Renal masses can be successfully ablated using a single probe cryoablation system. ProSense™ cryoprobes can be relocated up to three times in a single procedure. Relocation enables the physician to create a custom size and shape of the ice ball. Using a single cryoprobe is also more cost-effective for patients and providers.
The challenge: To treat a 34mm renal mass with a single probe cryoablation system using a relocation technique.
Patient Background: 69-year-old male with history of hypertension, diabetes mellitus and ischemic heart disease. Baseline imaging demonstrated 32x34mm suspected enhancing renal mass in the upper pole of the left kidney (Renal Score – 5).
Treatment: The cryoablation procedure was performed under sedation with CT guidance. Due to the size of the lesion, a single cryoprobe was repositioned to create two ice balls in order to ablate the lesion in one session. The first cryoablation cycle was 15-minutes freeze, 9-minute thaw, and 15-minutes freeze. After a warming extraction step, the cryoprobe was relocated for a second cryoablation cycle of 4-minutes freeze, 3-minutes-thaw, and 4-minutes freeze. The final size of the ice ball created was 40x30x44mm.
Outcome:
Follow-up imaging demonstrated a gradual decrease from the baseline lesion size to 25mm at 4-month follow up and 13mm at 16-months (scar tissue reduction by 50% in one year). There were no complications or adverse outcomes.
A special thanks to Professor Ofer Nativ, MD, Urological Surgeon, Elisha Hospital, Israel and Dr. Robert Sachner, MD, Head of Interventional Radiology, Bnai Zion Medical Center, Israel.
