Image-Guided Transbronchial Pulmonary Cryoablation with a Flexible Cryoprobe in Swine: Performance and...

Area of Science:

• Pulmonary Medicine
• Interventional Radiology
• Surgical Technology

Background:

• Cryoablation is an effective minimally invasive treatment for lung lesions.
• Current cryoablation techniques often involve rigid probes and percutaneous approaches.
• Flexible probes offer potential for less invasive, endobronchial delivery.

Purpose of the Study:

• To assess the performance of a novel flexible transbronchial cryoprobe.
• To compare its efficacy against percutaneous transthoracic cryoablation.
• To characterize cryolesion imaging and pathology features using cone-beam CT.

Main Methods:

• A prototype flexible cryoprobe was used for transbronchial lung ablations in a swine model.
• Transthoracic cryoablation with a rigid probe served as a comparator.
• Cone-beam CT was used for intraoperative imaging, correlated with gross and histopathology.

Main Results:

• The flexible cryoprobe was successfully navigated and deployed in all transbronchial procedures.
• Cryolesions were visualized on cone-beam CT, with volumes comparable to transthoracic ablations.
• Imaging correlated well with gross and histopathology, though one pneumothorax occurred.

Conclusions:

• Transbronchial cryoablation using a flexible cryoprobe is a feasible technique.
• Cryolesions created via this method are detectable with cone-beam CT.
• Pathology of transbronchial cryolesions mirrors that of transthoracic cryoablations.