title: Computerized tomography guided percutaneous renal cryoablation with the patient under conscious sedation: initial clinical experience.
abstract: OBJECTIVE
  We report on our initial clinical experience with CT guided percutaneous renal cryoablation.
  
  
  METHODS
  CT guided percutaneous renal cryoablation was performed on 27 tumors using conscious sedation in 20 patients. Eligible patients had tumors of 5 cm or less and were poor surgical candidates or otherwise warranted nephron sparing treatment. Tumors were classified as central or noncentral depending on their relationship to the renal sinus fat. During cryoablation intraoperative active ice ball formation was monitored with real-time CT imaging to ensure adequate tumor coverage. Postoperative followup imaging was obtained at regular intervals.
  
  
  RESULTS
  Our method appears technically feasible as of the 27 cryoablations performed, only 1 complication occurred requiring blood transfusion in a patient with a large, centrally located tumor. To date we have 16 tumors in 12 patients with imaging followup of 1 month or more (mean followup 5.9 months). Mean baseline tumor size in this group was 2.5 cm with 11 small (3 cm or less) and 5 large (more than 3 cm) tumors. Of the tumors 5 were centrally located and 11 were noncentrally located. Preliminary data suggest that of the 16 cryoablated tumors 15 showed no signs of enhancement on followup.
  
  
  CONCLUSIONS
  CT guided percutaneous renal cryoablation appears to be a feasible treatment option for small, noncentrally located renal tumors. While early results appear promising, longer followup is needed to more clearly define the role of this treatment method.
authors.affiliation: Russell H. Morgan Department of Radiology, Division of Cardiovascular and Interventional Radiology, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
authors.forename: Ajay
authors.initials: A
authors.lastname: Gupta
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Allaf
authors.forename: Louis R
authors.initials: LR
authors.lastname: Kavoussi
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Jarrett
authors.forename: David Y S
authors.initials: DY
authors.lastname: Chan
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Su
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Solomon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016292:Procedural Sedation; D003452:Cryosurgery / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed