Cryoablation as Second-line Therapy for Fibroadipose Vascular Anomaly

Abstract

Purpose: Fibroadipose vascular anomaly (FAVA) is a recently described intramuscular vascular anomaly that replaces normal skeletal muscle with fibrofatty proliferation and phlebectasia causing pain and contractures. Cryoablation has recently emerged as a means of treating FAVA with favorable outcomes. The purpose of our study was to examine our FAVA patients with failed prior interventions who underwent cryoablation as second-line treatment. Methods: A retrospective review was performed of all cases of cryoablation for FAVA (diagnosed on imaging or biopsy) who had undergone prior treatment from October 2014 to October 2020 at the adult and children’s hospital. Preprocedure, intraprocedural, and, when available, follow-up imaging was reviewed. Electronic medical record and imaging review was performed to determine demographics, indication, prior treatments both interventional and surgical, symptoms, and clinical response. Results: There were 9 patients with 11 ablation procedures; 8/9 patients had decrease in pain. One patient with diffuse FAVA had worsening pain after ablation and was subsequently treated with sirolimus. Conclusions: FAVA can be difficult to treat with traditional methods such as sclerotherapy or surgical resection. Cryoablation has recently emerged as a promising treatment. Our experience suggests FAVA with failed prior interventions may respond favorably to cryoablation.