patients with symptomatic intramuscular venous malformations who underwent percutaneous cryoablation between February 2015 and December 2018 were retrospectively studied. The mean age was 42 y (range, 19-58 y). Pain was reported by 11 patients (92%) and swelling by 1 (8%). Pain was assessed with a visual analog scale (VAS) before and after cryoablation. Lesion size was followed with magnetic resonance (MR) imaging at baseline and at 3-mo follow-up. Median initial VAS score was 7 (range, 0-8), and median initial lesion size was 32.5 mm (range, 11-150 mm). RESULTS: The median VAS score at 3 mo was 0 (range, 0-4), and the median lesion size at 3 mo was 0 mm (range, 0-142 mm). Eleven of 12 patients reported an improvement in their pain. MR imaging control showed a treatment scar with no residual lesion in 5 patients and decreased lesion size in 4. No major complications were reported. One minor hematoma and 1 small myositis were noted as defined by Society of Interventional Radiology criteria. CONCLUSIONS: Percutaneous cryoablation is effective and safe for treatment of symptomatic intramuscular venous malformations, with improvement of symptoms.
Asunto(s)
Criocirugía , Músculo Esquelético/irrigación sanguínea , Venas/cirugía , Adulto , Criocirugía/efectos adversos , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Dolor Postoperatorio/etiología , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Venas/anomalías , Venas/diagnóstico por imagen , Adulto JovenRESUMEN
BACKGROUND: Primary placement of percutaneous radiologic button gastrostomy has been successfully performed in adults but research is lacking as to its success in children during cancer treatment. OBJECTIVE: To assess the safety and effectiveness of such treatment at a single center. MATERIALS AND METHODS: We conducted a 3-year retrospective feasibility study reporting on placement procedure, feeding plan, acute complications and effectiveness of this technique based on the evolution of the weight and weight-to-height during a period of 3 months. RESULTS: Eleven gastrostomies were performed in 11 children and young adults (3-20 years old) during oncological treatment. No major complications occurred. Two patients experienced minor side effects -- local leakage and granulation tissue formation -- both easily treated. In all cases, enteral feeding started within 24 h following the button placement. The patients were able to go home within 72 h. After 1 month, 64% (7/11) had gained weight, 18% (2/11) had maintained weight and 9% (1/11) had lost weight. After 3 months, 73% (8/11) had gained weight and 9% (1/11) had lost weight. CONCLUSION: The procedure and devices were well tolerated and mostly effective in our cohort.
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Gastrostomía/instrumentación , Neoplasias/complicaciones , Radiografía Intervencional , Adolescente , Adulto , Niño , Preescolar , Estudios de Factibilidad , Femenino , Humanos , Masculino , Complicaciones Posoperatorias , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenAsunto(s)
Cementos para Huesos/efectos adversos , Extravasación de Materiales Terapéuticos y Diagnósticos/diagnóstico por imagen , Radiografía Intervencional , Fracturas de la Columna Vertebral/cirugía , Arteria Vertebral , Vertebroplastia/efectos adversos , Anciano , Diagnóstico Diferencial , Femenino , Fluoroscopía , Humanos , Dimensión del Dolor , Fracturas de la Columna Vertebral/diagnóstico por imagen , Tomografía Computarizada por Rayos XAsunto(s)
Ablación por Catéter/métodos , Dolor Crónico/prevención & control , Neurofibroma/cirugía , Neoplasias de la Médula Espinal/secundario , Neoplasias de la Médula Espinal/cirugía , Dolor Crónico/etiología , Femenino , Humanos , Persona de Mediana Edad , Neurofibroma/complicaciones , Neoplasias de la Médula Espinal/etiología , Resultado del TratamientoRESUMEN
OBJECTIVE: Cryoablation is being more and more often used to treat desmoid tumors. We report our experience of cryoablation as a local and analgesic treatment for inoperable or recurring desmoid tumors. METHODS: This study includes 34 patients who underwent percutaneous cryoablation of 41 desmoid tumors between July 2012 and September 2016. All patients underwent pain assessment using a visual analog scale (VAS) and preoperative imaging. All cryoablation procedures were performed using the same cryoablation system. Patients received clinical and radiological follow-up at 6 months post-procedure, with pain-rating and adverse events being recorded. A long-term follow-up was achieved until 31 December 2018. Disease-free survival at 3 years was also recorded. Radiological tumor response was determined by tumor measurements using RECIST 1.1. RESULTS: Twelve patients benefitted from curative treatment on 100% of the tumor volume, but 22 patients received debulking treatment because of the risk of neighboring structures. Two patients had a postoperative hematoma grade 2 of the CIRSE classification system for complications, and two patients had grade 4 complications involving palsy of the common fibular nerve. Disease-free survival at 3 years was 42.2%. The mean VAS pain scores were 5.7 and 2.4 at pretreatment and 6 months, respectively, showing a mean reduction of 3.3 (p < 0.001). At 6 months, all measured tumor dimensions were significantly lower than pretreatment. CONCLUSION: Cryoablation is an effective therapeutic option for the local treatment and for the analgesic management of desmoid tumors.
Asunto(s)
Analgesia/métodos , Criocirugía/métodos , Fibromatosis Agresiva/complicaciones , Fibromatosis Agresiva/cirugía , Dolor/etiología , Dolor/cirugía , Adolescente , Adulto , Anciano , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
PURPOSE: To evaluate safety, feasibility and efficacy of percutaneous cryoablation of breast tumours in patients with clinically stable metastatic breast cancer, and to compare the findings with reports on alternative procedures, namely surgery and local radiotherapy. METHODS: 17 female patients (average age of 54.8 years ± 10.8; range 37-72) with primary breast tumour not surgically treated because of metastatic disease were included. Patients were treated for their primary lesion by percutaneous cryotherapy in period of stable disease. This minimally intervention was performed using ultrasound or CT scan guidance. All patients had clinical and breast-MRI evaluation before and at 1, 3, 6 and 12 months after the procedure. RESULTS: All procedures were performed under local anaesthesia and technically successful. The mean largest diameter of the primary lesions was 16 ± 12 mm (size range 5-45 mm). In 15 patients, we obtained a complete regression of the primary breast lesion without recurrence during the follow-up period. Two patients with lesions measured at 40 and 45 mm had recurrence in follow up period. A second session of cryotherapy was performed for these 2 patients, not included in this study. Five patients had painful masses before cryotherapy. All were immediately relieved after the intervention and durably during all follow-up. CONCLUSION: These results show that the cryoablation of primary breast lesions seems to be well suited to the palliative care of metastatic patients, particularly because of its good tolerance, low complication rate and ability to provide local or analgesic control. Advances in knowledge: Therapies are limited for these symptomatic patients at metastatic state of primary breast tumour. This study shows that cryoablation in palliative care is achievable in common practice, is effective in local control of the tumour and can provide immediate and long-term analgesic control.