Prologo J D
Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image Guided Medicine, Emory University School of Medicine, Atlanta, GA.
Tech Vasc Interv Radiol. 2020 Mar;23(1):100660. doi: 10.1016/j.tvir.2020.100660. Epub 2020 Jan 11.
There are a number of pathologic conditions in the human body that may be modified by the interruption of neural signaling, both related to pain and otherwise. Many of these treatments currently involve implantable neuromodulation or frank surgical neural ligation, representing opportunities for the implementation of percutaneous device-mediated cryoneurolysis in interventional radiology. Computed tomography-guided cryovagotomy for the management of mild to moderate obesity represents one such opportunity currently under investigation. This procedure is designed to attenuate hunger signals by targeting the posterior vagal trunk using computed tomography for cryoablation with a needle, based on historical surgical and electrical vagotomy experience. Future investigations of this technique and others will expand and iterate the concept of percutaneous, image-guided cryoneurolysis as potential management for a wide variety of clinical challenges.
人体中有许多病理状况可通过中断神经信号来改变，这些状况既与疼痛相关，也涉及其他方面。目前，许多此类治疗涉及植入式神经调节或直接的外科神经结扎，这为介入放射学中经皮设备介导的冷冻神经溶解术的应用提供了机会。计算机断层扫描引导下的冷冻迷走神经切断术用于治疗轻度至中度肥胖就是目前正在研究的一个此类机会。基于以往的外科手术和电迷走神经切断术经验，该手术旨在通过计算机断层扫描引导用针进行冷冻消融，靶向迷走神经后干，以减弱饥饿信号。对该技术及其他技术的未来研究将扩展并迭代经皮、图像引导的冷冻神经溶解术这一概念，将其作为应对各种临床挑战的潜在治疗方法。
