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Cardiovasc Intervent Radiol. 2018 Feb;41(2):298-304. doi: 10.1007/s00270-017-1801-3. Epub 2017 Oct 3.

Percutaneous Ultrasound-Guided Cryoablation for Symptomatic Plantar Fibromas.

Author information

1
Division of Vascular and Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, WCC 308-F, 1 Deaconess Road, Boston, MA, 02215, USA. mahmed@bidmc.harvard.edu.
2
Division of Vascular and Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, WCC 308-F, 1 Deaconess Road, Boston, MA, 02215, USA.
3
Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA.
4
Department of Radiology, Yale Medical School, New Haven, CT, USA.

Abstract

PURPOSE:

Here, we report our experience in treating painful plantar fibromas with percutaneous cryoablation.

METHODS:

We retrospectively identified patients with symptomatic plantar fibromas who underwent percutaneous ultrasound-guided cryoablation between June 2014 and June 2015. In total, four patients (two male, two female) with five plantar fibromas undergoing a total of seven ablation procedures were identified. Each procedure was performed under general anesthesia using a single freeze-thaw cycle. The electronic medical record, procedure reports, and pain scores from a brief pain inventory administered before and after treatment were reviewed. Average and worst pain in 24 h, and time to peak symptom improvement post-procedure were compared. Complications were reviewed using the SIR classification.

RESULTS:

Five plantar fibromas were treated (mean size 2.2 ± 1.6 cm). Four of five lesions were present for more than 6 years, and 1/5 was present for less than 1 year. Surgical excision was previously performed on 3/5 lesions, all with short-term recurrence. Mean worst pain score in 24 h and average pain score in 24 h (scale of 10) at initial evaluation were 7.1 ± 1.8 and 5.8 ± 1.9, reduced after cryoablation to 0.8 ± 0.8 and 0.4 ± 0.6, respectively. Average time to symptom improvement was 2.8 ± 0.98 weeks (range 2-4 weeks). All patients reported improved ambulation and weight-bearing, and complete cessation of pain medication after treatment. The improvement was sustained on follow-up at 12 months. No major complications occurred. Minor complications occurred in 3/5 patients.

CONCLUSIONS:

Early experience with percutaneous ultrasound-guided cryoablation to treat painful plantar fibromas suggests that it is a safe and effective treatment option, with early and near-complete symptom improvement.

KEYWORDS:

Ablation; Cryoablation; Percutaneous; Plantar fibroma

PMID:
28975378
DOI:
10.1007/s00270-017-1801-3
[Indexed for MEDLINE]

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