Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
1.
J Vasc Interv Radiol ; 34(5): 807-813, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36581196

RESUMEN

PURPOSE: To evaluate the feasibility, safety, and efficacy of intercostobrachial nerve (ICBN) cryoneurolysis for pain control in patients with postmastectomy pain syndrome (PMPS). MATERIALS AND METHODS: Fourteen patients with PMPS were prospectively enrolled into this clinical trial after a positive response to a diagnostic computed tomography (CT)-guided percutaneous block of the ICBN. Participants subsequently underwent CT-guided percutaneous cryoneurolysis of the same nerve and were observed on postprocedural Days 10, 90, and 180. Pain scores, quality-of-life measurements, and global impression of change values were recorded before the procedure and at each follow-up point using established validated outcome instruments. RESULTS: Cryoneurolysis of the ICBN was technically successful in all 14 patients. The mean pain decreased significantly by 2.1 points at 10 days (P = .0451), by 2.4 points at 90 days (P = .0084), and by 2.9 points at 180 days (P = .0028) after cryoneurolysis. Pain interference with daily activities decreased significantly by 14.4 points after 10 days (P = .0161), by 16.2 points after 90 days (P = .0071), and by 20.7 points after 180 days (P = .0007). There were no procedure-related adverse events. CONCLUSIONS: Cryoneurolysis of the ICBN in patients with PMPS was technically feasible and safe and resulted in a significant decrease in postmastectomy pain for up to 6 months in this small cohort.


Asunto(s)
Neoplasias de la Mama , Dolor Crónico , Femenino , Humanos , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/cirugía , Dolor Crónico/etiología , Mastectomía/efectos adversos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
2.
J Vasc Interv Radiol ; 31(6): 912-916.e1, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32376178

RESUMEN

Eight patients who underwent percutaneous cryoablation of mixed and/or motor nerves over a period of 5 years were identified. Distances from the ablation sites to origins of distal musculature were measured, and times to initial clinical recovery were collected. Strength progression over time following muscle activation was also collected and analyzed. All patients demonstrated activation of all muscles distal to the ablation, and the calculated mean rate of nerve regeneration based on distance to the origin of the assessed musculature and time to muscle activation for the group was 1.5 mm/day ± 1.1.


Asunto(s)
Criocirugía , Desnervación Muscular/métodos , Fuerza Muscular , Músculo Esquelético/inervación , Regeneración Nerviosa , Dolor/cirugía , Traumatismos de los Nervios Periféricos/fisiopatología , Nervios Periféricos/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Criocirugía/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neuronas Motoras/patología , Desnervación Muscular/efectos adversos , Dolor/diagnóstico , Dolor/fisiopatología , Traumatismos de los Nervios Periféricos/diagnóstico , Traumatismos de los Nervios Periféricos/etiología , Traumatismos de los Nervios Periféricos/patología , Nervios Periféricos/patología , Nervios Periféricos/fisiopatología , Estudios Prospectivos , Recuperación de la Función , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
3.
Am J Hosp Palliat Care ; 37(8): 619-623, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32602380

RESUMEN

OBJECTIVES: The purpose of this report is to describe the effect of computed tomography-guided bilateral pudendal nerve cryoablations on pain and time to discharge in the setting of acute hospitalizations secondary to refractory pelvic pain from cancer. METHODS: Investigators queried the medical record for patients who underwent pudendal nerve cryoablation using the Category III Current Procedural Technology code assignment 0442T or Category I code 64640 for cases prior to 2015. The resulting list was reviewed, and procedures performed on inpatients for intractable pelvic pain related to neoplasm were selected. The final cohort was then analyzed with regard to patient demographics, procedure details, technical success, safety, pain scores, and time to discharge. RESULTS: Ten patients underwent cryoablation by 3 operators for palliation of painful pelvic neoplasms between June 2014 and January 2019. All probes were satisfactorily positioned and freeze cycles undertaken without difficulty. There were no procedure-related complications or adverse events. The mean difference in pre- and posttreatment worst pain scores was significant (n = 5.20, P = .003). The mean time to discharge following the procedure was 2.3 days. CONCLUSION: Computed tomography-guided percutaneous cryoablation of the bilateral pudendal nerves may represent a viable option in the setting of acute hospitalization secondary to intractable pain in patients with pelvic neoplasms.


Asunto(s)
Dolor en Cáncer/cirugía , Criocirugía/métodos , Dolor Intratable/cirugía , Cuidados Paliativos/métodos , Neoplasias Pélvicas/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Alta del Paciente , Estudios Retrospectivos , Factores Socioeconómicos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA