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

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 unaccepta...

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Autores principales:	Olivier Lopez, Olivier Chevallier, Kévin Guillen, Pierre-Olivier Comby, Julie Pellegrinelli, Claire Tinel, Nicolas Falvo, Marco Midulla, Eric Mourey, Romaric Loffroy
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	embolization cyanoacrylate NBCA lipiodol ablation cryoablation Medicine R
Acceso en línea:	https://doaj.org/article/040cc4764a03428b8fed452ef4572d66
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spelling	oai:doaj.org-article:040cc4764a03428b8fed452ef4572d662021-11-11T17:37:01ZSelective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience10.3390/jcm102149862077-0383https://doaj.org/article/040cc4764a03428b8fed452ef4572d662021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4986https://doaj.org/toc/2077-0383The 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 (<i>p</i> = 0.07), whereas significant decrease in hemoglobin concentration was noted (<i>p</i> = 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.Olivier LopezOlivier ChevallierKévin GuillenPierre-Olivier CombyJulie PellegrinelliClaire TinelNicolas FalvoMarco MidullaEric MoureyRomaric LoffroyMDPI AGarticleembolizationcyanoacrylateNBCAlipiodolablationcryoablationMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4986, p 4986 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	embolization cyanoacrylate NBCA lipiodol ablation cryoablation Medicine R
spellingShingle	embolization cyanoacrylate NBCA lipiodol ablation cryoablation Medicine R Olivier Lopez Olivier Chevallier Kévin Guillen Pierre-Olivier Comby Julie Pellegrinelli Claire Tinel Nicolas Falvo Marco Midulla Eric Mourey Romaric Loffroy Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience
description	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 (<i>p</i> = 0.07), whereas significant decrease in hemoglobin concentration was noted (<i>p</i> = 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.
format	article
author	Olivier Lopez Olivier Chevallier Kévin Guillen Pierre-Olivier Comby Julie Pellegrinelli Claire Tinel Nicolas Falvo Marco Midulla Eric Mourey Romaric Loffroy
author_facet	Olivier Lopez Olivier Chevallier Kévin Guillen Pierre-Olivier Comby Julie Pellegrinelli Claire Tinel Nicolas Falvo Marco Midulla Eric Mourey Romaric Loffroy
author_sort	Olivier Lopez
title	Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience
title_short	Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience
title_full	Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience
title_fullStr	Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience
title_full_unstemmed	Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience
title_sort	selective arterial embolization with n-butyl cyanoacrylate prior to ct-guided percutaneous cryoablation of kidney malignancies: a single-center experience
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/040cc4764a03428b8fed452ef4572d66
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Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience

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