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Percutaneous balloon compression of the gasserian ganglion is an effective management of trigeminal neuralgia and is the only percutaneous procedure that preferentially may be performed under general anesthesia.
Microvascular decompression has several advantages as compared with other methods used to treat trigeminal neuralgia such as percutaneous procedures including thermocoagulation, glycerol injection or balloon compression of the Gasserian ganglion, and stereotactic radiosurgery.
A systematic review of ablative neurosurgical techniques for the treatment of TN evaluated 166 studies reporting on RF thermocoagulation, glycerol rhizolysis, balloon compression of the gasserian ganglion, and stereotactic radiosurgery, concluded that RF thermocoagulation offers the highest rates of complete pain relief [ 34].
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The effects of balloon compression on the individual artery components is particularly described for two obstructed arteries with an intact collagenous cap, a pronounced lipid pool and with calcification.
Stridor or wheezing may be induced during esophageal dilation with a bougie or a balloon, therefore suggesting major compression of the airways.
This study investigates the effect of a new injection catheter design which is intended to resist the deleterious effect of balloon compression on cell viability for various flowrates, balloon pressures, and fluid viscosity values.
Infusion catheters, when used with balloons, are susceptible to compression of the catheter lumen.
Thermocoagulation and balloon compression are other forms of lesion treatment offered in Denmark.
Gasserian ganglion percutaneous denervation's like radiofrequency rhizotomy (RFT), retrogasserian glycerol injection or Gasserian balloon compression are employed in patients without evidence of neurovascular conflict or in case of contraindication to MVD or general anaesthesia but there are a lack of controlled clinical trials comparing these three different techniques [165].
If surgery is not contra-indicated, palliative destructive trigeminal nerve root procedures, such as radiofrequency lesioning, chemical destruction, balloon compression or stereotactic radiosurgery (Gamma Knife), should be considered over microvascular decompression because of the less invasive nature of these techniques.
**** Type of surgery: microvascular decompression (MVD) (N = 29), balloon compression (N = 10), both balloon compression and MVD within 12 months (N = 2), glycerol injection (N = 1), failed balloon compression due to bradycardia (N = 1).
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