title: Percutaneous trigeminal rhizotomy in a biplane angiosuite: technical assessment.
abstract: BACKGROUND
  Percutaneous trigeminal rhizotomy (PTR) uses fluoroscopic guidance to cannulate the foramen ovale for the treatment of trigeminal neuralgia.
  
  
  OBJECTIVE
  To describe the use of a high-resolution biplane neuroangiosuite for PTR and retrospectively to assess the performance of this technique.
  
  
  METHODS
  From 1990 through 2010, 67 PTRs were performed in 51 patients at our institution; 47 used the c-arm in the operating room (OR) and 20 used the biplane angiosuite. Hospital charts were reviewed for demographics, symptomatology, operative time, number of cannulation attempts, fluoroscopy time and pain outcome. Two-tailed univariate analyses were performed to compare the OR and angiosuite groups.
  
  
  RESULTS
  In 20 of 67 PTRs, biplane fluoroscopic guidance in the angiosuite was used. Variations in type of PTR, fluoroscopy technique and follow-up time barred meaningful comparison of these variables between OR and biplane groups. However, the biplane group had significantly fewer mean cannulation attempts (1 vs 2.2, p<0.001).
  
  
  CONCLUSIONS
  High-resolution biplane neuroangiosuites offer a readily available alternative to ORs for PTR in the treatment of trigeminal neuralgia. Use of the biplane fluoroscopy machine was practical, safe and at least as effective as the use of the c-arm. It may also offer the advantages of a reduced number of cannulation attempts.
authors.affiliation: Department of Neurosurgery, The University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Rose
authors.affiliation: Department of Neurosurgery, The University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Stone
authors.affiliation: Department of Neurosurgery, The University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Zeguang
authors.initials: Z
authors.lastname: Ren
authors.affiliation: Department of Neuroradiology, The University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, The University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Babak S
authors.initials: BS
authors.lastname: Jahromi
mesh_terms: D000368:Aged; D021721:Balloon Occlusion; D005260:Female; D054085:Foramen Ovale / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods*; D009873:Operating Rooms / Q000458:organization & administration*; D012189:Retrospective Studies; D019051:Rhizotomy / Q000379:methods*; D016896:Treatment Outcome; D012668:Trigeminal Ganglion / Q000601:surgery; D014276:Trigeminal Nerve / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000601:surgery*
keywords: Cranial nerve; Intervention; Peripheral nerve; Technique