Cryoablation

Cryoablation is a minimally invasive medical procedure that destroys abnormal or diseased tissue by freezing it to very low temperatures. The tissue injury results from the formation of intracellular and extracellular ice crystals, osmotic and vascular damage, and subsequent cell death. The technique can be delivered via percutaneous, laparoscopic, or open approaches.

During the procedure, cryoprobes deliver extremely cold temperatures using argon-based systems or liquid nitrogen. The tissue forms an ice ball that expands around the probe tip. Treatment typically uses one or more freeze-thaw cycles to maximize cellular injury while allowing surrounding tissues to be monitored.

Imaging guidance (ultrasound, CT, or MRI) plans probe placement and monitors the ice ball in real time. Cryoablation is commonly used for tumors in the kidney, liver, lung, and bone, and also in some cardiac rhythm procedures to ablate arrhythmogenic tissue. It is also employed for prostate cancer and for palliation of painful bone metastases.

Advantages include real-time visualization of the ablation zone, preservation of supporting connective structures, and potentially improved intraoperative pain control. Limitations include risk to adjacent organs from cold injury, longer procedures for larger lesions, and variable expertise. Complications may include bleeding, infection, damage to nearby structures, or rare cryoshock.

The development of modern cryoablation evolved from cryosurgery, with advances in cryoprobes and imaging in the late 20th century.