Purpose: To evaluate the technique, safety, and clinical outcomes of computed tomography-guided microwave ablation of cystic renal masses.
Material and methods: An institutional database was used to identify consecutive patients with cystic renal masses that were treated with percutaneous microwave ablation. Pre-ablation computed tomography or magnetic resonance images were reviewed by 2 board-certified, fellowship-trained abdominal radiologists to classify cystic renal masses as complex or Bosniak III/IV masses. A third board-certified, fellowship-trained radiologist served as the tiebreaker for cases of discordance between the two readers. Tumor factors such as size and renal nephrometry score were recorded. Ablation technique, including management of the cystic component of the tumors, adjunctive maneuvers, and power and time for the ablations, were recorded. Technical success, primary and secondary efficacy, adverse events, and clinical outcomes were assessed.
Results: Fifty-six patients with 61 cystic renal masses underwent CT-guided microwave ablation. The diagnostic yield of biopsy of cystic renal masses was 87%. Fifty of the 61 cystic renal masses (82%) were renal cell carcinoma. Primary technical success rate was 95.1%. There was no significant change in serum creatinine or estimated glomerular filtration rate pre-and post-ablation. There were 4 (8%) SIR grade 1 adverse events, all of which were small perinephric hematomas.
Conclusion: Computed tomography-guided microwave ablation of cystic renal masses, including cystic RCC, is technically feasible, highly effective, and associated with a low adverse event rate.
Objective: To compare chronic pelvic pain (CPP) outcomes after pelvic venous embolization in patients with pelvic venous disorders (PeVD) with versus without iliac vein compression (IVComp).
Methods: Patients with PeVD who underwent pelvic venous embolization at a single center were retrospectively reviewed. The patients were categorized into IVComp group and non-IVComp group based on the presence of IVComp. CPP control and CPP-free survival were compared between these two groups. Risk factors for CPP non-control were analyzed via logistic regression. Deep vein thrombosis (DVT) of the lower limb was examined in the IVComp group after the intervention.
Results: Among 102 collected patients, IVComp was identified in 51 patients (50.0%). The IVComp group was younger (35.7± 6.7 vs. 43.6±12.1, P< .001) and had more lower limb involvement (18/51, 35.3% vs. 6/51, 11.8%, p= .009). CPP control rates (non-IVComp group, 40/51, 78.4% vs. IVComp group, 42/51, 82.4%, P=1.00) and CPP-free survival rates (P=.941) did not differ significantly between groups. Pre-intervention VAS score (adjusted OR = 0.37, 95% CI: 0.21-0.67, p < .001) and lower limb involvement (adjusted OR = 7.49, 95% CI: 2.10-26.68, p = .002) were independent predictors for CPP non-control. No DVT of the lower limb was found at one month follow up in 47 IVComp patients.
Conclusions: In patients with PeVD and concomitant IVComp but without severe lower limb venous disorder, primary venous embolization alone, without iliac vein stent placement, appears to be safe and effective.

