Ablation Zones and Weight-Bearing Bones: Points of Caution for the Palliative Interventionalist |
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| Affiliation: | 1. Department of Radiology and Medical Imaging, University of Virginia Health System, 1215 Lee St., Box 800170, Room 1839, Charlottesville, VA 22908;2. Secic Statistical Consulting, Chardon, Ohio;3. Office of Medical Affairs, Medtronic Vascular, Santa Rosa, California;4. Division of Vascular Surgery and Endovascular Therapy, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;1. Center for Interventional Oncology, Clinical Center and National Cancer Institute, National Institutes of Health, Building 10, MSC 1182, Bethesda, MD 20892-1182;2. Critical Care Medicine Department, Clinical Center, National Institutes of Health, Building 10, MSC 1182, Bethesda, MD 20892-1182;3. VitalDyne, Inc, Cokato, Minnesota;4. Radiological Associates, Philadelphia, Pennsylvania;1. Unit of Vascular and Interventional Radiology, Sackler Faculty of Medicine, Rabin Medical Center and Beilinson Hospital, Petach Tikva 49100, Israel;2. Department of Vascular Surgery, Sackler Faculty of Medicine, Rabin Medical Center and Beilinson Hospital, Petach Tikva 49100, Israel;1. Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642;2. Department of Medicine, Division of Nephrology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642;3. Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642;1. Department of Urology, Winthrop University Hospital, Mineola, NY;2. Department of Urology, Columbia University Medical Center, College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY |
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| Abstract: | PurposeTo evaluate and classify underlying mechanisms of adverse outcomes after percutaneous computed tomography (CT)–guided cryoablation for palliation of painful musculoskeletal metastatic disease.Materials and MethodsData were collected for patients who underwent CT-guided percutaneous palliative cryoablation for painful musculoskeletal metastatic disease between January 2010 and December 2012. Cases with adverse outcomes or suboptimal response were identified and classified according to the Society of Interventional Radiology (SIR) classification system for complications by outcome and according to underlying mechanism of the outcome as delineated on follow-up examination.ResultsThere were 61 patients who received ablation for painful musculoskeletal metastatic disease. Six patients with adverse outcomes were identified. Two were minor complications (A, n = 1; B, n = 1), and four were major complications (C, n = 1; D, n = 3). Four patients incurred sequelae related to damage of ancillary structures included in the ablation zone, and two patients developed complete fractures after ablation of lesions in weight-bearing bones.ConclusionsComplete cryoablation of a painful musculoskeletal metastatic lesion may lead to ancillary damage of adjacent structures or fracture in weight-bearing bones. |
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| Keywords: | PMMA" },{" #name" :" keyword" ," $" :{" id" :" key0010" }," $$" :[{" #name" :" text" ," _" :" polymethyl methacrylate |
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