122 - Cost Analysis of Cryoablation Versus Sclerotherapy for Treatment for Low Flow Vascular Malformations

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Poster Presenter(s)

Alanna Joyce Supersad, MD (she/her/hers)

Interventional Radiology Fellow
University of Toronto - University Health Network (UHN), Canada

Author/Co-author(s)

AQ

Aziz Qazi, MD

Vascular and Interventional Radiologist
University of Toronto, University Health Network, Canada
BW

Blair Warren, MD

IR Fellow
University of Toronto, Canada
Kong Teng Tan, MD (he/him/his)

Interventional Radiology
Toronto General Hospital, Canada
JK

Julian Kwon, None

Research Student
University Health Network, Canada

Purpose: Low flow vascular malformations (LFVM) are the most common congenital vascular anomaly and often cause pain, negatively affecting quality of life{1}. First line treatment has shifted from surgical resection to sclerotherapy. Most patients require many sclerotherapy sessions in a lifetime. Per our institutional protocol, a patient is scheduled for 3 sessions upon consultation and for 3 more if they re-present with symptoms. Cryoablation is an effective treatment often requiring 1 session. This study is the first to outline the cost difference between the two treatments which can be extrapolated to the treatment cost over a lifetime.

Materials and Methods: 17 patients who underwent cryoablation for a LFVW from January 2023 to August 2024 after sclerotherapy were reviewed in this retrospective, single center study. Data was retrieved from electronic medical records (EPIC and Coral), including number of treatments, procedure time and materials. Visual analogue scale (VAS) for pain before and after measured the outcome of symptomatic improvement. Procedure costs (Table 1) were obtained from our institutional inventory database (Qsight) and finance team. Common products used for sclerotherapy and cryoablation were excluded, physician billing fees were not included due to variability.

Results: Preliminary data shows that the average cost of 1 session of cryoablation for a LFVM is $2175.70 and $341.12 for sclerotherapy (average 3.06 sessions of sclerotherapy per patient), the average cost of sclerotherapy per lesion is $1043.83. To date, all patients have required 1 cryotherapy treatment. Of 17 patients, 9 reported a lower VAS after cryoablation, 1 reported no change, 1 had no documented VAS but reported subjective pain improvement. 6 patients are awaiting follow up, this will be added to the final analysis.

Conclusion: Cryoablation costs 6 times more than sclerotherapy per session, but is more effective and often only requires 1 treatment 1,4. Over a patient's lifetime, if cryotherapy can be used as first line treatment for LFVMs, then overall healthcare costs would be reduced and quality of life would be improved through symptomatic control and reduction in need to use the healthcare system.