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Related Experiment Video

Updated: May 28, 2026

Multimodality Diagnosis of Mesenteric Ischemia

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Published on: July 21, 2023

Transcrural coeliac plexus block simulated on 200 computed tomography images.

I Y Yang¹, S Oraee, C Viejo

¹Department of Anesthesiology and Pain Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Avenue, Bronx, NY 10457, USA. iyangmd@gmail.com

British Journal of Anaesthesia

|October 5, 2011

Summary

This study optimized transcrural coeliac plexus block (tCPB) needle placement using CT imaging. Personalized CT-guided simulations improve tCPB accuracy and safety, reducing organ penetration risks.

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Area of Science:

Interventional Radiology
Pain Management
Anatomy

Background:

Previous work established a modified transcrural coeliac plexus block (tCPB) using patient-specific CT parameters.
This study aimed to refine tCPB needle placement by simulating the procedure on 200 CT images.

Purpose of the Study:

To determine optimal needle placement parameters for tCPB.
To compare simulated tCPB parameters with the classic technique.
To identify variations in optimal parameters based on patient characteristics.

Main Methods:

tCPB was simulated bilaterally on 200 CT images, targeting the coeliac trunk.
Needle trajectory, entrance distance from midline, insertion angle, and depth were measured.
Analysis considered laterality, gender, intra-abdominal conditions, and coeliac-aortic-vertebral (c-a-v) distribution.

Main Results:

Left-sided tCPB required shorter distances and steeper angles than right-sided placements (P<0.00001).
Left-left c-a-v distributions showed the shortest distances and steepest angles (P<0.00001).
Male gender and cancer pathology influenced needle insertion parameters (P≤0.05).

Conclusions:

tCPB needle placement parameters are influenced by laterality, gender, pathology, and c-a-v distribution.
Simulating tCPB on individual patient CT scans is recommended for accurate measurements.
Further clinical outcome studies are warranted to validate simulated findings.