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Feasibility and safety of percutaneous image-guided cryoablation of abdominal wall endometriosis

  • Special Section: Cross sectional interventions
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the feasibility and safety of percutaneous image-guided cryoablation of abdominal wall endometriosis (AWE).

Materials and methods

A retrospective review of percutaneous cryoablation (CT or MR) of AWE was performed from January 2018 to December 2020. Eighteen patients were identified from an internal percutaneous ablation database. Technical success, complications, and outcomes were analyzed according to standard nomenclature.

Results

Patients comprised 18 females (mean age 36.9 years) who underwent 18 cryoablation procedures to treat 23 AWE deposits. Three of the 18 cases were performed under MR guidance, while the remaining 15 employed CT guidance. Technical success was achieved in all 18 cases (100%). Fifteen of 18 patients (83%) had biopsy proven AWE deposits prior to treatment. Hydrodisplacement was used to displace adjacent bowel, bladder, or neurovascular structures in 13/18 cases (72%). The mean number of probes used per case was 3. Sixteen of 23 (70%) of AWE deposits had imaging follow-up (median 85 days). Of the 16 lesions with imaging follow-up, 15 (94%) demonstrated no residual enhancement or T1 hyperintensity at the treatment site and 1 lesion (6%) demonstrated residual/progressive disease. At clinical follow-up, 13 of 14 (93%) patients reported improvement in AWE-related symptoms. Eleven patients had clinically documented pain scores before and after ablation and all demonstrated substantial symptomatic improvement. No society of interventional radiology (SIR) major complications were observed.

Conclusions

Percutaneous cryoablation of AWE is feasible with a favorable safety profile. Further longitudinal studies are needed to document durable response over time.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 1st ST SW, Rochester, MN, 55905, USA

    Katherine A. Smith, Brian T. Welch, A. Nicholas Kurup, John J. Schmitz, Wendaline M. VanBuren, Eric C. Ehman & Thomas D. Atwell

  2. Department of Anesthesiology, Mayo Clinic, Rochester, USA

    Tasha L. Welch

  3. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, USA

    Adela G. Cope & Tatnai L. Burnett

  4. Department of Radiology, University of Wisconsin Madison, Madison, USA

    Erica Knavel Koepsel

Authors
  1. Katherine A. Smith
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  2. Brian T. Welch
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Correspondence to Brian T. Welch.

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All authors report no conflicts of interest. No external sources of funding were utilized.

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Smith, K.A., Welch, B.T., Kurup, A.N. et al. Feasibility and safety of percutaneous image-guided cryoablation of abdominal wall endometriosis. Abdom Radiol 47, 2669–2673 (2022). https://doi.org/10.1007/s00261-021-03344-w

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  • DOI: https://doi.org/10.1007/s00261-021-03344-w

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