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Percutaneous cryoablation of symptomatic venous malformations as a second-line therapeutic option: a five-year single institution experience

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Abstract

Purpose

To report the mid-term outcomes of percutaneous cryoablation (PCA) performed as second-line therapeutic option of venous malformations (VM).

Material and methods

From 2011 to 2015, PCA was offered in 24 patients (mean age: 31 years, range: 12–64) as second-line treatment for recurrence of symptoms after sclerotherapy and when resection was not possible (due to lesion location or previous failure) or refused by the patient. Adverse effects were recorded, disease-free survival (DFS) and local tissue control (LTC) rates were calculated based on symptoms and volume evolution.

Results

Mean follow-up was 18.7 months (6–48). Nine (37.5%, 9/24) adverse effects occurred and three (12.5%, 3/24) were severe. Mean pain assessed by visual analog scale (VAS) was 41.7 mm (0–80) before treatment and 20.3 mm (0–80) (p=0.01) after. Mean volume decreased significantly after treatment from 22.4 cm3 (0.9-146) to 8.35 cm3 (0–81.3) (p<0.001). Pain recurred in nine patients and size of one lesion increased. The DFS and LTC rates were 54% [95%CI: 22.94-77.27] and 93.33% [61.26-99.03] at 24 months, respectively. Only VM volume >10 cm3 was associated with a higher risk of local recurrence (p=0.05).

Conclusion

PCA as second-line treatment appears to be safe and effective for local control of VM according to mid-term results.

Key points

• Percutaneous cryoablation of venous malformations appeared well tolerated.

• Size of venous malformations decreased significantly after percutaneous cryoablation (p<0.001).

• Pain decreased significantly after percutaneous cryoablation of venous malformations (p=0.01).

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Acknowledgements

The authors thank Pippa McKelvie-Sebileau for medical editorial services, Corinne Castermans for her assistance with data collection and Pascal Garcia, PhD for his technical support.

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Authors and Affiliations

  1. Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    F. H. Cornelis, F. Marin, Y. Le Bras & N. Grenier

  2. Department of Radiology, Tenon Hospital, APHP, 4 rue de la Chine, 75020, Paris, France

    F. H. Cornelis

  3. Department of Pediatric Dermatology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    C. Labrèze

  4. Department of Aesthetic Surgery, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    V. Pinsolle

  5. Department of Vascular Surgery, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    D. Midy

Authors
  1. F. H. Cornelis
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  2. F. Marin
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  3. C. Labrèze
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  4. V. Pinsolle
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  5. Y. Le Bras
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  6. D. Midy
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  7. N. Grenier
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Corresponding author

Correspondence to F. H. Cornelis.

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Guarantor

The scientific guarantor of this publication is Francois CORNELIS.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

CHU Bordeaux provided partial funding (Grant No. NCT01845935). F.C. received research support from Galil Medical Inc., Arden Hills, MN, USA.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in "Cornelis F, Havez M, Labrèze C, Taieb A, Bui BN, Midy D, Grenier N. Percutaneous cryoablation of symptomatic localized venous malformations: preliminary short-term results. J Vasc Interv Radiol. 2013 Jun;24(6):823–7." and in "Cornelis FH, Labrèze C, Pinsolle V, Le Bras Y, Castermans C, Bader C, Thiebaut R, Midy D, Grenier N. Percutaneous Image-Guided Cryoablation as Second-Line Therapy of Soft-Tissue Venous Vascular Malformations of Extremities: A Prospective Study of Safety and 6-Month Efficacy. Cardiovasc Intervent Radiol. 2017 Mar 30. [Epub ahead of print] "

Methodology

• retrospective

• observational

• performed at one institution

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Cornelis, F.H., Marin, F., Labrèze, C. et al. Percutaneous cryoablation of symptomatic venous malformations as a second-line therapeutic option: a five-year single institution experience. Eur Radiol 27, 5015–5023 (2017). https://doi.org/10.1007/s00330-017-4892-y

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  • DOI: https://doi.org/10.1007/s00330-017-4892-y

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