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Adjunctive Thermoprotection During Percutaneous Thermal Ablation Procedures: Review of Current Techniques

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Abstract

Although rare, unintended thermal injury to organs surrounding the ablation zone can lead to severe complications. Over the past 15 years, different protective methods have been developed to limit risk of complications, and expand indications to include more challenging lesions in various locations including liver, kidney, lung and bone. The most frequently used techniques include hydrodissection, carbodissection, balloon interposition and probe torqueing. In most cases, tumours can be physically separated from sensitive structures, reducing risk of thermal injury. Endoluminal cooling/warming is an alternative option for complex ablations close to the ureter or major bile ducts. Different techniques may be combined to achieve successful protection in locations with complex anatomy. The purpose of this review is to provide an overview of available protective measures and discuss respective advantages/drawbacks.

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Authors and Affiliations

  1. Department of Interventional Radiology, University Hospital of Strasbourg, 1, place de l’Hôpital, 67096, Starsbourg Cedex, France

    Julien Garnon, Roberto Luigi Cazzato, Jean Caudrelier, Maud Nouri-Neuville, Emanuele Boatta, Guillaume Koch & Afshin Gangi

  2. Laboratoire I-Cube, Strasbourg, France

    Pramod Rao

  3. Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK

    Nitin Ramamurthy

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  1. Julien Garnon
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Correspondence to Julien Garnon.

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Julien Garnon is a proctor for BTG-Galil and has received fees for oral presentations for Toshiba and Medtronic. Roberto Luigi Cazzato has received fees for oral presentations for Medtronic. Guillaume Koch is a proctor for BTG-Galil.

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Garnon, J., Cazzato, R.L., Caudrelier, J. et al. Adjunctive Thermoprotection During Percutaneous Thermal Ablation Procedures: Review of Current Techniques. Cardiovasc Intervent Radiol 42, 344–357 (2019). https://doi.org/10.1007/s00270-018-2089-7

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  • DOI: https://doi.org/10.1007/s00270-018-2089-7

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