Kidney Resources

ICE Cryoablation Technology

Kidney cryoablation

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Overview

Percutaneous cryoablation (PCA) for renal cell carcinoma (RCC) has grown rapidly over the last decade. This is due in large part to a growing body of evidence demonstrating comparable outcomes with partial nephrectomy, but with decreased complications and greater preservation of renal function. Similarly, cryoablation has an advantage over heat-based ablation modalities, allowing for visualization of the ablation zone and preservation of critical structures, even in central lesions.

Outcomes comparison

How do cryoablation and ablation compare to partial nephrectomy across key outcomes?

Metric	How does cryo/ablation compare to partial nephrectomy (PN)	Limitations
Local recurrence free survival*	Level 1 data needed	Older data, meta-analyses include RF
Metastatic-free survival*	Ablation = PN
Cancer-specific survival*	Ablation = PN
Overall survival*	Level 1 data needed	Selection bias - ablation patients tend to be older with more comorbidities
Renal Function	Cryo/ablation > PN
Safety	Cryo/ablation > PN
Cost	Cryo/ablation > PN
Quality of life	Cryo/ablation > PN

*Oncological outcomes

Similar = | Better >

Case studies

Cryoablation successfully performed with three IceRod 1.5 CX needles for treatment of renal cell carcinoma.

Adjacent Structures and RCC

A 66-year-old man presented with 2.0 cm x 2.1 cm left sided, endophytic RCC and biopsy confirmed clear cell renal cell carcinoma. Initial CR images on the day of the procedure demonstrated the lesion and adjacent colon, which would likely be injured if not moved. Cryoablation was performed with three IceRod™ 1.5 CX Needles for treatment and a yueh needle was utilized to introduce normal saline to hydrodissect away the adjacent colon. The patient had no pain or significant complaints; he was discharged and returned to work the same day of the procedure. He continues to be without evidence of residual/recurrent disease one-year later.

Shamar Young, MD I University of Minnesota I Minneapolis, MN

IceForce 2.1 CX Needle successfully used to perform cryoablation on anterior aspect of the lower pole of the left kidney.

Using the Trajectory of the Needle to Protect Critical Structures

A 53-year-old man presented with 2.5 cm x 2.3 cm endophytic RCC in the anterior aspect of the lower pole of the left kidney. Cryoablation was performed with one IceForce™ 2.1 CX Needle. The tip of the needle was pointed toward the ureter since lethal ice only extends 5 mm beyond the tip of the needle. The patient was discharged the same day and follow-up imaging demonstrated no residual or recurrent disease 12-months post ablation.

AJ Gunn, MD I University of Alabama at Birmingham I Birmingham, AL

Cryoablation performed on 7cm left anterior conventional clear cell RCC using IceRod 1.5 Plus needles..

Cryoablation of 7 cm Renal Tumor after Previous Contralateral Nephrectomy

A 78-year-old man presented with right kidney multifocal RCC with vein invasion and concurrent 7 cm left anterior conventional clear cell RCC. The right tumor was treated with nephrectomy and the left tumor was treated with cryoablation 3 months after the nephrectomy. Hydrodissection was used to protect adjacent structures and 7 IceRod™ 1.5 PLUS needles were used to treat. There were no reported adverse events and early follow-up imaging of the left kidney confirmed adequate ablation.

Alex King, MD I University Hospital Southampton I Southampton, UK