Safety, feasibility, and technical success of percutaneous cryoablation to treat vascular anomalies of the extremities

Abstract

Aim

This retrospective study aims to ascertain the safety and efficacy of percutaneous cryoablation in treating vascular anomalies in the extremities.

Materials and Methods

Anomaly characteristics and safety metrics were extracted from the chart including complications classified according to the Cardiovascular and Interventional Radiological Society of Europe adverse event scale. Technical success was defined as achieving preprocedural goals in delivering cryotherapy to the targeted anatomy in the prescribed number of sessions. Clinical outcome metrics included assessment of reported symptom improvement and objective improvement on imaging.

Results

Eight patients met the selection criteria: seven paediatric patients aged 1–18 years and one adult patient aged 45 years, including six females and two males. Seven patients had vascular malformations and one had a vascular tumour. The most common presenting symptoms included localised pain, swelling, and loss of extremity function. Technical success was achieved in all eight patients. Reduction of pain was reported in all eight patients at follow-up in a clinic. Reduction of lesion size on imaging was seen for patients undergoing follow-up imaging. One major adverse event occurred in 11 treatment sessions (9%) resulting in a dermal blister with subsequent spontaneous healing within 6 weeks; a subsequent session was tolerated without incident. Other postoperative adverse effects were minor and transient; all complications and postoperative adverse effects resolved spontaneously within 2 months.

Conclusion

Cryoablation appears to be an effective and safe treatment in those with vascular anomalies, especially in those previously ineffectively treated with surgery or sclerotherapy, as was seen in seven of eight patients in this study.