E-ISSN 1305-3612
Interventional Radiology - Original Article
Cryoablation of low flow vascular malformations
1 Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA  
2 Division of Endovascular Surgery and Interventional Radiology, Department of Radiology, Lexington Veterans Affairs (VA) Medical Center, Lexington, KY, USA  
3 Department of Diagnostic and Interventional Radiology, University of Texas Health Center, Houston, Texas, USA  
Diagn Interv Radiol ; : -

Abstract

PURPOSE:  Evaluate the safety and efficacy of cryoablation in the treatment of low-flow malformations, specifically Venous Malformations (VM) and Fibroadipose Vascular Anomalies (FAVA).


METHODS
:  Retrospective review of 11 consecutive patients (14 lesions; 9 VM, 5 FAVA),  median lesion volume 10.8 cm3,  (range 1.8 to 55.6 cm3) with a median age of 19 years (range 10 – 50) with low-flow malformations that underwent cryoablation to achieve symptomatic control.  Average follow up was at a median of 207 days post-procedure (range 120-886 days). Indications for treatment included focal pain and swelling. Technical success was achieved if the cryoablation ice ball covered the region of the malformation that corresponded to the patient’s symptoms.  Clinical success was considered complete if all symptoms resolved and partial if some symptoms persisted but did not necessitate further treatment.


RESULTS
:  The technical success rate was 100%. At 1 month follow-up, 13/14 (93%) lesions had a complete response and 1/14 (7%) a partial response.  At 6 month follow-up 12/13 (92%) had a complete response and 1/13 (8%) a partial response.  A total of 6 patients underwent primary cryoablation.  Out of 9 venous malformation cases, 7 had prior sclerotherapy and 2 had primary cryoablation.   Out of the 5 FAVA cases, 1 had prior sclerotherapy and the remaining 4 cases underwent primary cryoablation.  There were three minor complications following cryoablation including two cases of skin blisters and one case of transient numbness.  These complications resolved with conservative management.


CONCLUSION
:  Cryoablation is safe and effective in the treatment of low flow vascular malformations, either after sclerotherapy or as primary treatment.

 

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