title: Percutaneous cryoablation of renal lesions with radiographic ice ball involvement of the renal sinus: analysis of hemorrhagic and collecting system complications.
abstract: OBJECTIVE
  The purpose of this study was to determine the incidence of collecting system and hemorrhagic complications resulting from CT-guided percutaneous cryoablation of renal tumors in which the radiographic ice ball abuts or involves the renal sinus.
  
  
  METHODS
  From November 2005 through July 2009 at our institution, we performed 129 CT-guided percutaneous cryoablation procedures on 107 patients (mean age, 64 years) with renal masses suspicious of being renal cell carcinoma. Radiographic ice balls that abutted or overlapped the renal sinus were classified as central; the other lesions were classified as noncentral. Medical records and follow-up images were retrospectively reviewed for hemorrhage requiring intervention and for evidence of collecting system injury. The mean follow-up period was 9.3 months.
  
  
  RESULTS
  The radiographic ice ball was classified as central in 67 cases. In these central ablations, the mean sinus involvement was 6.2 mm (range, 0-19 mm), 41 ice balls overlapping the renal sinus by 6 mm or more (mean, 9.4 mm). No cases of collecting system injury were identified for any ablation. Overall, there was only one hemorrhagic complication requiring intervention, and it occurred in a noncentral ablation.
  
  
  CONCLUSIONS
  CT-guided percutaneous cryoablation of renal masses with ice ball overlap of the renal sinus resulted in no cases of collecting system injury or serious hemorrhagic complications in our series.
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Rosenberg
authors.forename: Charles Y
authors.initials: CY
authors.lastname: Kim
authors.forename: Matvey
authors.initials: M
authors.lastname: Tsivian
authors.forename: Matthew N
authors.initials: MN
authors.lastname: Suberlak
authors.forename: David R
authors.initials: DR
authors.lastname: Sopko
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Polascik
authors.forename: Rendon C
authors.initials: RC
authors.lastname: Nelson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D003287:Contrast Media / Q000008:administration & dosage; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D007053:Ice; D007479:Iopamidol / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D015641:Radiography, Interventional; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D007053:Ice; D007479:Iopamidol