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Comparative Study
. 2021 Jun 7:2021:9306532.
doi: 10.1155/2021/9306532. eCollection 2021.

Comparison of Effectiveness and Safety between Intraoperative 3D-CT-Guided and C-Arm-Guided Percutaneous Balloon Compression for Idiopathic Trigeminal Neuralgia: A Multi-Center Retrospective Study

Xiong Xiao  1 , Zhengjun Wei  2 , Hao Ren  3 , Hongtao Sun  2 , Fang Luo  3
Affiliations
Comparative Study

Comparison of Effectiveness and Safety between Intraoperative 3D-CT-Guided and C-Arm-Guided Percutaneous Balloon Compression for Idiopathic Trigeminal Neuralgia: A Multi-Center Retrospective Study

Xiong Xiao et al. Pain Res Manag. .

Abstract

Objectives: To compare 3D-CT-guided and C-arm-guided percutaneous balloon compression (PBC) in terms of effectiveness and safety.

Methods: The medical records and follow-up data of patients with idiopathic trigeminal neuralgia who underwent 3D-CT-guided or C-arm-guided PBCs in Beijing Tiantan Hospital and the Characteristic Medical Center of the Chinese People's Armed Police Force between February 2018 and March 2020 were retrospectively reviewed and analysed.

Results: A total of 291 patients were included. Among them, 212 patients underwent PBC treatment with 3D-CT and others with C-arm. One (0.5%) patient in 3D-CT group and 4 (5.1%) patients in C-arm group failed to receive PBC treatment because of failure of foramen ovale (FO) puncture (P=0.020). Among patients with successful attempts, 5 (2.4%) patients in the 3D-CT group and 11 (14.7%) patients in the C-arm group received more than one needle pass during the procedure (P < 0.001). The 3D-CT group required less time than the C-arm group for puncture (P < 0.001) and for the whole operation (P < 0.001). The groups shared similar initial relief rates (P=0.749) and similar recurrence-free survival during follow-ups for a median of 22 months (P=0.839). No puncture-related complications occurred in either group and the two groups had similar incidences of compression-related complications.

Conclusion: 3D-CT facilitated FO puncture and improved success rate of PBC. The overall time efficiency of PBC was also increased with 3D-CT. Thus, 3D-CT is a potentially useful image guidance technology for treating idiopathic trigeminal neuralgia by PBC.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
2D images and reconstructed 3D-CT  images during FO puncture. (a) Scout image of spiral CT  during FO puncture; (b), (c) 2D and reconstructed 3D images of spiral CT showing the spatial relationship between the needle and the targeted FO; (d-f) axial, sagittal, and coronal views of the pear-shaped balloon; (g-i) reconstructed 3D-CT images provided confirmation of the position and shape of the balloon.
Figure 2
Figure 2
C-arm-guided FO puncture. (a) The needle penetrated the foramen ovale under lateral C-arm imaging; (b), (c) the balloon catheter was advanced into Meckel's cave under direct C-arm fluoroscopy; (d, e) the balloon was slowly inflated with nonionic contrast agent (omnipaque) under fluoroscopic monitoring; (f) the shape of the balloon was confirmed to be pear-like on lateral C-arm imaging.
Figure 3
Figure 3
Summary of study results. (a) Plot of patient selection procedure; (b) time consumption of FO puncture and whole procedure of PBC; (c) Kaplan–Meier curves of recurrence-free survival of both groups.
See this image and copyright information in PMC

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