Sequential MR-guided laser and cryoablation of a recurrent painful slow-flow venous malformation in a 6-year-old.

This case report evaluated the utilization of MR-guided ablation for a refractory painful slow-flow vascular malformation in the plantar aspect of the left foot in a 6-year-old male patient. Initially, MR-guided laser ablation was performed followed by MR-guided cryoablation 5 years later. Procedures were performed under general anesthesia using a 1.5-T Philips MRI system with real-time MRI guidance and monitoring. Pain outcomes were assessed using patient-reported improvement. The lesion diameter was 3.7 cm in the longest axis. The patient achieved sustained pain relief for 5 years after the initial laser ablation then MR-guided cryoablation which has given him 6 years of relief so far. No major complications occurred.