Airway spray cryotherapy: initial outcomes from a multiinstitutional registry

Area of Science:

• Pulmonology
• Oncology
• Interventional Gastroenterology

Background:

• Spray cryotherapy (SCT) utilizes a noncontact system delivering liquid nitrogen via an endoscopic catheter.
• Rapid freezing and thawing induce cellular death and provide hemostasis.
• SCT is explored for treating malignant airway tumors.

Purpose of the Study:

• To report preliminary results of spray cryotherapy for malignant airway tumors.
• To evaluate the safety and efficacy of SCT in this patient population.

Main Methods:

• Retrospective review of SCT procedures in 80 patients across 6 institutions.
• Airway narrowing was graded, and all treatment events were documented and assessed.
• Data collected included patient demographics, procedure details, and intraoperative/postoperative events.

Main Results:

• 114 SCT treatments were performed on 80 patients (median age 66 years).
• Most patients experienced minimal blood loss, with 58% treated as outpatients.
• Airway obstruction exceeded 75% in most treated lesions; 21 intraoperative events (19%) and 3 postoperative deaths were recorded. All but one patient achieved airway patency.

Conclusions:

• SCT demonstrates potential for treating highly vascular airway tumors, offering reduced bleeding complications.
• Intraoperative complications, including pneumothorax and deaths related to bradycardia, warrant caution.
• Larger studies are required to confirm the benefits and safety of widespread SCT use.