Rose Katherine R, Stone Jonathan J, Ren Zeguang, Wang Henry, Jahromi Babak S
Department of Neurosurgery, The University of Rochester Medical Center, Rochester, New York, USA.
Department of Neuroradiology, The University of Rochester Medical Center, Rochester, New York, USA.
J Neurointerv Surg. 2014 Nov;6(9):699-703. doi: 10.1136/neurintsurg-2013-010883. Epub 2013 Oct 23.
Percutaneous trigeminal rhizotomy (PTR) uses fluoroscopic guidance to cannulate the foramen ovale for the treatment of trigeminal neuralgia.
To describe the use of a high-resolution biplane neuroangiosuite for PTR and retrospectively to assess the performance of this technique.
From 1990 through 2010, 67 PTRs were performed in 51 patients at our institution; 47 used the c-arm in the operating room (OR) and 20 used the biplane angiosuite. Hospital charts were reviewed for demographics, symptomatology, operative time, number of cannulation attempts, fluoroscopy time and pain outcome. Two-tailed univariate analyses were performed to compare the OR and angiosuite groups.
In 20 of 67 PTRs, biplane fluoroscopic guidance in the angiosuite was used. Variations in type of PTR, fluoroscopy technique and follow-up time barred meaningful comparison of these variables between OR and biplane groups. However, the biplane group had significantly fewer mean cannulation attempts (1 vs 2.2, p<0.001).
High-resolution biplane neuroangiosuites offer a readily available alternative to ORs for PTR in the treatment of trigeminal neuralgia. Use of the biplane fluoroscopy machine was practical, safe and at least as effective as the use of the c-arm. It may also offer the advantages of a reduced number of cannulation attempts.
经皮三叉神经半月节切断术（PTR）使用荧光镜引导将导管插入卵圆孔以治疗三叉神经痛。
描述高分辨率双平面神经血管造影设备在PTR中的应用，并回顾性评估该技术的性能。
1990年至2010年，我们机构对51例患者进行了67次PTR；47例在手术室（OR）使用C形臂，20例使用双平面血管造影设备。查阅医院病历，了解患者的人口统计学资料、症状、手术时间、插管尝试次数、透视时间和疼痛结果。进行双尾单因素分析以比较手术室组和血管造影设备组。
在67次PTR中的20次中，使用了血管造影设备中的双平面荧光镜引导。PTR类型、透视技术和随访时间的差异使得无法对手术室组和双平面组之间的这些变量进行有意义的比较。然而，双平面组的平均插管尝试次数明显较少（1次对2.2次，p<0.001）。
高分辨率双平面神经血管造影设备为治疗三叉神经痛的PTR提供了一种可随时使用的替代手术室的方法。使用双平面荧光镜机器是实用、安全的，并且至少与使用C形臂一样有效。它还可能具有减少插管尝试次数的优点。
