title: CT-Guided, Ethanol Sympatholysis for Primary Axillary-Palmar Hyperhidrosis.
abstract: OBJECTIVE
  Primary hyperhidrosis is an excessive sweating due to an overactive sympathetic system. Our objective was to test the feasibility and provide early data on the safety/efficacy of CT-guided sympatholysis, for primary hyperhidrosis.
  
  
  METHODS
  Nine consecutive patients with axillary-palmar hyperhidrosis were treated between 2013 and 2015. CT-guided sympathetic block was performed in the outpatients at T-2, T-3, and T-4, bilaterally using alcohol under local anesthesia. Immediate postprocedure CT was obtained to assess the complications as per Common Terminology Criteria for Adverse Events, version 4. Technical success and clinical success were recorded. Primary and secondary efficacy were assessed by phone and clinical visits; mean follow-up was 12 months (6-26 months). Descriptive statistics was used to report the outcomes.
  
  
  RESULTS
  One procedure was aborted due to eyelid ptosis after lidocaine injection. All other eight patients (5:3, F:M) (median age 32) had immediate cessation of sweating. Two major complications (pneumothorax, one requiring a chest tube) occurred. Two patients recurred with unilateral and one with bilateral symptoms. One of the unilateral recurrence and the bilateral recurrence patients was retreated successfully. Median follow-up was 1 year. No cases of Horner's or compensatory hyperhidrosis were observed.
  
  
  CONCLUSIONS
  CT-guided EtOH sympatholysis for axillary/palmar primary hyperhidrosis is feasible. Technical failure rate was 11 %. Primary and secondary efficacy are 75 and 94 %, respectively, to a median follow-up of 1 year. Risk profile appears favorable. Despite a small sample size, results confirm feasibility and encourage a larger study.
authors.affiliation: Vascular & Interventional Radiology, American Medical Center, 215 Spyrou Kyprianou Avenue, 2047, Nicosia, Cyprus.
authors.forename: Maria
authors.initials: M
authors.lastname: Tsitskari
authors.affiliation: Neurosurgery, American Medical Center, 215 Spyrou Kyprianou Avenue, 2047, Nicosia, Cyprus.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Friehs
authors.affiliation: Neurosurgery, American Medical Center, 215 Spyrou Kyprianou Avenue, 2047, Nicosia, Cyprus.
authors.forename: Vassilis
authors.initials: V
authors.lastname: Zerris
authors.affiliation: Vascular & Interventional Radiology, Johns Hopkins Hospital, 1800 Orleans Street, Sheikh Zayed Tower-Suite 7203, Baltimore, MD, USA. g_christos@hotmail.com.
authors.forename: Christos
authors.identifier: http://orcid.org/0000-0002-4559-1639
authors.initials: C
authors.lastname: Georgiades
mesh_terms: D000328:Adult; D000772:Anesthesia, Local; D001365:Axilla; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods*; D012997:Solvents / Q000008:administration & dosage; D013562:Sympathectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012997:Solvents; D000431:Ethanol
keywords: Hyperhidrosis; Sympathectomy; Sympatholysis