Percutaneous Phenol Block of the Upper Thoracic Sympathetic Chain with Computed Tomography Guidance

Dondelinger, R. F.; Kurdziel, J. C.

doi:10.1177/028418518702800503

Cited by 42 publications

(23 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This was recently reconfirmed in a ''summary of evidence'' study [184]. Therefore, an initial attempt to obtain sympathetic block by phenol injections [185] may be beneficial, leaving the sympathetic chain intact for a repeated ablation for recurrent symptoms. Reoperative digital sympathectomy has been proven to be successful [186].…”

Section: Vasoconstrictive Ischaemiamentioning

confidence: 91%

Thoracic sympathectomy: a review of current indications

et al. 2015

View full text Add to dashboard Cite

Currently, thoracic sympathetic ablation is indicated mainly for primary hyperhidrosis, especially affecting the palm, and to a lesser degree, axilla and face, and for facial blushing. Despite modern pharmaceutical, endovascular and surgical treatments, sympathetic ablation has still a place in the treatment of very selected cases of angina, arrhythmias and cardiomyopathy. Thoracic sympathetic ablation is indicated in several painful conditions: the early stages of complex regional pain syndrome, erythromelalgia, and some pancreatic and other painful abdominal pathologies. Although ischaemia was historically the major indication for sympathetic ablation, its use has declined to a few selected cases of thromboangiitis obliterans (Buerger's disease), microemboli, primary Raynaud's phenomenon and Raynaud's phenomenon secondary to collagen diseases, paraneoplastic syndrome, frostbite and vibration syndrome. Thoracic sympathetic ablation for hypertension is obsolete, and direct endovascular renal sympathectomy still requires adequate clinical trials. There are rare publications of sympathetic ablation for primary phobias, but there is no scientific basis to support sympathetic surgery for any psychiatric indication.

show abstract

Section: Vasoconstrictive Ischaemiamentioning

confidence: 91%

Thoracic sympathectomy: a review of current indications

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Although its efficacy has long been debated for its recurrence, the improved results and its technique have guaranteed the benefit and efficacies of this procedure throughout many years of evolution [4][5][6][7][8]. In addition, PTS could be performed on out patients with just a light sedation or local analgesic infiltration and the results can be assessed immediately after the procedure.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the many benefits of percutaneous thoracic sympathectomy, there are also several complications, including pneumothorax, intercostal neuralgia, excessive dryness or compensatory hyperhidrosis, and superficial wound infection [1,4,[7][8][9]. Most of all, the life-threatening pneumothorax might be a serious complication that every physician wants to avoid.…”

Section: Introductionmentioning

confidence: 99%

“…Most of all, the life-threatening pneumothorax might be a serious complication that every physician wants to avoid. The incidence of pneumothorax after percutaneous thoracic sympathectomy has been reported as 0.2-0.9 %, varying between reports [4,[7][8][9]. Despite what appears to be very low incidence, once pneumothorax occurs, it must be regarded as a serious lifethreatening condition.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Modeling of safe window for percutaneous thoracic sympathectomy

et al. 2014

View full text Add to dashboard Cite

show abstract

“…The safety and efficacy of CT-guided LSL is well documented [1,2]. The purpose of this study was to modify the procedure according to the requirements of interventional MRI and to demonstrate equivalence of MR-and CT-guided LSL with respect to feasibility and safety.…”

mentioning

confidence: 99%

MR-guided lumbar sympathicolysis

et al. 2001

View full text Add to dashboard Cite

The aim of this study was to demonstrate the feasibility of MR-guided lumbar sympathicolysis (LSL) in a non-selected patient population. One hundred one MR-guided LSL procedures were performed in 89 patients according to Haaga's technique using a horizontally open clinical MR system (0.2 T) and non-ferromagnetic 20-G cannulas (neurolysis, n=93; blockade, n=8). Only gradient-recalled sequences in either single or multislice mode [fast imaging with steady-state precession (FISP) and fast low-angle shot] were applied for anatomical survey and needle guiding. Bupivacaine injection was monitored with MR fluoroscopically. Fluid distribution was subsequently documented in a CT scan in 65 patients. Ninety-one LSL procedures could be successfully completed. Ten patients were not treated using MR due to patient inconvenience, severe motion artifacts ( n=4 each), excessive spondylophytes, and retroperitoneal hematoma ( n=1 each). One case of ureteral necrosis occurred. Motion artifacts were rated less severe in single-slice FISP sequences and in obese patients. An average of 3.48 sequence measurements were required for definitive needle placement. Average table time was 32.3 min. An MR-guided LSL is feasible and can be performed with acceptable safety and time effort. It can be recommended for repeated sympathetic blockades in younger patients to avoid cumulative irradiation associated with CT guidance.

show abstract

Percutaneous Phenol Block of the Upper Thoracic Sympathetic Chain with Computed Tomography Guidance

Cited by 42 publications

References 16 publications

Thoracic sympathectomy: a review of current indications

Thoracic sympathectomy: a review of current indications

Modeling of safe window for percutaneous thoracic sympathectomy

MR-guided lumbar sympathicolysis

Contact Info

Product

Resources

About