Percutaneous Cryoablation of Symptomatic Intramuscular Venous Malformation.

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.

Local Control and Analgesic Efficacy of Percutaneous Cryoablation for Desmoid Tumors.

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.

Percutaneous Cryotherapy for Treatment of Chondroblastoma: Early Experience.

Surgical curettage is currently the standard of care for the chondroblastoma, but in peri-articular tumors it is limited by its morbidity. In this preliminary report, we evaluate the feasibility of percutaneous cryotherapy as an alternative ablative treatment for chondroblastoma. Three patients with a chondroblastoma treated by CT scan-guided cryotherapy are presented in this article. Pain permanently disappeared 2 days after the procedure. No local tumor recurrence or cartilage damage was observed by MRI performed 1 year after the intervention. This preliminary case report suggests that percutaneous cryotherapy may be a possible alternative to the current standard of care in chondroblastoma. Further studies are needed to evaluate if this technique offers similar anti-tumoral efficacy while providing better pain relief and less morbidity than curettage.