Interventional Oncology

Session: Educational Exhibit Presentations - Station 7: Imaging and Interventional Oncology

Tip of the Iceberg: Emerging Applications and Technical Considerations for Cryoablation Therapy

Monday, March 6, 2023

5:00 PM – 5:05 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

Alexander Song, MD

Resident Physician
Zucker School of Medicine at Hofstra/Northwell at Staten Island University Hospital

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

George A. Michael, DO

Resident Physician
Zucker School of Medicine at Hofstra/Northwell at Staten Island University Hospital
HB

Hannah Bae, MD

Resident Physician
Zucker School of Medicine at Hofstra/Northwell at Staten Island University Hospital
Sherley Demetrius, MD (she/her/hers)

Resident Physician
Zucker School of Medicine at Hofstra/Northwell at Staten Island University Hospital
AI

Arton Isa, MD
NC

Nathan Cornish, DO

Attending Interventional Radiologist
Staten Island University Hospital

Disclosure(s):

Alexander Song, MD: No financial relationships to disclose

George A. Michael, DO: No financial relationships to disclose

Sherley Demetrius, MD: No financial relationships to disclose

Learning Objectives:

Review mechanism of cryoablation therapy and common indications.

Discuss newer applications of cryoablation and clinical significance.

Review current available cryoablation systems, methods and indications for use, and periprocedural care.

Background: Cryoablation therapy has proven to be a useful alternative in the treatment of certain solid organ malignancies such as those involving the liver, lung, or kidney. Among its many advantages, cryoablation has shown to be less painful for patients and can also act as a form of local anesthesia, compared to the effects of thermal ablation. Within the last decade, interest in expanding cryoablation techniques and indications have continued to grow.

Clinical Findings/Procedure Details: We aim to provide a case based review of newer applications of cryoablation. Cryoneurolysis for primary pain palliation as well as perioperative pain management have been performed with technical and clinical success, including cryoneurolysis of the celiac axis and pudendal nerve. In cases of cholecystitis, cryoablation of the gallbladder has demonstrated feasibility as an alternative to not only cholecystectomy, but to percutaneous cholecystostomy altogether. Cryoablation is also efficacious as a definitive treatment of vascular malformations and tumors, which are often treated endovascularly. This has been expanded to include more superficial tumors such as breast and desmoid tumors. Special care is needed in selection of cryoablation devices and close attention must be paid to anatomic approach and surrounding anatomy. Cases that were not feasible historically such as large renal tumors are now also possible due to several novel techniques that we will discuss in detail.

Conclusion and/or Teaching Points: Cryoablation has great potential for application in a wide range of clinical scenarios and should not be limited to oncologic indications. It provides a safe, minimally invasive alternative to surgery in otherwise high-risk candidates and can also be performed for pain management. Further study of potential uses of cryoablation are needed to maximize its utility and promote interventional radiology services to patients and providers.