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The Feasibility of Percutaneous Renal Cryoablation Under Local Anaesthesia

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Abstract

Objectives

The aim of this study was to evaluate the feasibility of cryoablation of renal tumours without sedation.

Materials and methods

We prospectively evaluated 149 computed tomography-guided renal cryoablation procedures that were performed at our institution between 2009 and 2013. The patients received only 1 g of IV paracetamol prior to the procedure; intraprocedural, local anaesthesia was administered. We recorded the date and duration of the procedure, size and location of the tumour, number of cryoneedles used, need for dissection with saline or carbon dioxide and intraprocedural degree of pain, which was scored using an established visual analogue pain score (VAS) (0–10). Multivariate analysis was used to identify the associations between the recorded parameters and VAS.

Results

An interventional radiologist and a technician could perform all procedures without the help of anaesthesiologists and with adequate analgesia. The pain level ranged from 0 to 8 (mean, 2.0). It did not correlate with the tumour size or with the number of cryoneedles. It was significantly greater when the ice ball involved renal cavities (p = .0033) and when carbon dioxide was used for dissection (p < .0001). Conversely, the team experience was positively correlated with lower pain levels (p = .0381).

Conclusion

This study demonstrates that the cryoablation of renal tumours is feasible by interventional radiologists alone using a combination of IV paracetamol and local anaesthesia.

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Conflict of Interest

Eric de Kerviler is consultant for Galil Medical, Constance de Margerie-Mellon has no conflict of interest, Alexandre Coffin has no conflict of interest, Guillaume Legrand has no conflict of interest, Matthieu Resche-Rigon has no conflict of interest, Guillaume Ploussard has no conflict of interest, Paul Meria has no conflict of interest, Pierre Mongiat-Artus has no conflict of interest, François Desgrandchamps has no conflict of interest, Cédric de Bazelaire has no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

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.

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Authors and Affiliations

  1. Service de Radiologie, INSERM UMR_S1165, Hôpital Saint-Louis, Assistance Publique, Hôpitaux de Paris, Université Paris 7 Denis Diderot, Sorbonne Paris-Cité, 1 Avenue Claude Vellefaux, 75010, Paris, France

    Eric de Kerviler, Pierre Mongiat-Artus & Cédric de Bazelaire

  2. Service de Radiologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris 7 Denis Diderot, Sorbonne Paris-Cité, 1 Avenue Claude-Vellefaux, 75010, Paris, France

    Constance de Margerie-Mellon & Alexandre Coffin

  3. Service d’Urologie, Hôpital Saint-Louis, Assistance Publique, Hôpitaux de Paris, Université Paris 7 Denis Diderot, Sorbonne Paris-Cité, 1 Avenue Claude-Vellefaux, 75010, Paris, France

    Guillaume Legrand, Guillaume Ploussard, Paul Meria & François Desgrandchamps

  4. Service de Biostatistique et d’Information Médicale (SBIM), Hôpital Saint-Louis, Assistance Publique, Hôpitaux de Paris, Université Paris 7 Denis Diderot, Sorbonne Paris-Cité, 1 Avenue Claude-Vellefaux, 75010, Paris, France

    Matthieu Resche-Rigon

Authors
  1. Eric de Kerviler
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  2. Constance de Margerie-Mellon
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  3. Alexandre Coffin
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  4. Guillaume Legrand
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  5. Matthieu Resche-Rigon
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  6. Guillaume Ploussard
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  7. Paul Meria
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  8. Pierre Mongiat-Artus
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  9. François Desgrandchamps
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  10. Cédric de Bazelaire
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Corresponding author

Correspondence to Eric de Kerviler.

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de Kerviler, E., de Margerie-Mellon, C., Coffin, A. et al. The Feasibility of Percutaneous Renal Cryoablation Under Local Anaesthesia. Cardiovasc Intervent Radiol 38, 672–677 (2015). https://doi.org/10.1007/s00270-014-0995-x

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  • DOI: https://doi.org/10.1007/s00270-014-0995-x

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