Semin intervent Radiol 2022; 39(02): 138-141
DOI: 10.1055/s-0042-1745762
Review Article

Celiac Plexus Cryoneurolysis

Aron Chary
1   MidSouth Imaging, Vascular Interventional Physicians, Memphis, Tennessee
,
Faramarz Edalat
2   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations

Abstract

Intractable, chronic abdominal pain from upper abdominal malignant and benign diseases is a significant challenge for healthcare providers and burden on the healthcare system. While opioid analgesics are commonly used to provide pain relief, the adverse effects of chronic opioid use cannot be overlooked. Celiac plexus neurolysis via chemical or thermal means represents an alternative minimally invasive approach to provide palliative pain relief and increase patients' quality of life. Through the use of computed tomography guidance, celiac plexus neurolysis can be performed by accurately targeting the celiac plexus, while minimizing risks to adjacent structures. Historically, celiac plexus neurolysis was performed via instillation of ethanol or phenol; however, within the past decade cryoablation has gained increasing use with potentially fewer side effects.



Publication History

Article published online:
30 June 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 de Oliveira R, dos Reis MP, Prado WA. The effects of early or late neurolytic sympathetic plexus block on the management of abdominal or pelvic cancer pain. Pain 2004; 110 (1-2): 400-408
  • 2 Wong GY, Schroeder DR, Carns PE. et al. Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: a randomized controlled trial. JAMA 2004; 291 (09) 1092-1099
  • 3 Filippiadis DK, Tselikas L, Bazzocchi A, Efthymiou E, Kelekis A, Yevich S. Percutaneous management of cancer pain. Curr Oncol Rep 2020; 22 (05) 43
  • 4 Thompson GE, Moore DC, Bridenbaugh LD, Artin RY. Abdominal pain and alcohol celiac plexus nerve block. Anesth Analg 1977; 56 (01) 1-5
  • 5 Loukas M, Klaassen Z, Merbs W, Tubbs RS, Gielecki J, Zurada A. A review of the thoracic splanchnic nerves and celiac ganglia. Clin Anat 2010; 23 (05) 512-522
  • 6 De Cicco M, Matovic M, Balestreri L, Fracasso A, Morassut S, Testa V. Single-needle celiac plexus block: Is needle tip position critical in patients with no regional anatomic distortions?. Anesthesiology 1997; 87 (06) 1301-1308
  • 7 Kambadakone A, Thabet A, Gervais DA, Mueller PR, Arellano RS. CT-guided celiac plexus neurolysis: a review of anatomy, indications, technique, and tips for successful treatment. Radiographics 2011; 31 (06) 1599-1621
  • 8 Nitschke AM, Ray Jr CE. Percutaneous neurolytic celiac plexus block. Semin Intervent Radiol 2013; 30 (03) 318-321
  • 9 Wang ZJ, Webb EM, Westphalen AC, Coakley FV, Yeh BM. Multi-detector row computed tomographic appearance of celiac ganglia. J Comput Assist Tomogr 2010; 34 (03) 343-347
  • 10 Zhang XM, Zhao QH, Zeng NL. et al. The celiac ganglia: anatomic study using MRI in cadavers. AJR Am J Roentgenol 2006; 186 (06) 1520-1523
  • 11 Cornman-Homonoff J, Holzwanger DJ, Lee KS, Madoff DC, Li D. Celiac plexus block and neurolysis in the management of chronic upper abdominal pain. Semin Intervent Radiol 2017; 34 (04) 376-386
  • 12 Kaufman M, Singh G, Das S. et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol 2010; 44 (02) 127-134
  • 13 Wang PJ, Shang MY, Qian Z, Shao CW, Wang JH, Zhao XH. CT-guided percutaneous neurolytic celiac plexus block technique. Abdom Imaging 2006; 31 (06) 710-718
  • 14 Prologo JD, Patel I, Buethe J, Bohnert N. Ablation zones and weight-bearing bones: points of caution for the palliative interventionalist. J Vasc Interv Radiol 2014; 25 (05) 769-775.e2
  • 15 Titton RL, Lucey BC, Gervais DA, Boland GW, Mueller PR. Celiac plexus block: a palliative tool underused by radiologists. AJR Am J Roentgenol 2002; 179 (03) 633-636
  • 16 Eisenberg E, Carr DB, Chalmers TC. Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesth Analg 1995; 80 (02) 290-295
  • 17 Bittman RW, Peters GL, Newsome JM. et al. Percutaneous image-guided cryoneurolysis. AJR Am J Roentgenol 2018; 210 (02) 454-465
  • 18 Behbahani K, Chary A, Patel S, Mitchell JW, Fleishon H, Prologo JD. Percutaneous CT-guided cryoablation of the celiac plexus: a retrospective cohort comparison with ethanol. J Vasc Interv Radiol 2020; 31 (08) 1216-1220
  • 19 Yarmohammadi H, Nakamoto DA, Azar N, Hayek SM, Haaga JR. Percutaneous computed tomography guided cryoablation of the celiac plexus as an alternative treatment for intractable pain caused by pancreatic cancer. J Cancer Res Ther 2011; 7 (04) 481-483
  • 20 Interventional Pain Management: Image-Guided Procedures. Saunders Elsevier; 2008