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CardioVascular and Interventional Radiology

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01-02-2018 | Clinical Investigation

Changes in Perioperative Systolic Blood Pressure in Percutaneous Renal Mass Cryoablation

Authors: Sung Yoon Park, Young Taik Oh, Kyunghwa Han, Dae Chul Jung, Man Deuk Kim, Jong Yun Won

Published in: CardioVascular and Interventional Radiology | Issue 2/2018

Abstract

Objectives

To analyze changes in systolic blood pressure (SBP) in the perioperative period of percutaneous renal mass cryoablation and risk factors.

Methods

This retrospective study included 54 patients who underwent percutaneous renal cryoablation. SBP before ablation (pre-Tx), during ablation (intra-Tx), immediately after ablation (post-Tx), and before discharge (discharge) were measured using a BP cuff. The highest SBP during cryoablation was regarded as SBP at intra-Tx. Antihypertensive agents were administrated when SBP was 160 mmHg or greater during cryoablation. Relationship between SBP at pre-Tx, pain degree, tumor size, cryoprobe number, or endophytic extension of the radiographic ice-ball, and SBP elevation or administration of antihypertensive agents was investigated.

Results

Mean SBP elevation from pre-Tx to intra-Tx was 22.9 ± 18.0 mmHg (range −6–78 mmHg). SBP of intra-Tx was significantly higher than that of the other periods (p < .001), while SBP of post-Tx or discharge was similar with that of pre-Tx (p > .05). Tumor size (r = .324; p = .016), cryoprobe number (r = .300; p = .027), and endophytic extension (r = .348; p = .009) were correlated with SBP elevation, while SBP at pre-Tx or pain degree were not (p > .05). Antihypertensive agents were administrated for 24 patients (44.4%). In multivariate analysis, SBP at pre-Tx and endophytic ablation was associated with administration of antihypertensive agents during cryoablation (p < .05).

Conclusions

SBP elevation may occur during percutaneous renal mass cryoablation, but be improved before discharge. Endophytic extension of the radiographic ice-ball may be associated with significant BP elevation during ablation.

Thompson RH, Atwell T, Schmit G, et al. Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol. 2015;67(2):252–9.CrossRefPubMed

Zargar H, Atwell TD, Cadeddu JA, et al. Cryoablation for small renal masses: selection criteria, complications, and functional and oncologic results. Eur Urol. 2016;69(1):116–28.CrossRefPubMed

Hartman JB, Bhojwani N, Corn DJ, et al. Incidence of hypercoagulable events after image-guided percutaneous cryoablation of renal tumors: a single-center experience. J Vasc Interv Radiol. 2014;25(5):776–9.CrossRefPubMedPubMedCentral

Atwell TD, Carter RE, Schmit GD, et al. Complications following 573 percutaneous renal radiofrequency and cryoablation procedures. J Vasc Interv Radiol. 2012;23(1):48–54.CrossRefPubMed

Sidana A, Aggarwal P, Feng Z, et al. Complications of renal cryoablation: a single center experience. J Urol. 2010;184(1):42–7.CrossRefPubMed

Johnson DB, Taylor GD, Lotan Y, et al. The effects of radio frequency ablation on renal function and blood pressure. J Urol. 2003;170(6 Pt 1):2234–6.CrossRefPubMed

Basile DP, Anderson MD, Sutton TA. Pathophysiology of acute kidney injury. Compr Physiol. 2012;2(2):1303–53.PubMedPubMedCentral

Chedid A, Le Coz S, Rossignol P, et al. Blunt renal trauma-induced hypertension: prevalence, presentation, and outcome. Am J Hypertens. 2006;19(5):500–4.CrossRefPubMed

Patel N, King AJ, Breen DJ. Percutaneous image-guided cryoablation of small renal masses. Abdom Radiol. 2016;41(4):754–66.CrossRef

10.

Varon J, Marik PE. Perioperative hypertension management. Vasc Health Risk Manag. 2008;4(3):615–27.CrossRefPubMedPubMedCentral

11.

Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.CrossRefPubMed

12.

Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral

13.

Gupta A, Allaf ME, Kavoussi LR, et al. Computerized tomography guided percutaneous renal cryoablation with the patient under conscious sedation: initial clinical experience. J Urol. 2006;175(2):447–52 discussion 452–443.CrossRefPubMed

14.

Li CL. Effect of cooling on neuromuscular transmission in the rat. Am J Physiol. 1958;194(1):200–6.PubMed

15.

Lloyd JW, Barnard JD, Glynn CJ. Cryoanalgesia: a new approach to pain relief. Lancet. 1976;2(7992):932–4.CrossRefPubMed

16.

Green CR, de Rosayro AM, Tait AR. The role of cryoanalgesia for chronic thoracic pain: results of a long-term follow up. J Natl Med Assoc. 2002;94(8):716–20.PubMedPubMedCentral

17.

Park SY, Park BK, Kim CK. Thermal ablation in renal cell carcinoma: what affects renal function? Int J Hyperth. 2012;28(8):729–34.CrossRef

18.

Lambeth CB, Derrick JR, Hansen AE. Stenosis of a branch of the renal artery causing hypertension in a child, including a complication of translumbar renal arteriography. Pediatrics. 1960;26:822–7.PubMed

19.

Lee SM, Drach GW. Renovascular hypertension from segmental renal artery stenosis: importance of segmental renal vein renin sampling. J Urol. 1980;124(5):704–6.CrossRefPubMed

20.

Mishima E, Hashimoto J, Akiyama Y, et al. Impact of small renal ischemia in hypertension development: renovascular hypertension caused by small branch artery stenosis. J Clin Hypertens (Greenwich). 2016;18(3):248–9.CrossRef

21.

Welch BT, Atwell TD, Nichols DA, et al. Percutaneous image-guided adrenal cryoablation: procedural considerations and technical success. Radiology. 2011;258(1):301–7.CrossRefPubMed

Title: Changes in Perioperative Systolic Blood Pressure in Percutaneous Renal Mass Cryoablation
Authors: Sung Yoon Park
Young Taik Oh
Kyunghwa Han
Dae Chul Jung
Man Deuk Kim
Jong Yun Won
Publication date: 01-02-2018
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 2/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-017-1772-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in Perioperative Systolic Blood Pressure in Percutaneous Renal Mass Cryoablation

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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