Ultrasound-guided percutaneous ethanol ablation of parathyroid hyperplasia: preliminary experience in patients on chronic dialysis.
OBJECTIVE
We report on a 3-year experience using single-shot, ultrasonography-guided, percutaneous ethanol ablation (PEA) of hyperplastic parathyroid glands in chronic dialysis patients suffering from secondary or tertiary hyperparathyroidism.


METHODS
Seventeen uraemic patients (mean age 52 +/- 14 years) with hypercalcaemia and elevated serum levels of parathyroid hormone were assessed for ethanol ablation. Ten patients did not fulfil the inclusion criteria and underwent surgical parathyroidectomy. Seven patients were treated using PEA.


RESULTS
All patients treated with PEA tolerated the procedure well, and no major complications were observed. Three out of seven patients underwent further ethanol ablation due to recurrent symptomatic hyperparathyroidism. Following the procedures, serum values of total calcium and parathyroid hormone remained within target range with concomitant medical therapy in all patients.


CONCLUSIONS
PEA performed as a single-shot therapy can be used as a minimally invasive and safe supplement to medical therapy in the treatment of secondary or tertiary hyperparathyroidism in selected patients. In case of recurrence, treatment can be repeated without any problems.
Schamp
S
S
Department of Radiology, Wilhelminenspital, Montleartstrasse 37, A-1160 Vienna, Austria. schamp_hertling@yahoo.de
Dünser
E
E
Schuster
H
H
Kramer-Deimer
J
J
Kettenbach
J
J
Funovics
M
M
Lang
U
U
Meisl
F T
FT
Umek
H
H
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D000431:Ethanol; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010280:Parathyroid Glands / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006435:Renal Dialysis / Q000009:adverse effects*; D012449:Safety; D014463:Ultrasonography; D014511:Uremia / Q000628:therapy*
D000431:Ethanol