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Percutaneous trigeminal rhizotomy in a biplane angiosuite: technical assessment
Katherine R Rose1, Jonathan J Stone1, Zeguang Ren1
1Department of Neurosurgery, The University of Rochester Medical Center, Rochester, New York, USA.
Journal of Neurointerventional Surgery
|October 25, 2013
Summary
High-resolution biplane neuroangiosuites provide a safe and effective alternative for percutaneous trigeminal rhizotomy (PTR) in treating trigeminal neuralgia. This technique may reduce the number of attempts needed to cannulate the foramen ovale.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Medical Imaging
Background:
- Percutaneous trigeminal rhizotomy (PTR) is a treatment for trigeminal neuralgia.
- This procedure uses fluoroscopic guidance to cannulate the foramen ovale.
Purpose of the Study:
- To describe the use of high-resolution biplane neuroangiosuites for PTR.
- To assess the performance of this technique retrospectively.
Main Methods:
- Retrospective review of 67 PTR procedures performed between 1990 and 2010.
- Comparison of procedures using c-arm in the operating room (47) versus biplane angiosuites (20).
- Analysis of demographics, operative time, cannulation attempts, fluoroscopy time, and pain outcomes.
Main Results:
- Biplane fluoroscopic guidance was used in 20 of 67 PTRs.
- The biplane group showed significantly fewer mean cannulation attempts (1 vs 2.2, p<0.001).
- Meaningful comparison of other variables was limited by procedural variations.
Conclusions:
- High-resolution biplane neuroangiosuites are a practical, safe, and effective alternative to operating rooms for PTR.
- This technique may reduce the number of cannulation attempts for trigeminal neuralgia treatment.
- Biplane fluoroscopy offers advantages for PTR procedures.
