Cryoablation of Soft Tissues Low-Flow Vascular Malformations: Clinical Outcomes and Safety.

Abstract

To report the clinical effectiveness and the safety of cryoablation in first or second-line therapy in symptomatic soft tissues vascular malformation, a mini-invasive therapeutic alternative to sclerotherapy or surgery. This retrospective and monocentric study included patients with symptomatic low-flow vascular malformation. The interventions were carried out under computed tomography (CT) scan, Cone-beam CT (CBCT) and/or USA guidance. Clinical response was evaluated by collecting the Numerical Rating Scale (NRS) for symptoms before and after the ablation. Safety was assessed based on criteria proposed by the Cardiovascular and Interventional Radiological Society of Europe. Imaging response was evaluated with post-ablation Magnetic Resonance Imaging. Twenty-one patients were included. Cryoablation was the first operative treatment for 12 patients (12/21, 57%). The remaining patients had already undergone surgery (2/21, 9%) or one or more sclerotherapy procedures (7/21, 33%).Symptoms assessed by Numerical Rating Scale dropped from a median of 7 [IQR 6-8] before the procedure to a median of 1 [IQR 0-2] after cryoablation (p < 0.001). Half of the patients declared a full effectiveness of cryoablation on their symptoms (11/21). No major complications and four minor adverse events (two skin lesions, two patients with neuropathic pain) were reported (19%). Lesional volume significantly decreased after cryoablation (median from 3.7 cm3 [1-10.4] to 0.25 cm3 [0-2.0], p < 0.001). Cryoablation seems to be a safe and effective first- or second-line therapy for soft tissue vascular malformations.