November 30, 2005

Less Invasive Procedure Can Now Cure Sweaty Palms

By M. Mary Conroy

CHICAGO -- A minimally invasive procedure, developed by interventional radiologists in Belgium, cures patients who have excessive sweating of the palms without the need for surgery, according to results reported at the Radiological Society of North American annual meeting.

The treatment for the condition, also known as palmar hyperhidrosis, involves blockage of the nerve, referred to as sympathectomy, to stop the excessive sweating.

Forty-seven of 50 patients were treated successfully on the first attempt and the remaining three achieved dry palms with a repeat procedure, said lead investigator Dr. Hugues Brat, head of the radiology department at Center Hospitalier Hornu-Frameries.

Guided by CT fluoroscopy, Brat places a highly flexible needle at the third vertebra and threads it into the sympathetic junction, after saline is injected to avoid the accumulation of fluid around the lungs. He then injects phenol to "kill the nerve and cure the patient." Patients require two procedures, one for each hand.

The procedure takes about 20 minutes and is done under local anesthesia. In this series 16 patients had side effects such as chest pain, but the symptoms resolved in a few hours.

Before this technique, called percutaneous sympathectomy, was developed, surgical sympathectomy was used to treat this condition, which requires an open chest operation and a hospital stay of several days, Brat pointed out.

Typically, the surgery costs about $5,000 for each side and has a potential risk of bleeding and partial paralysis. The estimated cost for percutaneous sympathectomy is $1,000, he said.

Brat said he and his colleagues have already performed more than 300 procedures and "now we have some patients who we have followed for more than 4 years, so we know this works."

Currently the procedure is done at his institution and a second center in Belgium, but he said that his team has been teaching the technique in a series of workshops and they plan to launch an online training program early next year.