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CardioVascular and Interventional Radiology

, Volume 41, Issue 2, pp 291–297 | Cite as

Changes in Perioperative Systolic Blood Pressure in Percutaneous Renal Mass Cryoablation

  • Sung Yoon Park
  • Young Taik Oh
  • Kyunghwa Han
  • Dae Chul Jung
  • Man Deuk Kim
  • Jong Yun WonEmail author
Clinical Investigation

Abstract

Objectives

To analyze changes in systolic blood pressure (SBP) in the perioperative period of percutaneous renal mass cryoablation and risk factors.

Methods

This retrospective study included 54 patients who underwent percutaneous renal cryoablation. SBP before ablation (pre-Tx), during ablation (intra-Tx), immediately after ablation (post-Tx), and before discharge (discharge) were measured using a BP cuff. The highest SBP during cryoablation was regarded as SBP at intra-Tx. Antihypertensive agents were administrated when SBP was 160 mmHg or greater during cryoablation. Relationship between SBP at pre-Tx, pain degree, tumor size, cryoprobe number, or endophytic extension of the radiographic ice-ball, and SBP elevation or administration of antihypertensive agents was investigated.

Results

Mean SBP elevation from pre-Tx to intra-Tx was 22.9 ± 18.0 mmHg (range −6–78 mmHg). SBP of intra-Tx was significantly higher than that of the other periods (p < .001), while SBP of post-Tx or discharge was similar with that of pre-Tx (p > .05). Tumor size (r = .324; p = .016), cryoprobe number (r = .300; p = .027), and endophytic extension (r = .348; p = .009) were correlated with SBP elevation, while SBP at pre-Tx or pain degree were not (p > .05). Antihypertensive agents were administrated for 24 patients (44.4%). In multivariate analysis, SBP at pre-Tx and endophytic ablation was associated with administration of antihypertensive agents during cryoablation (p < .05).

Conclusions

SBP elevation may occur during percutaneous renal mass cryoablation, but be improved before discharge. Endophytic extension of the radiographic ice-ball may be associated with significant BP elevation during ablation.

Keywords

Cryoablation Kidney Renal Blood pressure Complication 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Thompson RH, Atwell T, Schmit G, et al. Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol. 2015;67(2):252–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Zargar H, Atwell TD, Cadeddu JA, et al. Cryoablation for small renal masses: selection criteria, complications, and functional and oncologic results. Eur Urol. 2016;69(1):116–28.CrossRefPubMedGoogle Scholar
  3. 3.
    Hartman JB, Bhojwani N, Corn DJ, et al. Incidence of hypercoagulable events after image-guided percutaneous cryoablation of renal tumors: a single-center experience. J Vasc Interv Radiol. 2014;25(5):776–9.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Atwell TD, Carter RE, Schmit GD, et al. Complications following 573 percutaneous renal radiofrequency and cryoablation procedures. J Vasc Interv Radiol. 2012;23(1):48–54.CrossRefPubMedGoogle Scholar
  5. 5.
    Sidana A, Aggarwal P, Feng Z, et al. Complications of renal cryoablation: a single center experience. J Urol. 2010;184(1):42–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Johnson DB, Taylor GD, Lotan Y, et al. The effects of radio frequency ablation on renal function and blood pressure. J Urol. 2003;170(6 Pt 1):2234–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Basile DP, Anderson MD, Sutton TA. Pathophysiology of acute kidney injury. Compr Physiol. 2012;2(2):1303–53.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Chedid A, Le Coz S, Rossignol P, et al. Blunt renal trauma-induced hypertension: prevalence, presentation, and outcome. Am J Hypertens. 2006;19(5):500–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Patel N, King AJ, Breen DJ. Percutaneous image-guided cryoablation of small renal masses. Abdom Radiol. 2016;41(4):754–66.CrossRefGoogle Scholar
  10. 10.
    Varon J, Marik PE. Perioperative hypertension management. Vasc Health Risk Manag. 2008;4(3):615–27.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.CrossRefPubMedGoogle Scholar
  12. 12.
    Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Gupta A, Allaf ME, Kavoussi LR, et al. Computerized tomography guided percutaneous renal cryoablation with the patient under conscious sedation: initial clinical experience. J Urol. 2006;175(2):447–52 discussion 452–443.CrossRefPubMedGoogle Scholar
  14. 14.
    Li CL. Effect of cooling on neuromuscular transmission in the rat. Am J Physiol. 1958;194(1):200–6.PubMedGoogle Scholar
  15. 15.
    Lloyd JW, Barnard JD, Glynn CJ. Cryoanalgesia: a new approach to pain relief. Lancet. 1976;2(7992):932–4.CrossRefPubMedGoogle Scholar
  16. 16.
    Green CR, de Rosayro AM, Tait AR. The role of cryoanalgesia for chronic thoracic pain: results of a long-term follow up. J Natl Med Assoc. 2002;94(8):716–20.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Park SY, Park BK, Kim CK. Thermal ablation in renal cell carcinoma: what affects renal function? Int J Hyperth. 2012;28(8):729–34.CrossRefGoogle Scholar
  18. 18.
    Lambeth CB, Derrick JR, Hansen AE. Stenosis of a branch of the renal artery causing hypertension in a child, including a complication of translumbar renal arteriography. Pediatrics. 1960;26:822–7.PubMedGoogle Scholar
  19. 19.
    Lee SM, Drach GW. Renovascular hypertension from segmental renal artery stenosis: importance of segmental renal vein renin sampling. J Urol. 1980;124(5):704–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Mishima E, Hashimoto J, Akiyama Y, et al. Impact of small renal ischemia in hypertension development: renovascular hypertension caused by small branch artery stenosis. J Clin Hypertens (Greenwich). 2016;18(3):248–9.CrossRefGoogle Scholar
  21. 21.
    Welch BT, Atwell TD, Nichols DA, et al. Percutaneous image-guided adrenal cryoablation: procedural considerations and technical success. Radiology. 2011;258(1):301–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • Sung Yoon Park
    • 1
  • Young Taik Oh
    • 1
  • Kyunghwa Han
    • 1
  • Dae Chul Jung
    • 1
  • Man Deuk Kim
    • 1
  • Jong Yun Won
    • 1
    Email author
  1. 1.Department of Radiology and Research Institute of Radiological ScienceYonsei University College of MedicineSeoulRepublic of Korea

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