Vascular casts demonstrate microcirculatory insufficiency in acute frostbite

Daum, Patricia; Bowers, Wilbert D.; Tejada, Jorge; Hamlet, Murray P.

doi:10.1016/0011-2240(87)90008-3

Cited by 42 publications

(16 citation statements)

References 14 publications

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“…When the temperature reaches -20 0 C, ice forms in both the intra and extracellular spaces, causing irreversible damage to the cell membranes. However, the delayed effect resulting from damage to the microvasculature of the renal parenchyma is believed to be the most important mechanism of action of cryoablation [16]. Majority of times, the repeated cycles of freezing and thawing enhances tissue destruction, with some animal model experiments showing evidence that double freezing lead to large areas of tissue destruction compared to single freezing [17] …”

Section: Cryotherapymentioning

confidence: 99%

Ablative Therapy in 2016 for Small Renal Masses

Ian¹,

Farrag²,

Sriprasad³

2017

UNOAJ

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Introduction: Incidental diagnosis of small renal masses (SRMs), less than 4 cm in size, is increasing due to the widespread use of different forms of diagnostic imaging. The natural history of these tumours remains unknown and there is no reliable way to predict their behaviour or growth. Partial nephrectomy is currently the gold standard in the treatment of these tumours. However, the more minimally invasive, non-excisional, ablative therapies such as cryoablation (CRA) and radiofrequency ablation (RFA) are providing comparable oncological outcomes.Methods: This article critically reviews the principles, indications, modalities of treatment, oncological outcome, complication and effect on renal function, of the different ablative therapies.Results: Cryotherapy induces tissue ablation by freezing and thawing using argon and helium gases respectively.RFA ablates the tissue by heating. These Ablative treatments for SRMs are particularly indicated in the elderly patients, those with co-morbidities, in patients with solitary kidneys and in those with impaired renal function. The procedure related complication rate with ablative therapies are lower. These procedures have a promising medium term oncological outcome, while longer-term results are awaited. It appears that Cryotherapy may be evolving as a better modality for oncological control than RFA. Conclusion:The Ablative therapies for SRMs are emerging as viable treatment options with recurrence free survival rates approaching that of extirpative surgery. However, there is currently no consensus in the literature on the best selection criteria for this form of treatment. With further refinement of selection criteria and more prospective long-term data on the oncological outcome, these ablative methods would have a promising future in the management of SRMs.

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Section: Cryotherapymentioning

confidence: 99%

Ablative Therapy in 2016 for Small Renal Masses

Ian¹,

Farrag²,

Sriprasad³

2017

UNOAJ

View full text Add to dashboard Cite

show abstract

“…Irreversible damage of the cell membrane occurs when the temperature reaches −20°C as ice forms in both the intra and extracellular spaces. However, it is believed that the important mechanism of action of cryoablation is the delayed effect resulting from damaging the microvasculature of the renal parenchyma [16]. In the majority of the time, repeated cycles of freezing and thawing enhances tissue destruction with some evidence from animal model experiments showed that double freezing led to large areas of tissue destruction compared to single freezing [17].…”

Section: Cryotherapymentioning

confidence: 99%

Non-Surgical Ablative Therapy for Management of Small Renal Masses—Current Status and Future Trends

Farrag

Sriprasad

2016

Indian J Surg Oncol

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A large number of small renal masses (SRMs) with size less than 4 cm are being identified due to advances in diagnostic imaging. As the natural history of these tumours remains unknown, there is no reliable way to predict their behaviour or future growth. Although, partial nephrectomy is the gold standard for treatment of these tumours, ablative non-surgical therapies such as cryoablation and radiofrequency ablation provide a less invasive option of treatment with comparable oncological outcomes. In this systematic review, the principle, indications, methods of treatment, oncological control, complication and renal function of ablative therapies are critically reviewed. Cryotherapy utilizes the principle of inducing tissue destruction by freezing and thawing using argon and helium gasses, respectively. Radiofrequency ablation (RFA) works on the principle of tissue heating. Ablative treatments are particularly useful in the elderly patients, those with comorbidities or in patients with SRMs in solitary kidneys or renal impairment. Ablative therapies have less procedurerelated complications and have promising medium-term oncological outcome. Longer-term results are accumulating. Cryotherapy may be a better modality for oncological control than RFA. Ablative therapy has emerged as a viable treatment options for SRMs with recurrence free survival rates approaching that of extirpative surgery. However, there is no consensus in the literature on the best selection criteria and this needs further refinement. Prospective long-term data with regards to oncological control is still needed

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“…This is due to damage to the microvasculature of the target tissue and formation of microthrombi. This phenomenon leads to delayed cell death and is believed to be the significant mechanism of action of cryotherapy [15]. Tissue destruction is achieved better by the combination of freezing and thawing processes.…”

Section: Mechanism Of Cryoablationmentioning

confidence: 99%