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Single 15-Min Protocol Yields the Same Cryoablation Size and Margin as the Conventional 10-8-10-Min Protocol: Results of Kidney and Liver Swine Experiment

TitleSingle 15-Min Protocol Yields the Same Cryoablation Size and Margin as the Conventional 10-8-10-Min Protocol: Results of Kidney and Liver Swine Experiment
Publication TypeJournal Article
Year of Publication2018
AuthorsWerner, JD, Tregnago, AC, Netto, GJ, Frangakis, C, Georgiades, CS
JournalCardiovasc Intervent Radiol
Volume41
Pagination1089-1094
Date PublishedJul
ISBN Number0174-1551
Accession Number29651581
Keywords*Margins of Excision, Ablation size, Animals, Cryoablation, Cryosurgery/*methods, Female, Kidney/*surgery, Liver/*surgery, Margin, Models, Animal, Necrosis, Swine, Time Factors
Abstract

INTRODUCTION: The objective was to determine the ablation size of a single 15-min freeze and compare it with the conventional 10-min freeze-8-min thaw-10-min freeze protocol. Secondary objectives were to determine the ablation margin and to ascertain whether islands of viable tissue remain within the ablation zone. MATERIALS AND METHODS: Five adult swine under general anesthesia were used. After surgical abdominal exposure, two ablations were performed in liver and two in kidney. One ablation utilized the 15-min and the second the 10-8-10-min protocol. At maximum ice-ball, tissue ink was infused via an angiographic catheter in hepatic or renal artery to stain the non-frozen tissue. Animals were euthanized and organs examined macro- and microscopically. RESULTS: Three histological regions were observed: (A) a viable/stained region representing the tissue outside the ice-ball, (B) a central necrotic area representing the ablated region within the ice-ball and (C) an unstained but viable margin representing the non-lethal margin within ice-ball. Ablation size did not vary with protocol but did for tissue type. Renal ablation was approximately 5 x 4 cm with both protocols, whereas liver ablation was approximately 6.7 x 4.4 cm. Ablation margin was measured at 1 mm irrespective of ablation protocol or tissue. No islands of viable tissue were identified within the ablation zone. DISCUSSION: Fifteen-minute cryoablation yielded an ablation size and margin identical to that of the conventional 10-8-10-min protocol. Within the ablated region, cell death was uniform. The only difference was a larger cryoablation zone in hepatic tissue compared to renal tissue, likely attributable to differences in blood perfusion.