The overall complication rate at our hospital was 13% with major complication rate of 4.6% (Fig 16),
which is comparible with literature which shows complication rate of 8 to 13% with major complication rates of 4 to 6%.7,11
Fig. 16: Pie chart: Frequency of various complications related to RFA of renal lesions at our Institute.
Fig. 17: Bar chart: Comparison of frequency of complications and major complications related to RFA of renal lesions at our institute with literature.
The most frequent complication remains hemorrhage involving the collecting system.
Second,
most common complication is ureteral strictures followed by urine leaks.
Pain and paranesthesia are also reported in one patient,
which was likely not related to RFA procedure.
The society of interventional radiology has divided the complications into major and minor.
Major complications require hospitalization and minor complication needs only observation or monitoring. We present a pictorial review of complications with tips from our own experience to try to avoid these as well as management strategies for their occurrence.
Following are few cases with complications related to RFA reported in our institute:
Case 1a: A 80 year old male with right renal mass.
Post RFA hemorrhage at the RFA site resolved on followup examinations.
(Fig.
1 to 5)
Case 1b: A 80 year old male patient with known bladder tumor and a 20 mm left lower pole exophytic enhancing lesion with small amount of blood collecting around the site of treatment,
which resolved on followup. Patient had numbness of left,
which resovled and had no association with procedure.
(Fig.
6 to 8)
Case 2: A 85 year old male patient with right renal mass develops right hydronephrosis secondary to post RFA stricture,
which resolved on conservative management.
(Fig.
9 to 11)
Case 3: A 85 year old male right superior pole lesion presents with abnormal enhancement in the lateral and inferior part of the treated right upper pole tumour - ? post RFA AV malformation/ local recurrence after 2 years.
Subsequent MRI showed AV malformation.
(Fig.
12 & 13)
Case 4: A 80 year old male with with right upper lobe lesion presented with delayed pelvic calyceal leak following radiofrequency ablation 4 months ago.
(Fig.
14)
Case 5: A 75 year old male with left renal mass presented with post RFA pancreatitis.
(Fig.
15)
The various risk factors for major complications included: advanced age,
increased tumor size and central location of the renal mass.