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Percutaneous Image-guided Cryoneurolysis: Applications and Techniques.

Alan Alper Sag¹, Ross Bittman¹, Frank Prologo¹

¹From the Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, 2301 Erwin Road, DUMC Box 3808, Durham, NC 27710 (A.A.S.); Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image Guided Medicine (R.B., E.B.F., J.D.P.), Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics (S.A.), Emory University School of Medicine, Atlanta, Ga; Department of Biological Sciences. Clemson University, Clemson, SC (F.P.); Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (N.N.); and Experimental Therapeutics Program, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Md (N.N.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc

|October 3, 2022

Summary

This summary is machine-generated.

Interventional cryoneurolysis, guided by advanced imaging, offers a non-opioid pain relief option. This technique is expanding beyond pain management, with new procedural codes supporting its clinical use.

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Area of Science:

Interventional Radiology
Neurology
Pain Management

Background:

Interventional cryoneurolysis has expanded due to advanced imaging and improved understanding of cold nerve effects.
Its applications are growing beyond pain management.
Clinical translation requires careful consideration of nerve targets, imaging guidance, pain causes, neuroregeneration, and potential complications.

Purpose of the Study:

To review the factors influencing the clinical translation of interventional cryoneurolysis.
To highlight its role as a non-opioid pain palliation option.
To discuss its potential beyond pain management and the considerations for interventional radiologists.

Main Methods:

Review of current literature and clinical practice considerations for interventional cryoneurolysis.
Discussion of imaging guidance, neuropathology, and procedural factors.
Analysis of regulatory and reimbursement changes, including new CPT codes.

Main Results:

Cryoneurolysis is recognized as an effective non-opioid pain management strategy.
New CPT codes support cryoablation of nerves with advanced imaging guidance.
Interventional radiologists can integrate cryoneurolysis into practice, offering benefits like reduced opioid dependence and faster discharge.

Conclusions:

Interventional cryoneurolysis is a viable and expanding technique with significant potential.
Its integration into interventional radiology practice offers advantages for patient care and practice growth.
Further development and understanding will enhance its therapeutic applications.