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Initial Results of Image-Guided Percutaneous Ablation as Second-Line Treatment for Symptomatic Vascular Anomalies

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The purpose of this study was to determine the feasibility, safety, and early effectiveness of percutaneous image-guided ablation as second-line treatment for symptomatic soft-tissue vascular anomalies (VA).

Materials and Methods

An IRB-approved retrospective review was undertaken of all patients who underwent percutaneous image-guided ablation as second-line therapy for treatment of symptomatic soft-tissue VA during the period from 1/1/2008 to 5/20/2014. US/CT- or MRI-guided and monitored cryoablation or MRI-guided and monitored laser ablation was performed. Clinical follow-up began at one-month post-ablation.


Eight patients with nine torso or lower extremity VA were treated with US/CT (N = 4) or MRI-guided (N = 2) cryoablation or MRI-guided laser ablation (N = 5) for moderate to severe pain (N = 7) or diffuse bleeding secondary to hemangioma–thrombocytopenia syndrome (N = 1). The median maximal diameter was 9.0 cm (6.5–11.1 cm) and 2.5 cm (2.3–5.3 cm) for VA undergoing cryoablation and laser ablation, respectively. Seven VA were ablated in one session, one VA initially treated with MRI-guided cryoablation for severe pain was re-treated with MRI-guided laser ablation due to persistent moderate pain, and one VA was treated in a planned two-stage session due to large VA size. At an average follow-up of 19.8 months (range 2–62 months), 7 of 7 patients with painful VA reported symptomatic pain relief. There was no recurrence of bleeding at five-year post-ablation in the patient with hemangioma–thrombocytopenia syndrome. There were two minor complications and no major complications.


Image-guided percutaneous ablation is a feasible, safe, and effective second-line treatment option for symptomatic VA.

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Scott M. Thompson thanks the Mayo Clinic MSTP for fostering an outstanding environment for physician-scientist training. This publication was supported by Center for Clinical and Translational Science (CCaTS) Grant Number TL1 TR000137 from the National Center for Advancing Translational Science (NCATS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Conflict of interest

Matthew R. Callstrom has received research Grants from Thermedical Inc., General Electric Company, Siemens AG and Galil Medical Ltd. Scott Thompson, Michael A. McKusick, and David A. Woodrum report no conflicts of interest related to the subject of this manuscript.

Statement of informed consent

A waiver of informed consent was granted by the local institutional review board in accordance with 45 CFR 46.116(d). For this type of retrospective study, formal consent is not required. All individual participants consented to use of their medical record for research purposes in accordance with Minnesota state law.

Statement of human rights

For this type of retrospective study, formal consent is not required.

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Correspondence to David A. Woodrum.

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Thompson, S.M., Callstrom, M.R., McKusick, M.A. et al. Initial Results of Image-Guided Percutaneous Ablation as Second-Line Treatment for Symptomatic Vascular Anomalies. Cardiovasc Intervent Radiol 38, 1171–1178 (2015).

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