title: Percutaneous CT-Guided Sympathicolysis with Radiofrequency for the Treatment of Palmar Hyperhidrosis.
abstract: OBJECTIVE
  To evaluate the benefits of computed tomography (CT)-guided percutaneous sympathicolysis with radiofrequency in patients with primary palmar hyperhidrosis (PPHH) in terms of safety, patient satisfaction, and short- and long-term efficacy.
  
  
  METHODS
  A total of 139 procedures in 108 patients (mean age, 29.89 y ± 10.94), including 50 men and 58 women, with PPHH and therapy-resistance of nonsurgical treatments were retrospectively analyzed. Treatment was performed bilaterally at T2, T3, and T4 levels, reaching 90°C during 8 minutes. Technical success, immediate efficacy, and presence of complications were analyzed. For follow-up, the Hyperhidrosis Disease Severity Scale was used to evaluate the hyperhidrosis before, at one month, and in the long-term through a survey of 42 patients. Patients' satisfaction and complications were also recorded.
  
  
  RESULTS
  The technical success rate was 98.56%. The increase in palmar skin temperature was 4.88°C ± 1.85. A total of 85.3% of participants had completely dry hands immediately after treatment. The mean follow-up time was 41.34 months (range, 6-62 mo). One month after treatment, the response rate was 77.38% (P < .001). At long-term follow-up, the response rate was 69.04% (P < .001). Two major complications were observed (1.8%), 52.38% of patients were satisfied, and 59.52% of patients presented compensatory hyperhidrosis at long-term follow-up.
  
  
  CONCLUSIONS
  Percutaneous CT-guided sympathicolysis is a safe and effective technique for the treatment of PPHH and can be considered as a second choice in patients in whom other nonsurgical therapeutic options have failed, despite the compensatory hyperhidrosis rates.
authors.affiliation: Radiology Service, Clinica Universidad de Navarra, Pamplona, Spain. Electronic address: paulagarciabarquin@gmail.com.
authors.forename: Paula
authors.initials: P
authors.lastname: García-Barquín
authors.affiliation: Radiology Service, Clinica Universidad de Navarra, Pamplona, Spain.
authors.forename: Jesús Dámaso
authors.initials: JD
authors.lastname: Aquerreta Beola
authors.affiliation: Radiology Service, Clinica Universidad de Navarra, Pamplona, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Bondía Gracía
authors.affiliation: Dermatology Service, Clinica Universidad de Navarra, Pamplona, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: España Alonso
authors.affiliation: Unit of Pain, Grupo Universitario HM Hospitales de Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Pérez Cajaraville
authors.affiliation: Radiology Service, Clinica Universidad de Navarra, Pamplona, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Bartolomé Leal
authors.affiliation: Radiology Service, Clinica Universidad de Navarra, Pamplona, Spain.
authors.forename: Gorka
authors.initials: G
authors.lastname: Bastarrika
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013562:Sympathectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome