Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
Diagn Interv Imaging. 2022 Nov;103(11):510-515. doi: 10.1016/j.diii.2022.07.001. Epub 2022 Aug 4.
The purpose of this study was to report the technical feasibility and outcomes of percutaneous image-guided cryoablation with temporary balloon occlusion of the renal artery for the treatment of central renal tumors.
All consecutive patients with central renal tumors treated with cryoablation and temporary renal artery occlusion from January 2017 to October 2021 were retrospectively included. Patient demographics, tumor's characteristics, procedural data, technical success, primary and secondary clinical efficacy, complications (according to Cardiovascular and Interventional Radiology Society of Europe [CIRSE] classification) and follow-up were investigated.
A total of 14 patients (8 men, 6 women; mean age 72.4 years ± 21.4 [SD] years; age range: 42-93 years) with 14 central renal tumors (median size, 32 mm; IQR: 23.5, 39.5 mm; range: 13-50 mm) were treated with percutaneous image-guided cryoablation and temporary balloon occlusion of the renal artery. Technical success was 13/14 (93%), with 1/14 (7%) failure of vascular access. A median of 4 cryoprobes (IQR: 3, 4.75) were inserted and protective hydrodissection was performed in 11/14 (79%) patients. Median time to perform cryoprobes insertion, hydrodissection and vascular access was 26.5 min (IQR: 18, 35 min), 10 min (IQR: 10, 17 min) and 30 min (IQR: 20, 45 min) respectively. Median duration of the whole intervention was 150 min (IQR: 129, 180 min; range: 100-270 min). Median hospital stay was 2.5 days (IQR: 2, 4 days; range: 2-14 days). Major complications occurred in 3/14 (21%) patients. Primary efficacy rate was 93% (13/14 patients). Median oncological follow-up was 25 months (IQR: 11, 33 months; range: 6-39 months). One patient experienced renal tumor recurrence at 14-months of follow-up, which was successfully treated with repeat cryoablation.
Percutaneous image-guided cryoablation of renal tumors with temporary balloon occlusion of the renal artery is technically feasible, with a high technical success rate and paths the way for percutaneous treatment of central renal tumors.
本研究旨在报告经皮影像引导下冷冻消融联合肾动脉临时球囊阻断治疗中央型肾肿瘤的技术可行性和结果。
回顾性纳入 2017 年 1 月至 2021 年 10 月期间接受冷冻消融和肾动脉临时阻断治疗的所有连续中央型肾肿瘤患者。分析患者的人口统计学特征、肿瘤特征、手术数据、技术成功率、主要和次要临床疗效、并发症（根据心血管和介入放射学会 [CIRSE] 分类）和随访情况。
共纳入 14 例患者（8 例男性，6 例女性；平均年龄 72.4 岁±21.4[SD]岁；年龄范围：42-93 岁），共 14 个中央型肾肿瘤（中位大小 32mm；IQR：23.5，39.5mm；范围：13-50mm）接受了经皮影像引导下冷冻消融联合肾动脉临时球囊阻断治疗。技术成功率为 13/14（93%），1/14（7%）例患者血管入路失败。中位数插入 4 个冷冻探针（IQR：3，4.75），11/14（79%）例患者进行了保护性水分离。冷冻探针插入、水分离和血管入路的中位时间分别为 26.5min（IQR：18，35min）、10min（IQR：10，17min）和 30min（IQR：20，45min）。中位总手术时间为 150min（IQR：129，180min；范围：100-270min）。中位住院时间为 2.5 天（IQR：2，4 天；范围：2-14 天）。3/14（21%）例患者发生主要并发症。主要疗效率为 93%（13/14 例患者）。中位随访时间为 25 个月（IQR：11，33 个月；范围：6-39 个月）。1 例患者在随访 14 个月时出现肾肿瘤复发，经重复冷冻消融治疗成功。
经皮影像引导下冷冻消融联合肾动脉临时球囊阻断治疗肾肿瘤技术上是可行的，具有较高的技术成功率，为经皮治疗中央型肾肿瘤开辟了道路。
