Percutaneous CT-Guided Sympathicolysis with Radiofrequency for the Treatment of Palmar Hyperhidrosis
García-Barquín P (1), Aquerreta Beola JD (2), Bondía Gracía JM (2), España Alonso A (3), Pérez Cajaraville J (4), Bartolomé Leal P (2), Bastarrika G (2).
(1) Radiology Service, Clínica Universidad de Navarra, Avenida Pío XII, 36, C.P. 31008, Pamplona, Spain.
(2) Radiology Service, Clínica Universidad de Navarra, Avenida Pío XII, 36, C.P. 31008, Pamplona, Spain.
(3) Dermatology Service, Clinica Universidad de Navarra, Pamplona, Spain.
(4) Unit of Pain, Grupo Universitario HM Hospitales de Madrid, Spain.
Magazine: Journal of Vascular and Interventional Radiology
Date: Mar 30, 2017Dermatology Radiology [SP]
To evaluate the benefits of computed tomography (CT)-guided percutaneous sympathicolysis with radiofrequency in patients with primary palmar hyperhidrosis (PPHH) in terms of safety, patient satisfaction, and short- and long-term efficacy.
MATERIALS AND METHODS:
A total of 139 procedures in 108 patients (mean age, 29.89 y ± 10.94), including 50 men and 58 women, with PPHH and therapy-resistance of nonsurgical treatments were retrospectively analyzed.
Treatment was performed bilaterally at T2, T3, and T4 levels, reaching 90°C during 8 minutes. Technical success, immediate efficacy, and presence of complications were analyzed. For follow-up, the Hyperhidrosis Disease Severity Scale was used to evaluate the hyperhidrosis before, at one month, and in the long-term through a survey of 42 patients. Patients' satisfaction and complications were also recorded.
The technical success rate was 98.56%. The increase in palmar skin temperature was 4.88°C ± 1.85. A total of 85.3% of participants had completely dry hands immediately after treatment. The mean follow-up time was 41.34 months (range, 6-62 mo). One month after treatment, the response rate was 77.38% (P < .001).
At long-term follow-up, the response rate was 69.04% (P < .001). Two major complications were observed (1.8%), 52.38% of patients were satisfied, and 59.52% of patients presented compensatory hyperhidrosis at long-term follow-up.
Percutaneous CT-guided sympathicolysis is a safe and effective technique for the treatment of PPHH and can be considered as a second choice in patients in whom other nonsurgical therapeutic options have failed, despite the compensatory hyperhidrosis rates.
CITATION J Vasc Interv Radiol. 2017 Mar 30. pii: S1051-0443(17)30220-8. doi: 10.1016/j.jvir.2017.02.025
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