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Related Experiment Videos

Percutaneous radiofrequency upper thoracic sympathectomy

H A Wilkinson1

  • 1Division of Neurological Surgery, University of Massachusetts Medical School, Worchester, USA.

Neurosurgery
|April 1, 1996
PubMed
Summary

Percutaneous radiofrequency sympathectomy offers an effective, minimally invasive treatment for various vascular and pain conditions. The refined Phase III technique demonstrates high long-term success rates with minimal complications.

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Area of Science:

  • Minimally Invasive Surgery
  • Pain Management
  • Vascular Surgery

Background:

  • Sympathectomy is used to treat conditions like hyperhidrosis, Raynaud's disease, and causalgia.
  • Traditional open sympathectomy has limitations, prompting the development of less invasive techniques.
  • Percutaneous radiofrequency sympathectomy has evolved over 15 years, with significant procedural refinements.

Purpose of the Study:

  • To evaluate the efficacy and safety of a refined percutaneous radiofrequency sympathectomy technique (Phase III).
  • To compare the success rates of different phases of the radiofrequency sympathectomy technique.
  • To assess the long-term outcomes of radiofrequency sympathectomy for various indications.

Main Methods:

  • 148 percutaneous radiofrequency sympathectomies were performed on 247 limbs in 110 patients.

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  • The Phase III technique utilizes neuroleptanalgesia, local anesthesia, and two radiofrequency needle electrodes.
  • Lesion targeting involved C-arm fluoroscopy and electrical stimulation; effectiveness was monitored by plethysmography and temperature measurements.

    • Main Results:

    • The Phase III technique achieved complete or significant sympathetic interruption in 96% of limbs at 2 years and 91% at 3 years.
    • Success rates for Phase III significantly surpassed those of Phase I (83% at 2 years, 72% at 3 years) and Phase II (77% at 2 years, 71% at 3 years).
    • Symptomatic pneumothorax was the only serious complication, occurring in six patients.

    Conclusions:

    • The refined percutaneous radiofrequency sympathectomy (Phase III) is a highly effective and safe procedure.
    • This technique offers superior long-term success rates compared to earlier iterations.
    • Minimally invasive radiofrequency sympathectomy provides a viable alternative for patients with hyperhidrosis, vasculopathies, and chronic pain.