GreatWall International Cancer Center
Tumor Targeted Cryoablation  

Cryoablation also called cryosurgery or tumor targeted cryoablation therapy, is a minimally
invasive surgery treatment that uses extreme cold to destroy(ablation) diseased tissue,  
including cancer cells.  Cryoablation unit is approved by the U.S. Food and Drug
Administration (FDA) in 1999.

The common application of cryoablation is to ablate solid tumors found in the lung, liver,
breast, kidney, prostate gland,skin and soft tissue. In United States, the most common
application is to ablate prostate cancer. But in China, the most common application is to
ablate lung, liver and kidney cancer and the clinical application has been in progress for more
than 9 years. More than 30,000 cancer patients have took the treatment in China. It has
proven in medical practice that cyoablation is a safe, high effective, little pain and little side-
effects therapy.


Principles The System controls up to 8
CryoProbes to deliver cold temperature to the
targeted tissue and 8 independent TempProbes
to monitor temperature in the surrounding tissue.
Each cryoprobe incorporates a thermocouple to
measure temperature at the probe tip and its
signal is used to monitor and control some
operations of the system.

Cryoprobes operate on the Joule-Thompson
Principle and utilize inert Argon and utilize inert
Argon and Helium gases at room temperature as cooling or heating agents. It freezes very
fast. The tissues can be frozen to below -100℃ within 30 seconds. Also the freezing capacity
is focused (targeted) and limited to the distal tip of the probes, to destroy cancerous tissues
while sparing normal ti
ssues. Both are distinctive advantages over any other cryo-medical devices. It is the only
device could be used for percutaneous applications too.

How does the procedure work?   

Cryotherapy applies nitrogen or argon gas at extremely cold temperatures to destroy
diseased tissue. To destroy diseased tissue located outside the body, liquid nitrogen is
applied directly with a cotton swab or spray device. For internal tumors, the physician will use
image-guidance to insert a cryoprobe or a series of small needles through the skin to the site
of the diseased tissue and then deliver liquid nitrogen or argon gas.   
Living tissue, healthy or diseased, cannot withstand extremely cold conditions and will die
from:


Cryoablation Effects

Fast freezing grows ice crystals in and outside the cells rapidly; and fast thawing by helium
gas cracked the lethal ice quickly. The Cell mitochondria disappear, the membranes are split,
nucleuses are broken or dissolved, which result in cell death. Cryoablation causes cell
structure damage and cell membrane obstruction; it also causes imbalance of electrolysis in
and out of the cells and osmosis pressure as well as protein denaturation. In this way,
cancerous cells are destroyed.



Embolism Effects on Blood VesselsCryoablation allows for rapid freezing/thawing exchanges
in targeted zone to cause dehydration of micro blood vessels, protein denaturation, interior
membrane damage of these vessels and ischemia. It gathers platelets in targeted zone,
causes blood vessel congestion and shrinking and deformation of cells. Cryotherapy induced
embolism have apparently ablation effect on the peripheral parts of the targeted zone.


Anti-cancer Cryoimmunology EffectsTargeted Cryoablation cause cracking and necrosis of
tumor cells and force decline of tumor makers like CEA, AFP and PSA. It can regulate and
control tumor antigen, boost lymph cell hyperplasia, increase secretion of IL-2, IL-6, apoptosis
factors and anti-cancer antibody and improve patients’ immunity.


Treatment Procedure


Image-guided procedures such as cryotherapy are most often performed by a specially
trained interventional radiologist in an interventional radiology suite or occasionally in the
operating room.

This procedure is often done on an outpatient basis. You will be positioned on the examining
table. To destroy diseased tissue located outside the body, your physician will apply liquid
nitrogen to the area with a cotton swab or spray device.

For internal tumors, your physician will perform a percutaneous procedure, which involves
inserting small, hollow, needles through the skin.

You will be connected to monitors that track your heart rate, blood pressure and pulse during
the procedure. A nurse or technologist will insert an intravenous (IV) line into a vein in your
hand or arm so that sedative medication can be given intravenously. You may also receive
general anesthesia.  

The area where the electrodes or cryoprobe are to be inserted will be shaved, sterilized and
covered with a surgical drape.

A very small nick is made in the skin at the site. Using image-guidance, the physician will
insert the cryoprobe or a series of small needles through the skin to the site of the diseased
tissue. Once the needles or cryoprobe(s) are in place, the liquid nitrogen or argon gas is
delivered.

For prostate cancer, six to eight needle probes
are inserted through the perineum (the tissue
between the rectum and the scrotum and
penis) using ultrasound guidance.


At the end of the procedure, the needles or
cryoprobe(s) are removed and pressure will
be applied to stop any bleeding. The opening
in the skin is covered with a bandage.
No sutures are needed. Your intravenous line
will be removed.                     

The entire procedure is usually completed
within one to two hours.


Benefit of Cryoablation

There are a number of reasons why, as a patient undergoing ablation treatment for an
arrhythmia, you might choose cryoablation over radiofrequency (RF) ablation:


Highly Visible under Image Guidance                                   

Cryoablation can be guided by ultrasound
(US), CT, X-ray, DSA, simulator, etc. Good
intraoperative imaging monitoring ensures
accurate control of ablation zones.

CT Guidance  In CT imaging, ice ball
produces a 40 Hounsfield unit drop in
attenuation 8 which is shown as low-density
shadow. CT allows for complete visual
monitoring and verification of the
ice ablation zone. Ultrasound Guidance In US
imaging, ice ball is clearly visible. The ice is
in low echo field (dark) while its periphery is a
strong echo field (bright).


Less Discomfort

Cold is one of nature’s anesthetics; accordingly, cryoablation results in little or no discomfort
or pain during the procedure.

Greater Stability

When cold temperatures are applied, cryocatheters stick to the tissue they touch, much like a
tongue on cold metal. This is an advantage because ablation is performed in a beating heart
where there is constant movement. By sticking to the exact spot to be ablated, the
electrophysiologist can avoid any accidental slips of the catheter tip, thereby preventing
accidental damage to critical structures nearby.

Ability to Confirm Target Ablation Site

Cryoablation allows the electrophysiologist to slightly freeze tissue to test whether it is
responsible for conducting an arrhythmia. Heat-based therapies don’t allow that – once the
tissue is burned, it stays burned. By contrast, cryoablation allows the electrophysiologist to re-
warm frozen tissue (that is not responsible for the arrhythmia) and restore its normal electrical
function.

Minimizes the Risk of Damaging Critical Structures

Treating arrhythmias with ablation involves working very close to critical structures, for
example, the heart’s natural pacemakers, the esophagus or coronary arteries. Damage to
critical structures can result in the permanent interruption of normal electrical conduction in
the heart and require the placement of an artificial pacemaker in the patient – an outcome
everyone absolutely wants to avoid. With cryoablation – which freezes tissue instead of
burning it – the risk of damage to these critical structures is minimized.

Minimizes the Risk of Perforation

Perforation – for example, to the atrial wall – is a dangerous risk that can lead to serious
complications. Thanks to its ability to preserve tissue integrity, there is minimal risk of
perforation with cryoablation.

No Crust Formation

Heat burns. Burns can cause a crust to form over the affected tissue; this is known as
thrombus in medical terms. The crust may fall off and lodge in a blood vessel, causing a
blood clot which can lead to stroke. With cryoablation, this risk is minimized.

Multiple cryoprobes may be used simultaneously

Multiple Cryoprobes used simultaneously can create a large ablation zone.

Multiple Cryoprobes allow treatment of multiple tumors concurrently.




Clinical Study Reference

1. Clinical Study of TACE Combined with CT Guided Percutaneous Targeted Argon-helium
Cryoablation to Treat Liver Carcinoma, SONG Qian, LI Lu-Jia, et al., China Journal of Modern
Medicine, 2005, 15: 3178-80

2. Percutaneous Cryoablation in Combination with Chemoembolization in Treatment of Liver
Malignancy: A Report of 34 Cases, QIAN GuoJun, CHEN Han, et al., Chin J Hepatobiliary
Surg, 2004, 10: 542-45

3. Treatment of 50 Cases with Advanced Hepatocellular Carcinoma by Combination of TACE
with Cryotherapy of Employing Argon/Helium, LIAN Zu-Ping, BAI Guang-De, et al., Modern
Oncology, 2006, 14: 1106-08

4. Percutaneous Cryoablation in Treatment of Liver Cancer: a Report of 31 Cases, QIAN Guo-
Jun, CHEN Han, et al., World Chin J Digestol, 2003, 11: 712-15   

5. Cryosurgical Ablation for Aged Patients with Severe Benign Prostate Hyperplasia A Report
of 21 Cases, QIAN Guojun, CHEN han, et al., Fu Bu Wai Ke, 2003, 16-18  

6. Treatment Efficacy of Argon Super Cyrosurgery System Therapy in Combination with
Transcatheter Arteria Chemoembolization for hepatocellular Carcinoma, CHEN Ye, CHEN Mei,
et al., Central Plains medical Journal, 2008, 35: 8-9  

4. Immune-enhancing Effect of Ar-He Targeted Cryoablation for Treatment of Advanced Non-
small Cell Lung Cancer, ZHANG Cai-Xia, CHENG Ying, et al., Tumor, 2007, 27: 741-743   

5. Cryosurgical Ablation for Aged Patients with Severe Benign Prostate Hyperplasia A Report
of 21 Cases, WANG An-Xi, WANG Dong, et al., National Journal of Andrology, 2007, 13: 421-
23   

6. Analysis of Treatment Effect of Hysteromyoma by Cryocare Surgical System, CHENG Gou-
Chang, He Xiang-Ming, et al., Maternal and Child Health Care of China, 2005, 20: 3021-22

7. A Clinical Study of Percutaneous Cryoablation in Treatment of Advaned non-small Cell
Lung Cancer, ZHANG Cai-xia, MA Li-xia, et al., Jilin Medical Journal, 2006, 27: 711-12   

8. Clinical Analysis of the Therapy for Recurrent and Intractable Non-small Cell Lung Cancer
with Combination of Cryoablation and Intervention, ZHANG Fu-tong, LI Xiu-li, et al., J Intervent
Radiol, 2007, 16: 759-61   

9. Clinical Study of Cryosurgery on Lung Cancer, CHENG Ying, ZHANG Cai-xia, et al., Jilin
Medical Journal, 2005, 26: 599-600   

10. Clinical Study of Percutaneous Cryosurgery Combined with Chemotherapy in Treatment
for 253 Cases with Advanced Non-small Cell Lung Cancer, FENG Hua-song, NIE Zhou-shan,
et al., China Cancer, 2007, 16: 898-901    

11. Clinical Study on Targeted Argon-Helium Cryotherapy in Treatment for 725 Cases with
Pulmonary Neoplasm, FENG Hua-song, DUAN Yun-you, et al., China Cancer, 2007, 16: 906-
909  

12. Percutaneous Trageted Metastatic Lung Cancer Cryoablation Guided by Computer
Tomography, WANG Hong-wu, DUAN Yun-you, et al., Journal of Navy Medicine, 2002, 24:
113-117  

13. The Influence of Cryosurgery on Great Vessels and Heart in Patients with Lung Cancer,
WANG Hongwu, LIU Jing, Chin J Lung Cancer, 2004, 7: 423-26  

14. Immune-enhancing Effect of Ar-He Targeted Cryoablation for Treatment of Advanced Non-
small Cell Lung Cancer, ZHANG Cai-Xia, CHENG Ying, et al., Tumor, 2007, 27: 741-743  

15. Percutaneous cryosurgery for the treatment of hepatic colorectal metastases. Ke-Cheng,
Xu Li-Zhi, et al. World Journal of Gastroenterology, 2008, 14(9):1430-1436  

16.  Analysis of Treatment Effect of Hysteromyoma by Cryocare Surgical System, CHENG
Gou-Chang, He Xiang-Ming, et al., Maternal and Child Health Care of China, 2005, 20: 3021-
22  

17. Clinical Application of CT-guided Percutaneous Targeted Argon-Helium Cryoablation for
Soft Tissue Sarcoma, SONG Qian, ZHAN Ying, et al., J South Med Univ, 2006, 26: 229-30    



Last Updated ( Tuesday, 09 September 2008 22:36 )  



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