Five-year Experience of Percutaneous Cryoablation of Symptomatic Venous Vascular Malformations as Second-Line Therapeutic Option

Background: To report the mid-term outcomes of percutaneous cryoablation (PCA) performed as second-line therapeutic option of venous vascular malformations (VVM). Methods: From 2011 to 2015, PCA was offered in 24 patients (mean age: 31 years, range: 12-64) as second-line treatment for recurrences of symptoms after sclerotherapy and when resection was not possible (due to lesion location or previous failure) or refused by the patient. Adverse effects were recorded, disease-free survival (DFS) and local tissue control (LTC) rates were calculated based on symptoms and volume evolution. Results: Mean follow-up was 18.7 months (6-48). Nine (37.5%, 9/24) adverse effects occurred but only three (12.5%, 3/24) were severe. Mean pain assessed by visual analogic scale (VAS) was 41.7 mm (0-80) before treatment and 20.3 mm (0-80) (P = 0.01) after. Mean volume decreased significantly after treatment from 22.4 cm3 (0.9-146) to 8.35 cm3 (0-81.3) (P < 0.001). Pain recurred in nine patients and size of one lesion increased. The DFS and LTC rates were 54% (95% CI: 22.94-77.27) and 93.33% (61.26-99.03) at 24 months, respectively. Only VVM volume >10 cm³ was associated with a higher risk of local recurrence (P = 0.05). Conclusions: PCA as second-line treatment appears to be safe and effective for local control of VVM according to mid-term results.

Publication History

Article published online:
26 April 2021