Cryoablation of low-flow vascular malformations

Özet

PURPOSEWe aimed to evaluate the safety and effectiveness of cryoablation in the treatment of low-flowmalformations, specifically venous malformation (VM) and fibroadipose vascular anomaly (FAVA).METHODSWe conducted a retrospective review of 11 consecutive patients with low-flow malformations(14 lesions; 9 VM, 5 FAVA), median lesion volume 10.8 cm3, (range, 1.8–55.6 cm3) with a median age of 19 years (range, 10–50 years) who underwent cryoablation to achieve symptomaticcontrol. Average follow-up was at a median of 207 days postprocedure (range, 120–886 days).Indications for treatment included focal pain and swelling. Technical success was achieved if thecryoablation ice ball covered the region of the malformation that corresponded to the patient’ssymptoms. Clinical success was considered complete if all symptoms resolved and partial if somesymptoms persisted but did not necessitate further treatment.RESULTSThe technical success rate was 100%. At 1-month follow-up, 13 of 14 lesions (93%) had a completeresponse and one (7%) had a partial response. At 6-month follow-up 12 of 13 (92%) had a completeresponse and 1 (8%) had a partial response. A total of 6 patients underwent primary cryoablation.Out of 9 VM cases, 7 had prior sclerotherapy and 2 had primary cryoablation. Out of the 5 FAVAcases, 1 had prior sclerotherapy and the remaining 4 cases underwent primary cryoablation. Therewere 3 minor complications following cryoablation including 2 cases of skin blisters and 1 case oftransient numbness. These complications resolved with conservative management.CONCLUSIONCryoablation is safe and effective in the treatment of low-flow vascular malformations, eitherafter sclerotherapy or as primary treatment.