Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience - Université de Bourgogne Accéder directement au contenu
Article Dans Une Revue Journal of Clinical Medicine Année : 2021

Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience

Olivier Lopez
  • Fonction : Auteur
Olivier Chevallier
Kévin Guillen
Pierre-Olivier Comby
Julie Pellegrinelli
  • Fonction : Auteur
Claire Tinel
Nicolas Falvo
  • Fonction : Auteur
Eric Mourey
  • Fonction : Auteur
Romaric Loffroy

Résumé

The study’s purpose was to assess the safety, feasibility and efficiency of selective arterial embolization (SAE) using N-butyl cyanoacrylate (NBCA) glue before percutaneous cryoablation (PCA) of renal malignancies in patients whose tumor characteristics and/or comorbidities resulted in an unacceptable risk of bleeding. In this single-center retrospective study of 19 consecutive high-risk patients (median age, 74 years) with renal malignancies managed in 2017–2020 by SAE with NBCA followed by PCA, data about patients, tumor and procedures characteristics, complications, renal function and hemoglobin concentration before and after treatment, as well as recurrence were collected. Charlson comorbidity index was ≥4 in 89.5% of patients. Ten patients were treated by antiplatelet and/or anticoagulant therapy. Median tumor largest diameter was 3.75 cm (range, 1–6.5 cm) and R.E.N.A.L. nephrometry score was ≥7 in 80%, indicating substantial tumor complexity. No major complications were recorded and minor complications occurred in 7 patients. No residual tumor was found at 6-week imaging follow-up in 18/19 patients. Tumor recurrence was visible in 1/16 patients at 6-month imaging follow-up. No significant difference was found for renal function after treatment (p = 0.07), whereas significant decrease in hemoglobin concentration was noted (p = 0.00004), although it was relevant for only one patient who required only blood transfusion and no further intervention. SAE prior to PCA is safe and effective for managing renal malignancies in high-risk patients.

Dates et versions

hal-03613347 , version 1 (18-03-2022)

Identifiants

Citer

Olivier Lopez, Olivier Chevallier, Kévin Guillen, Pierre-Olivier Comby, Julie Pellegrinelli, et al.. Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience. Journal of Clinical Medicine, 2021, 10 (21), pp.4986. ⟨10.3390/jcm10214986⟩. ⟨hal-03613347⟩
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