Tze Min Wah MBChB, FRCR, Presenter: Consultant, Galil Medical Ltd

Janette Bambrook, Abstract Co-Author: Nothing to Disclose

Dena Cohen MSc, Abstract Co-Author: Nothing to Disclose

Walter Gregory PhD, Abstract Co-Author: Nothing to Disclose

Jim Zhong, Abstract Co-Author: Nothing to Disclose

Jonathan Timothy Smith MBChB, FRCR, Abstract Co-Author: Nothing to Disclose

Rohit Puthan Veettil, Abstract Co-Author: Nothing to Disclose

Simon Min Whiteley MD, Abstract Co-Author: Nothing to Disclose

Peter J. Selby MD, DSc, Abstract Co-Author: Nothing to Disclose

Raul Nirmal Uppot MD, Abstract Co-Author: Nothing to Disclose

Debra Ann Gervais MD, Abstract Co-Author: Research Grant, Covidien AG

Peter Raff Mueller MD, Abstract Co-Author: Consultant, Cook Group Incorporated

The historical incidence of complete post-ablation syndrome in patients undergoing radiofrequency ablation (RFA) of renal tumors was 29.4% with both flu-like symptoms (malaise, myalgia and nausea) and low grade fever. This study aims: (1) to evaluate the incidence of post-ablation syndrome in the patients undergoing image-guided CRYO of their renal tumors (2) to determine its impact on the quality of life in the 10 days post-renal CRYO and compare it to the post-RFA historical data.  

Thirty eight patients (age 24-83 years) underwent image guided CRYO for 40 renal tumors. A telephone survey using a standardized questionnaire was conducted on days 1, 3, 5, 7 and 10 following post-CRYO. The patients’ demographic details, temperature, degree of flu-like symptoms (malaise, myalgia, nausea/ vomiting), severity of pain and percentage of relief with oral analgesics, interference with general activity and with work were documented prospectively. The symptoms and interference of lifestyles were graded on a 0-10 Numeric Intensity Scale. 

Post-CRYO, 6 patients (15.8%) developed low-grade fever (range 37.2-38.5ºC), 24 (63.2%) had flu-like symptoms, and 14 (36.8%) had no symptoms. The low grade fever did not exhibit any peak but the flu-like symptoms peaked on day-3 and resolved spontaneously in most patients by day-10. Six patients (15.8%) developed the full post ablation syndrome which was lower in incidence and the symptoms were less severe when compared to the post-RFA historical data (Figure 1). Post-CRYO patients with symptoms experienced pain and interference with general and work activities, peaking on day-3 in contrast to post RFA where symptoms peaked on day-1 and completely resolved by day-10.  

Post-CRYO the incidence of complete post-ablation syndrome was 16% of patients with less severe symptoms compared to post-RFA. However, two third (63.2%) of the patients experienced at least one of the components of the syndrome. These symptoms were self-limiting with most symptoms peaking at day-3 and majority of the patients resumed their baseline pre-procedural levels of activity within 10 days following CRYO. 

Post renal-CRYO, the incidence of complete post-ablation syndrome is lower and less severe than post-RFA and this information is useful when obtaining consent from patients during the consultation.   

Wah, T, Bambrook, J, Cohen, D, Gregory, W, Zhong, J, Smith, J, Veettil, R, Whiteley, S, Selby, P, Uppot, R, Gervais, D, Mueller, P, Incidence of Post Ablation Syndrome in Image-Guided Percutaneous Cryoablation (CRYO) of Renal Tumors: A Prospective Survey.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010460.html