Percutaneous Ultrasound-Guided Cryoablation for Symptomatic Plantar Fibromas

  • Muneeb Ahmed
  • Jeffrey L. Weinstein
  • Jawad Hussain
  • Ammar Sarwar
  • Megan Anderson
  • Brian Dillon
Clinical Investigation

Abstract

Purpose

Here, we report our experience in treating painful plantar fibromas with percutaneous cryoablation.

Methods

We retrospectively identified patients with symptomatic plantar fibromas who underwent percutaneous ultrasound-guided cryoablation between June 2014 and June 2015. In total, four patients (two male, two female) with five plantar fibromas undergoing a total of seven ablation procedures were identified. Each procedure was performed under general anesthesia using a single freeze–thaw cycle. The electronic medical record, procedure reports, and pain scores from a brief pain inventory administered before and after treatment were reviewed. Average and worst pain in 24 h, and time to peak symptom improvement post-procedure were compared. Complications were reviewed using the SIR classification.

Results

Five plantar fibromas were treated (mean size 2.2 ± 1.6 cm). Four of five lesions were present for more than 6 years, and 1/5 was present for less than 1 year. Surgical excision was previously performed on 3/5 lesions, all with short-term recurrence. Mean worst pain score in 24 h and average pain score in 24 h (scale of 10) at initial evaluation were 7.1 ± 1.8 and 5.8 ± 1.9, reduced after cryoablation to 0.8 ± 0.8 and 0.4 ± 0.6, respectively. Average time to symptom improvement was 2.8 ± 0.98 weeks (range 2–4 weeks). All patients reported improved ambulation and weight-bearing, and complete cessation of pain medication after treatment. The improvement was sustained on follow-up at 12 months. No major complications occurred. Minor complications occurred in 3/5 patients.

Conclusions

Early experience with percutaneous ultrasound-guided cryoablation to treat painful plantar fibromas suggests that it is a safe and effective treatment option, with early and near-complete symptom improvement.

Keywords

Ablation Percutaneous Plantar fibroma Cryoablation 

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Copyright information

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

Authors and Affiliations

  • Muneeb Ahmed
    • 1
  • Jeffrey L. Weinstein
    • 1
  • Jawad Hussain
    • 1
  • Ammar Sarwar
    • 1
  • Megan Anderson
    • 2
  • Brian Dillon
    • 3
  1. 1.Division of Vascular and Interventional Radiology, Department of RadiologyBeth Israel Deaconess Medical Center/Harvard Medical SchoolBostonUSA
  2. 2.Department of Orthopedic SurgeryBeth Israel Deaconess Medical Center/Harvard Medical SchoolBostonUSA
  3. 3.Department of RadiologyYale Medical SchoolNew HavenUSA

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