Safety of percutaneous renal cryoablation: an international multicentre experience from the EuRECA retrospective percutaneous database

  • J. GarnonEmail author
  • M. J. Van Strijen
  • T. K. Nielsen
  • A. J. King
  • A. D. Montauban Van Swijndregt
  • R. L. Cazzato
  • P. Auloge
  • C. Rousseau
  • D. Dalili
  • F. X. Keeley Jr
  • B. W. Lagerveld
  • D. J. Breen



To investigate the safety profile of percutaneous cryoablation of renal tumours < 7 cm, utilising data extracted from an international multicentre registry.

Materials and methods

A retrospective review of all immediate and delayed complications from a multicentre database was performed and was categorised according to the Clavien-Dindo classification. Statistical analysis was performed for both overall complications (all Clavien-Dindo) and major complications (Clavien-Dindo 3 to 5). The following criteria were identified as potential predictive factors for complications: centre number, modality of image guidance, tumour size (≤ 4 cm vs. > 4 cm), number of tumours treated in the same session (1 vs. > 1) and tumour histology.


A total of 713 renal tumours underwent ablation in 647 individual sessions. In 596 of the cases, one tumour was treated; in the remaining 51 cases, several tumours were treated per session. Mean lesion size was 2.8 cm. Fifty-four complications (Clavien-Dindo 1 to 5) occurred as a result of the 647 procedures, corresponding to an overall complication rate of 8.3%. The most frequent complication was bleeding (3.2%), with 9 cases (1.4%) requiring subsequent treatment. The rate of major complication was 3.4%. The only statistically significant prognostic factor for a major complication was a tumour size > 4 cm.


Percutaneous renal cryoablation is associated with a low rate of complications. Tumours measuring more than 4 cm are associated with a higher risk of major complications.

Key Points

• Percutaneous kidney cryoablation has a low rate of complications.

• Bleeding is the most frequent complication.

• A tumour size superior to 4 cm is a predictive factor of major complication.


Kidney Cryoablation Complications Bleeding 



Cone-beam CT


Computed tomography


European Registry for Renal Cryoablation


Magnetic resonance imaging


Renal cell carcinomas


Radiofrequency ablation



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Julien Garnon—University Hospital of Strasbourg.

Conflict of interest

Dr. Garnon is a proctor for BTG Galil and received fees for oral presentation for Medtronic and Canon. Dr. Van Strijen, Lagerweld and Breen are proctors for BTG Galil. All other authors have no conflict of interest.

Statistics and biometry

Dr. Rousseau has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was not required because of the retrospective design of the study.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in:

• Buy X, Lang H, Garnon J, Sauleau E, Roy C, Gangi A. Percutaneous renal cryoablation: prospective experience treating 120 consecutive tumors. AJR Am J Roentgenol. 2013 Dec;201(6):1353–61.

• Breen DJ, Bryant TJ, Abbas A, Shepherd B, McGill N, Anderson JA, Lockyer RC,Hayes MC, George SL. Percutaneous cryoablation of renal tumours: outcomes from 171 tumours in 147 patients. BJU Int. 2013 Oct;112(6):758–65.


• retrospective

• observational

• multicentre study


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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • J. Garnon
    • 1
    Email author
  • M. J. Van Strijen
    • 2
  • T. K. Nielsen
    • 3
  • A. J. King
    • 4
  • A. D. Montauban Van Swijndregt
    • 5
  • R. L. Cazzato
    • 1
  • P. Auloge
    • 1
  • C. Rousseau
    • 6
  • D. Dalili
    • 7
  • F. X. Keeley Jr
    • 8
  • B. W. Lagerveld
    • 5
  • D. J. Breen
    • 4
  1. 1.Department of Interventional RadiologyNouvel Hôpital CivilStrasbourg CedexFrance
  2. 2.Department of RadiologySt. Antonius HospitalNiewegeinthe Netherlands
  3. 3.Department of UrologyAarhus University HospitalAarhusDenmark
  4. 4.Department of RadiologyUniversity Hospital Southampton NHS TrustSouthamptonUK
  5. 5.Department of UrologyOnze Lieve Vrouwe GasthuisAmsterdamNetherlands
  6. 6.Clinical Investigation Center INSERM 1414University Hospital of Rennes and University of RennesRennesFrance
  7. 7.Department of RadiologyGuy’s and St. Thomas’ Hospitals NHS Foundation TrustLondonUK
  8. 8.Department of UrologyBristol Urological InstituteBristolUK

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