Ibrahim Sacit Tuna, Presenter: Nothing to Disclose

Servet Tatli MD, Abstract Co-Author: Nothing to Disclose

Kemal Tuncali MD, Abstract Co-Author: Nothing to Disclose

Stuart George Silverman MD, Abstract Co-Author: Consultant, Galil Medical Ltd, Yokneam, Israel Consultant, Siemens AG

To evaluate the frequency and clinical impact of portal or hepatic venous thrombosis after percutaneous cryoablation of the hepatic tumors.

143 hepatic tumors (125 metastases, 18 HCC) in 89 patients (mean 61 years, range 29-88; 47F, 42M) were treated with percutaneous cryoablation (107 procedures) using MRI (n=77) or CT (n=30) guidance. Postprocedural (24hr) enhanced MRI (n=101) or CT scans (n=6) were evaluated retrospectively for new portal or hepatic vein thrombosis; the involved venous segment, its diameter, and relationship with the ablation zone were recorded. Patients had follow up ultrasound at one week (n=10) and enhanced MRI (n=19) or CT (n=2) scans at three months. Clinical sequealae were determined with a review of medical records, and follow up imaging.

Venous thrombosis developed after 22 (20.5%) of 107 procedures and included branches of the portal vein (n=15), hepatic vein (n=6) or both (n=1). Thrombosed veins were located into the ablation zone (n=16) or along the shaft of the cryoprobe (n=6). Thrombus extended into left main (n=2) and right main (n=1) portal veins. Mean diameter of the thrombosed vein closest to the ablation zone was 4.6 mm (range 1.7-8.4). All patients were asymptomatic and developed no clinical sequealae. At three month, all thrombosed veins were recanalized either completely (n= 15) or partially (n=6).

Portal and hepatic venous thrombosis are common early after percutaneous cryoablation, do not cause clinical sequealae, and frequently resolves.

Thrombosis involving distal branches of portal and hepatic veins are common following percutaneous cryoablation, but are typically asymptomatic, cause no clinical sequealae and resolve spontaneously.

Tuna, I, Tatli, S, Tuncali, K, Silverman, S, Frequency and Clinical Impact of Venous Thrombosis Following Percutaneous Cryoablation of Hepatic Tumors.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6010221.html