title: Initial Results of Image-Guided Percutaneous Ablation as Second-Line Treatment for Symptomatic Vascular Anomalies.
abstract: OBJECTIVE
  The purpose of this study was to determine the feasibility, safety, and early effectiveness of percutaneous image-guided ablation as second-line treatment for symptomatic soft-tissue vascular anomalies (VA).
  
  
  METHODS
  An IRB-approved retrospective review was undertaken of all patients who underwent percutaneous image-guided ablation as second-line therapy for treatment of symptomatic soft-tissue VA during the period from 1/1/2008 to 5/20/2014. US/CT- or MRI-guided and monitored cryoablation or MRI-guided and monitored laser ablation was performed. Clinical follow-up began at one-month post-ablation.
  
  
  RESULTS
  Eight patients with nine torso or lower extremity VA were treated with US/CT (N = 4) or MRI-guided (N = 2) cryoablation or MRI-guided laser ablation (N = 5) for moderate to severe pain (N = 7) or diffuse bleeding secondary to hemangioma-thrombocytopenia syndrome (N = 1). The median maximal diameter was 9.0 cm (6.5-11.1 cm) and 2.5 cm (2.3-5.3 cm) for VA undergoing cryoablation and laser ablation, respectively. Seven VA were ablated in one session, one VA initially treated with MRI-guided cryoablation for severe pain was re-treated with MRI-guided laser ablation due to persistent moderate pain, and one VA was treated in a planned two-stage session due to large VA size. At an average follow-up of 19.8 months (range 2-62 months), 7 of 7 patients with painful VA reported symptomatic pain relief. There was no recurrence of bleeding at five-year post-ablation in the patient with hemangioma-thrombocytopenia syndrome. There were two minor complications and no major complications.
  
  
  CONCLUSIONS
  Image-guided percutaneous ablation is a feasible, safe, and effective second-line treatment option for symptomatic VA.
authors.affiliation: Mayo Graduate School, Mayo Medical School and the Mayo Clinic Medical Scientist Training Program, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Thompson.scott@mayo.edu.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Thompson
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. callstrom.matthew@mayo.edu.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Callstrom
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. mckusick.michael@mayo.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: McKusick
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. woodrum.david@mayo.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Woodrum
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003452:Cryosurgery; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015642:Radiology, Interventional; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D054079:Vascular Malformations / Q000601:surgery*; D055815:Young Adult
keywords: CT; Cryoablation; Laser ablation; MRI; Vascular anomaly; Vascular malformation; Vasoproliferative neoplasm
references.citation: Pharmacol Ther. 2013 Sep;139(3):327-33
references.pmid: 23665062
references.citation: Radiographics. 2013 Jul-Aug;33(4):1195-215
references.pmid: 23842979
references.citation: J Vasc Interv Radiol. 2013 Jun;24(6):823-7
references.pmid: 23707090
references.citation: Cardiovasc Intervent Radiol. 2013 Jun;36(3):853-6
references.pmid: 22722720
references.citation: J Am Acad Dermatol. 2000 Feb;42(2 Pt 1):225-35
references.pmid: 10642677
references.citation: J Vasc Interv Radiol. 2012 Oct;23(10):1391-3
references.pmid: 22999762
references.citation: Semin Roentgenol. 2012 Apr;47(2):106-17
references.pmid: 22370189
references.citation: Cardiovasc Intervent Radiol. 2014 Aug;37(4):977-89
references.pmid: 24196269
references.citation: J Vasc Interv Radiol. 2011 Jul;22(7):929-34
references.pmid: 21708319
references.citation: Tech Vasc Interv Radiol. 2011 Mar;14(1):22-31
references.pmid: 21335290
references.citation: Pediatr Clin North Am. 2010 Oct;57(5):1085-9
references.pmid: 20888459
references.citation: Perspect Vasc Surg Endovasc Ther. 2009 Jun;21(2):133-48
references.pmid: 19713211
references.citation: J Vasc Surg. 2009 Aug;50(2):424-7
references.pmid: 19631880
references.citation: Cardiovasc Intervent Radiol. 2009 May;32(3):529-34
references.pmid: 19219496
references.citation: J Vasc Interv Radiol. 2003 Sep;14(9 Pt 2):S199-202
references.pmid: 14514818
references.citation: J Vasc Interv Radiol. 2014 Nov;25(11):1657-64
references.pmid: 25245367
references.citation: Ann Vasc Surg. 2014 Jul;28(5):1335-49
references.pmid: 24509373
references.citation: Cardiovasc Intervent Radiol. 2013 Dec;36(6):1624-8
references.pmid: 23665861
references.citation: Radiology. 2014 Oct;273(1):241-60
references.pmid: 24927329
references.citation: Cardiovasc Intervent Radiol. 2013 Oct;36(5):1427-35
references.pmid: 23070103
references.citation: Urology. 2013 Oct;82(4):870-5
references.pmid: 23910089
references.citation: Radiographics. 2011 Sep-Oct;31(5):1321-40; discussion 1340-1
references.pmid: 21918047