title: The feasibility of percutaneous renal cryoablation under local anaesthesia.
abstract: OBJECTIVE
  The aim of this study was to evaluate the feasibility of cryoablation of renal tumours without sedation.
  
  
  METHODS
  We prospectively evaluated 149 computed tomography-guided renal cryoablation procedures that were performed at our institution between 2009 and 2013. The patients received only 1 g of IV paracetamol prior to the procedure; intraprocedural, local anaesthesia was administered. We recorded the date and duration of the procedure, size and location of the tumour, number of cryoneedles used, need for dissection with saline or carbon dioxide and intraprocedural degree of pain, which was scored using an established visual analogue pain score (VAS) (0-10). Multivariate analysis was used to identify the associations between the recorded parameters and VAS.
  
  
  RESULTS
  An interventional radiologist and a technician could perform all procedures without the help of anaesthesiologists and with adequate analgesia. The pain level ranged from 0 to 8 (mean, 2.0). It did not correlate with the tumour size or with the number of cryoneedles. It was significantly greater when the ice ball involved renal cavities (p = .0033) and when carbon dioxide was used for dissection (p < .0001). Conversely, the team experience was positively correlated with lower pain levels (p = .0381).
  
  
  CONCLUSIONS
  This study demonstrates that the cryoablation of renal tumours is feasible by interventional radiologists alone using a combination of IV paracetamol and local anaesthesia.
authors.affiliation: Service de Radiologie, INSERM UMR_S1165, Hôpital Saint-Louis, Assistance Publique, Hôpitaux de Paris, Université Paris 7 Denis Diderot, Sorbonne Paris-Cité, 1 Avenue Claude Vellefaux, 75010, Paris, France, eric.de-kerviler@sls.aphp.fr.
authors.forename: Eric
authors.initials: E
authors.lastname: de Kerviler
authors.forename: Constance
authors.initials: C
authors.lastname: de Margerie-Mellon
authors.forename: Alexandre
authors.initials: A
authors.lastname: Coffin
authors.forename: Guillaume
authors.initials: G
authors.lastname: Legrand
authors.forename: Matthieu
authors.initials: M
authors.lastname: Resche-Rigon
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ploussard
authors.forename: Paul
authors.initials: P
authors.lastname: Meria
authors.forename: Pierre
authors.initials: P
authors.lastname: Mongiat-Artus
authors.forename: François
authors.initials: F
authors.lastname: Desgrandchamps
authors.forename: Cédric
authors.initials: C
authors.lastname: de Bazelaire
mesh_terms: D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D003452:Cryosurgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D059408:Pain Management / Q000379:methods*; D011446:Prospective Studies; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed