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BackTable Vascular & Interventional

Ep. 394 Cryoneurolysis Pearls and Pitfalls with Dr. Alexa Levey

Dec 18, 2023
Dr. Alexa Levey, interventional radiologist, discusses cryoneurolysis in interventional radiology, highlighting its advantages over radiofrequency ablation and its potential applications. Topics include stellate ganglion procedures, patient-centered care, financial discussions in medicine, cryoneurolysis as desmoid tumor treatment, and the importance of physician availability. The podcast also explores the innovative problem-solving mindset of interventional radiologists, the role and benefits of blocking the stellate ganglion, future applications, research, collaboration, and reflections on being a female in a male-dominated field.
01:03:00

Episode guests

Podcast summary created with Snipd AI

Quick takeaways

  • Cryo-Neurolysis causes a centerline type two nerve injury, which damages the axon but leaves the nerve layers intact, while RF always causes more extensive nerve damage. Cryo-Neurolysis allows for shorter freezing times and provides more visibility during the procedure. RF can cause adjacent tissues to char and has a higher risk of complications.
  • Stellate ganglion block and cryo-ablation are used for various nerve targets, including stellate ganglion itself for regulation of heart rate and blood pressure, V-tach, complex regional pain syndrome, long COVID symptoms, co-stimulators, and more. Cryo-ablation also shows potential for treating trigeminal nerves. The procedures offer a multimodal approach, and patient response and duration of relief can vary.

Deep dives

Advantages of Cryo-Neurolysis over RF

Cryo-Neurolysis causes a centerline type two nerve injury, which damages the axon but leaves the nerve layers intact, while RF always causes more extensive nerve damage. Cryo-Neurolysis allows for shorter freezing times and provides more visibility during the procedure. RF can cause adjacent tissues to char and has a higher risk of complications.

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