Percutaneous Image-Guided Cryoablation for the Treatment of Phantom Limb Pain in Amputees: A Pilot Study

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• 作者：J. David Prologo ; MD^a ; ^{john.david.prologo@emory.edu} ; Charles A. Gilliland ; MD^a ; Michael Miller ; MD^a ; Paul Harkey ; MD^b ; Jackie Knight ; NP-C^e ; Darren Kies ; MD^a ; C. Matthew Hawkins ; MD^a ; David Corn ; MS^e ; David K. Monson ; MD^c ; Faramarz Edalat ; MD^b ; Sean Dariushnia ; MD^a ; Luke Brewster ; MD^d
• 关键词：AE ; adverse event ; PLP ; phantom limb pain ; RLP ; residual limb pain ; RMDQ ; Roland Morris Disability Questionnaire ; SAE ; serious adverse event ; VAS ; visual analog scale
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：28
• 期：1
• 页码：24-34.e4
• 全文大小：1743 K
• 卷排序：28

文摘

To prospectively evaluate percutaneous image-guided nerve cryoablation for treatment of refractory phantom limb pain (PLP) in a pilot cohort for purposes of deriving parameters to design a larger, randomized, parallel-armed, controlled trial.Materials and MethodsFrom January 2015 to January 2016, 21 patients with refractory PLP underwent image-guided percutaneous cryoneurolysis procedures. Visual analog scale scores were documented at baseline and 7, 45, and 180 days after the procedure. Responses to a modified Roland Morris Disability Questionnaire were documented at baseline and 7 and 45 days after the procedure.ResultsTechnical success rate of the procedures was 100%. There were 6 (29%) minor procedure-related complications. Disability scores decreased from a baseline mean of 11.3 to 3.3 at 45-day follow-up (95% confidence interval 5.8, 10.3; P < .0001). Pain intensity scores decreased from a baseline mean of 6.2 to 2.0 at long-term follow-up (95% confidence interval 2.8, 5.6; P < .0001).ConclusionsImage-guided percutaneous nerve cryoablation is feasible and safe and may represent a new efficacious therapeutic option for patients with phantom pains related to limb loss.