TY - JOUR
T1 - Immediate Effect of Kidney Cryoablation on Renal Arterial Structure in a Porcine Model Studied by Imaging Cryomicrotome
AU - Lagerveld, Brunolf W.
AU - van Horssen, Pepijn
AU - Pes, M. Pilar Laguna
AU - van den Wijngaard, Jeroen P. H. M.
AU - Streekstra, Geert J.
AU - de La Rosette, Jean J. M. C. H.
AU - Wijkstra, Hessel
AU - Spaan, Jos A. E.
PY - 2010
Y1 - 2010
N2 - Purpose: Injury to blood microvessels has a crucial role in effective cryoablation for renal masses. We visualized vascular injury induced by a clinically applied cryoablation instrument and established a microvascular diameter threshold for vascular damage. Materials and Methods: In 5 anesthetized pigs 1 kidney each was exposed and 3, 17 gauge cryoneedles were inserted in 1 pole. Tissue was exposed to freezing for 2 x 10 minutes with a 10-minute thaw between freezes. After nephrectomy the arteries were injected with fluorescence dyed casting material and the kidney was frozen to -20C and cut in 40 to 60 mu slices in the imaging cryomicrotome, where fluorescent images of the cutting plane of the bulk were obtained. This resulted in a 3-dimensional image of the arterial tree that was segmented, resulting in unbranched vessel segments. Histograms were constructed with the total segment length per diameter bin plotted as function of diameter. Results: The ablated zone was sharply demarcated on fluorescent and normal light images. Mean SD diameter at the peak of the histogram from control areas was 152.4 +/- 5.3 mu. Compared to control areas the peak diameter of ablated areas was shifted to a larger diameter by an average of 25.4 +/- 2.6 mu. Conclusions: Immediate renal cryoablation injury destroys arteries smaller than 180 mu. Branching structures of larger arteries remain anatomically intact and connected to vascular structures in surrounding tissue
AB - Purpose: Injury to blood microvessels has a crucial role in effective cryoablation for renal masses. We visualized vascular injury induced by a clinically applied cryoablation instrument and established a microvascular diameter threshold for vascular damage. Materials and Methods: In 5 anesthetized pigs 1 kidney each was exposed and 3, 17 gauge cryoneedles were inserted in 1 pole. Tissue was exposed to freezing for 2 x 10 minutes with a 10-minute thaw between freezes. After nephrectomy the arteries were injected with fluorescence dyed casting material and the kidney was frozen to -20C and cut in 40 to 60 mu slices in the imaging cryomicrotome, where fluorescent images of the cutting plane of the bulk were obtained. This resulted in a 3-dimensional image of the arterial tree that was segmented, resulting in unbranched vessel segments. Histograms were constructed with the total segment length per diameter bin plotted as function of diameter. Results: The ablated zone was sharply demarcated on fluorescent and normal light images. Mean SD diameter at the peak of the histogram from control areas was 152.4 +/- 5.3 mu. Compared to control areas the peak diameter of ablated areas was shifted to a larger diameter by an average of 25.4 +/- 2.6 mu. Conclusions: Immediate renal cryoablation injury destroys arteries smaller than 180 mu. Branching structures of larger arteries remain anatomically intact and connected to vascular structures in surrounding tissue
U2 - https://doi.org/10.1016/j.juro.2009.11.064
DO - https://doi.org/10.1016/j.juro.2009.11.064
M3 - Article
C2 - 20096877
SN - 0022-5347
VL - 183
SP - 1221
EP - 1226
JO - Journal of urology
JF - Journal of urology
IS - 3
ER -