Percutaneous MR-Guided Cryoablation of Low-Flow Vascular Malformation: Technical Feasibility, Safety and Clinical Efficacy

Technical success defined as complete coverage of the LFVM by the iceball without involvement of nearby non-target thermal-sensitive structures was achieved in 9/9 (100%) cases. Mean procedure time was 122 ± 20 min (range 90–150); 2–6 cryoprobes (mean 3.7 ± 1.2) and 2–4 freezing cycles (mean freezing time 19.8 ± 11.8 min; range 4–40) were applied. No complications were noted. Mean time from the first treatment to the last follow-up was 548 days (range 30–1776). Persistent/recurring pain was noted in 3/9 cases (33%) 30, 133 and 639 days after cryoablation, respectively, and was related in all cases to MR-confirmed local residual/recurring disease. A second cryoablation treatment was performed in these 3 cases with complete pain control at the last available follow-up (153, 25, 91 days, respectively). In the whole population, at mean 161 days (range 25–413) after the last treatment, on the numerical pain rate scale, pain significantly dropped from mean 6.4 ± 2.1 (range 3–9/10) before CA to mean 0.3 ± 0.9 (range 0–3/10) after (p = 0.009).