CardioVascular and Interventional Radiology

, Volume 42, Issue 3, pp 344–357 | Cite as

Adjunctive Thermoprotection During Percutaneous Thermal Ablation Procedures: Review of Current Techniques

  • Julien GarnonEmail author
  • Roberto Luigi Cazzato
  • Jean Caudrelier
  • Maud Nouri-Neuville
  • Pramod Rao
  • Emanuele Boatta
  • Nitin Ramamurthy
  • Guillaume Koch
  • Afshin Gangi


Although rare, unintended thermal injury to organs surrounding the ablation zone can lead to severe complications. Over the past 15 years, different protective methods have been developed to limit risk of complications, and expand indications to include more challenging lesions in various locations including liver, kidney, lung and bone. The most frequently used techniques include hydrodissection, carbodissection, balloon interposition and probe torqueing. In most cases, tumours can be physically separated from sensitive structures, reducing risk of thermal injury. Endoluminal cooling/warming is an alternative option for complex ablations close to the ureter or major bile ducts. Different techniques may be combined to achieve successful protection in locations with complex anatomy. The purpose of this review is to provide an overview of available protective measures and discuss respective advantages/drawbacks.


Percutaneous thermal ablation Protection Cryoablation Radiofrequency ablation Hydrodissection 


Compliance with Ethical Standards

Conflict of interest

Julien Garnon is a proctor for BTG-Galil and has received fees for oral presentations for Toshiba and Medtronic. Roberto Luigi Cazzato has received fees for oral presentations for Medtronic. Guillaume Koch is a proctor for BTG-Galil.


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© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Julien Garnon
    • 1
    Email author
  • Roberto Luigi Cazzato
    • 1
  • Jean Caudrelier
    • 1
  • Maud Nouri-Neuville
    • 1
  • Pramod Rao
    • 2
  • Emanuele Boatta
    • 1
  • Nitin Ramamurthy
    • 3
  • Guillaume Koch
    • 1
  • Afshin Gangi
    • 1
  1. 1.Department of Interventional RadiologyUniversity Hospital of StrasbourgStarsbourg CedexFrance
  2. 2.Laboratoire I-CubeStrasbourgFrance
  3. 3.Department of RadiologyNorfolk and Norwich University HospitalNorwichUK

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