The Application of the Balloon Pre-Inflating Technique in Percutaneous Balloon Compression for Primary Trigeminal Neuralgia: A Retrospective Study.

BACKGROUND

Percutaneous balloon compression (PBC) is a safe and effective surgical technique for treating trigeminal neuralgia. The filling balloon can compress the trigeminal ganglion in Meckel's cave to achieve the interruption of pain signals. The core of the operation is the successful placement of a balloon catheter into Meckel's cave so that effective compression of the trigeminal ganglion can be achieved after the balloon is inflated.

OBJECTIVE

In this article, we try to determine the application value of the balloon pre-inflating technique (using contrast agents as guides during positioning) by studying its effect on the ideal balloon formation rate in PBC.

STUDY

DESIGN

A retrospective study.

SETTING

A single center.

METHODS

To compare the small-dose balloon pre-inflating technique with traditional techniques during PBC surgery, we conducted a retrospective study on the clinical data of patients who had primary trigeminal neuralgia and underwent PBC surgery at the Department of Pain Management of the Second Xiangyi Hospital at Central South University in Changsha from January 2018 to January 2024. In total, 170 patients underwent the pre-inflating technique (pre-inflating group), and 199 patients underwent the traditional non-pre-inflating technique (control group).

RESULTS

A total of 369 patients were included in the study, with a follow-up period of 12 months. When the initial balloon morphology was suboptimal, the success rate of re-catheterization to obtain the ideal balloon shape in the pre-inflating group and the non-pre-inflating group was 84.3% and 58.9%, respectively. The success rate in the pre-inflating group was significantly higher than in the non-pre-inflated group (P < 0.001). The numbers of re-punctures and re-catheterizations were significantly lower than in the non-pre-inflating group, as was the radiation dose. The instances of re-punctures in the pre-inflating group and the non-pre-inflating group were 0.41(ranging from 0.23 to 0.59 instances) and 0.71 (0.55-0.87 instances), respectively; and the re-catheterizations in the pre-inflating group and the non-pre-inflating group took place a respective 1.08 (0.77-1.40 instances) and 1.59 (1.28-1.90) instances. The radiation dose was 5.59 mGy (4.88-6.38 mGy) in the pre-inflating group and 7.69 mGy (6.86-8.52 mGy) in the non-pre-inflating group.

LIMITATIONS: This single-center investigation may be subject to institution-specific protocols and potential physician biases, with the generalizability of findings further constrained by the limited sample size.

CONCLUSION

We found that using the low-dose balloon pre-inflating technique in PBC surgery significantly improved the success rate of subsequent balloon deployment when the initial balloon morphology was suboptimal. This pre-inflating technique may decrease radiation exposure as well as the occurrences of multiple balloon catheter placements and repeated punctures.