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

Scott M. Thompson, Matthew R Callstrom, Michael A. McKusick, David A Woodrum

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

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

Original languageEnglish (US)
Pages (from-to)1171-1178
Number of pages8
JournalCardioVascular and Interventional Radiology
Volume38
Issue number5
DOIs
StatePublished - Apr 1 2015

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Blood Vessels
Cryosurgery
Laser Therapy
Therapeutics
Pain
Hemorrhage
Torso
Research Ethics Committees
Lower Extremity
Safety
Recurrence

Keywords

  • Cryoablation
  • CT
  • Laser ablation
  • MRI
  • Vascular anomaly
  • Vascular malformation
  • Vasoproliferative neoplasm

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Initial Results of Image-Guided Percutaneous Ablation as Second-Line Treatment for Symptomatic Vascular Anomalies. / Thompson, Scott M.; Callstrom, Matthew R; McKusick, Michael A.; Woodrum, David A.

In: CardioVascular and Interventional Radiology, Vol. 38, No. 5, 01.04.2015, p. 1171-1178.

Research output: Contribution to journalArticle

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abstract = "Purpose: 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. Results: 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. Conclusion: Image-guided percutaneous ablation is a feasible, safe, and effective second-line treatment option for symptomatic VA.",
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KW - Laser ablation

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KW - Vascular malformation

KW - Vasoproliferative neoplasm

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