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Incidence and clinical sequelae of portal and hepatic venous thrombosis following percutaneous cryoablation of liver tumors

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Abstract

Purpose

To assess the incidence and sequelae of portal and hepatic venous thrombosis after percutaneous cryoablation of hepatic tumors.

Methods

From November 1998 through December 2010, 223 hepatic tumors were cryoablated during 170 ablation procedures in 135 patients. 24-h post-procedure MR images were reviewed retrospectively by two abdominal radiologists in consensus to identify tumor ablations that developed one or more new portal or hepatic venous thromboses in or outside the ablation zone. On follow-up MRI and CT examinations the outcomes of thromboses were classified as resolved, partially recanalized, persistent, or propagated.

Results

Venous thrombosis developed in association with 54 (24%) of 223 tumor ablations treated during 53 (31%) ablation procedures in 39 (28.8%) patients (15 women, 24 men; age range 40–82 years, mean 59 years). Of these 54 thromboses, 49 (91%) were located in portal vein branches, four (7%) in both portal and hepatic vein branches, and one (2%) in a hepatic vein branch. Thrombosed veins were outside but abutted the ablation zone in 36 (66.7%), and within it in 18 (33.3%). On follow-up imaging (n = 49), thrombi resolved in 29 (59%), partially recanalized in two (4%), persisted in 18 (37%) and propagated from sub-segmental or segmental branches to the left or right portal branches in five (10%). No thrombus propagated to the main portal vein or inferior vena cava.

Conclusion

Portal and hepatic vein branch thromboses are common in small branches following percutaneous cryoablation of hepatic tumors and most resolve spontaneously without sequelae.

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Conflict of interest

All authors declare that he/she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent from all individual participants was waived for this retrospective study approved by our Institutional Review Board.

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Authors and Affiliations

  1. Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Nisha I. Sainani, Stuart G. Silverman, Ibrahim S. Tuna, Ayaz Aghayev, Paul B. Shyn, Kemal Tuncali & Servet Tatli

  2. Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Vivek Kadiyala

Authors
  1. Nisha I. Sainani
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  2. Stuart G. Silverman
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  3. Ibrahim S. Tuna
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  4. Ayaz Aghayev
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  5. Paul B. Shyn
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  6. Kemal Tuncali
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  7. Vivek Kadiyala
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  8. Servet Tatli
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Corresponding author

Correspondence to Nisha I. Sainani.

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Sainani, N.I., Silverman, S.G., Tuna, I.S. et al. Incidence and clinical sequelae of portal and hepatic venous thrombosis following percutaneous cryoablation of liver tumors. Abdom Radiol 41, 970–977 (2016). https://doi.org/10.1007/s00261-015-0626-2

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  • DOI: https://doi.org/10.1007/s00261-015-0626-2

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