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Abstract: SA-PO745

Outcomes of Foam Sclerotherapy for Large Kidney/Liver Cysts using Multi-Stage (Same/Next Day) and Multiple Sequential Procedures

Session Information

Category: Genetic Diseases of the Kidneys

  • 1201 Genetic Diseases of the Kidneys: Cystic

Authors

  • Howe, Cassie, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Helland, Ryan, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Gregory, Adriana, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kline, Timothy L., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Vaughan, Lisa E., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Torres, Vicente E., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Hogan, Marie C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

We have been performing sotradecol foam sclerotherapy (SFS) outpatient procedures to ablate liver/kidney cysts. SFS has led to substantial reductions in Targeted Kidney & Liver Cyst (TKCV/TLCVs), total kidney/liver volumes (TKV/TLV), improved QOL, & augments cyst volume reduction in addition to tolvaptan (kidney cysts) & octreotide (liver cysts). We examined efficacy in individuals with multiple large cysts who opt to undergo multiple or multi-stage SFS (same day or 2 consecutive days).

Methods

Kidneys & liver were segmented using a deep-learning algorithm & cysts segmented using semi-automated segmentation software, pre & 4+ mo post SFS. Wilcoxon tests assessed %△ pre/post SFS. Median % △ TKCV/TLCVs were calculated (per-patient) by taking median %△ of targeted cysts within patient & compared to outcomes from single stage cyst procedures.

Results

For multiple liver procedures,(n=15) median △% TKCV/TLCVs was -76.5% [IQR, -90.3%, -42.8%, P<0.001] & △TLV % -1.9% [IQR, -7.4%, 0.42%, P=0.11] (Fig 1). For patients undergoing multiple kidney procedures (n=16), median % △TKCV was -88.8% [IQR, -95.1%, -82.0%, P<0.001] & △% TKV -13% [IQR, -23.8%, -4.9%, P<0.001]. Only 5 had multi-stage liver procedures; median △% TLCV post SFS -73% [IQR, -93%, -71%, P=0.06], & only 2 underwent multi-stage kidney procedures; median △% TKCV -52%[IQR, -73.5%, -31%, P=0.5].

Conclusion

Multiple SFS procedures led to substantial reductions in TKCV/TLCV/TKV/TLV; data on patients who underwent multi-stage procedures were sparse, but still demonstrated positive results. SFS is feasible & convenient for patients seeking ablation of multiple cysts in a single 1 or 2 day session. Multiple & multi-stage SFS appear to be effective for patients with high cyst burden mainly due to a limited number of large cysts, with good patient satisfaction.

Percent Change in Targeted Cyst Volumes, Liver & Kidney Volumes. Black bars: % △ of each cyst. Black dots: median % △within each participant. Dashed line: 0% change.

Funding

  • NIDDK Support