Percutaneous image-guided cryoablation with temporary balloon occlusion of the renal artery for the treatment of central renal tumors

Purpose: The purpose of this study was to report the technical feasibility and outcomes of percutaneous image-guided cryoablation with temporary balloon occlusion of the renal artery for the treatment of central renal tumors. Materials and methods: All consecutive patients with central renal tumors treated with cryoablation and tem-porary renal artery occlusion from January 2017 to October 2021 were retrospectively included. Patient dem-ographics, tumor's characteristics, procedural data, technical success, primary and secondary clinical efficacy, complications (according to Cardiovascular and Interventional Radiology Society of Europe [CIRSE] classifica-tion) and follow-up were investigated. Results: A total of 14 patients (8 men, 6 women; mean age 72.4 years +/- 21.4 [SD] years; age range: 42-93 years) with 14 central renal tumors (median size, 32 mm; IQR: 23.5, 39.5 mm; range: 13-50 mm) were treated with percutaneous image-guided cryoablation and temporary balloon occlusion of the renal artery. Technical success was 13/14 (93%), with 1/14 (7%) failure of vascular access. A median of 4 cryoprobes (IQR: 3, 4.75) were inserted and protective hydrodissection was performed in 11/14 (79%) patients. Median time to perform cryoprobes inser-tion, hydrodissection and vascular access was 26.5 min (IQR: 18, 35 min), 10 min (IQR: 10,17 min) and 30 min (IQR: 20, 45 min) respectively. Median duration of the whole intervention was 150 min (IQR: 129, 180 min; range: 100-270 min). Median hospital stay was 2.5 days (IQR: 2, 4 days; range: 2-14 days). Major complications occurred in 3/14 (21%) patients. Primary efficacy rate was 93% (13/14 patients). Median oncological follow-up was 25 months (IQR: 11, 33 months; range: 6-39 months). One patient experienced renal tumor recurrence at 14-months of follow-up, which was successfully treated with repeat cryoablation. Conclusion: Percutaneous image-guided cryoablation of renal tumors with temporary balloon occlusion of the renal artery is technically feasible, with a high technical success rate and paths the way for percutaneous treatment of central renal tumors.(c) 2022 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Automated summary

This study aimed to investigate the technical feasibility and outcomes of percutaneous image-guided cryoablation with temporary balloon occlusion of the renal artery for the treatment of central renal tumors. The results showed that this method is technically feasible with a high success rate and provides good primary efficacy. However, there are also potential complications associated with the procedure.