Endovascular Denervation: A New Approach for Cancer Pain Relief?

J Vasc Interv Radiol. 2018 Dec;29(12):1639-1644. doi: 10.1016/j.jvir.2018.08.008. Epub 2018 Nov 7.

Abstract

Purpose: To evaluate the effects of endovascular denervation (EDN) on abdominal cancer pain relief.

Materials and methods: From April 2017 to February 2018, 7 cancer patients (2 males and 5 females) were enrolled in this study. The diagnoses of the patients included 3 pancreatic cancer, 2 cervical carcinoma, 1 cholangiocarcinoma, and 1 esophageal cancer with retroperitoneum lymph nodes invasion. Denervation was carried out at the abdominal aorta close to the origin of celiac artery and superior mesenteric artery with the use of a multielectrode radiofrequency ablation catheter with settings of time 120 seconds and temperature 60°C. The primary end point was improvement in pain scores. The secondary end points included change in quality of life, intake of narcotics, and the safety of EDN.

Results: All of the patients experienced pain relief. The pain scores as measured by means of visual analog scores at 1, 2, 4, 8, and 12 weeks after the procedure were significantly lower than before the operation (P < .001). A > 4 score reduction was observed in all cases. A significant reduction in narcotics use within 3 months after the operation was also seen. The quality of life scores of the patients improved significantly (P < .005) with better sleep. No severe treatment-related adverse events or major complications were observed.

Conclusions: EDN is a safe and effective means to alleviate pain caused by cancer and may serve as a new approach for cancer pain relief and palliative care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Neoplasms / complications
  • Abdominal Neoplasms / diagnosis
  • Abdominal Neoplasms / therapy*
  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Abdominal Pain / prevention & control*
  • Adult
  • Aged
  • Angiography, Digital Subtraction
  • Aortography / methods
  • Autonomic Denervation / adverse effects
  • Autonomic Denervation / methods*
  • Catheter Ablation* / adverse effects
  • Celiac Plexus / surgery*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Narcotics / therapeutic use
  • Pain Measurement
  • Palliative Care
  • Pilot Projects
  • Preliminary Data
  • Quality of Life
  • Time Factors
  • Treatment Outcome

Substances

  • Narcotics