Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience
| Autor: | Marco Midulla, Julie Pellegrinelli, Pierre-Olivier Comby, Kévin Guillen, Romaric Loffroy, E. Mourey, Claire Tinel, Olivier Lopez, Nicolas Falvo, Olivier Chevallier |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Blood transfusion medicine.medical_treatment cryosurgery Renal function lipiodol embolization Single Center ablation Article cyanoacrylate medicine kidney neoplasms Embolization Kidney business.industry Arterial Embolization Cryoablation General Medicine NBCA Surgery medicine.anatomical_structure cryoablation Lipiodol Medicine business medicine.drug |
| Zdroj: | Journal of Clinical Medicine Volume 10 Issue 21 Journal of Clinical Medicine, Vol 10, Iss 4986, p 4986 (2021) |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm10214986 |
| Popis: | The study’s purpose was to assess the safety, feasibility and efficiency of selective arterial embolization (SAE) using N-butyl cyanoacrylate (NBCA) glue before percutaneous cryoablation (PCA) of renal malignancies in patients whose tumor characteristics and/or comorbidities resulted in an unacceptable risk of bleeding. In this single-center retrospective study of 19 consecutive high-risk patients (median age, 74 years) with renal malignancies managed in 2017–2020 by SAE with NBCA followed by PCA, data about patients, tumor and procedures characteristics, complications, renal function and hemoglobin concentration before and after treatment, as well as recurrence were collected. Charlson comorbidity index was ≥4 in 89.5% of patients. Ten patients were treated by antiplatelet and/or anticoagulant therapy. Median tumor largest diameter was 3.75 cm (range, 1–6.5 cm) and R.E.N.A.L. nephrometry score was ≥7 in 80%, indicating substantial tumor complexity. No major complications were recorded and minor complications occurred in 7 patients. No residual tumor was found at 6-week imaging follow-up in 18/19 patients. Tumor recurrence was visible in 1/16 patients at 6-month imaging follow-up. No significant difference was found for renal function after treatment (p = 0.07), whereas significant decrease in hemoglobin concentration was noted (p = 0.00004), although it was relevant for only one patient who required only blood transfusion and no further intervention. SAE prior to PCA is safe and effective for managing renal malignancies in high-risk patients. |
| Databáze: | OpenAIRE |
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