Indications, technique, and efficacy of alcohol injection of enlarged parathyroid glands in patients with primary hyperparathyroidism

C. R. Harman, C. S. Grant, Ian D Hay, D. L. Hurley, J. A. Van Heerden, G. B. Thompson, C. C. Reading, J. W. Charboneau, W. B. Inabnet, L. A. Danto, P. Angelos

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Background. Percutaneous alcohol ablation of the parathyroid gland (PAAP) has been proposed as an alternative treatment for primary hyperparathyroidism in patients unsuitable for surgery. The current study aimed to determine the (1) selection criteria, (2) associated morbidity, and (3) efficacy of PAAP. Methods. From 1987 to 1998, 36 patients with primary hyperparathyroidism (mean age 65 years) underwent PAAP. The indications for PAAP were (1) medical comorbidity, (2) technically unsafe reoperative surgery, (3) partial ablation of a single remaining gland, and (4) patient choice. Results. There were no long-term complications. Two patients had temporary recurrent laryngeal nerve injury and 4 had temporary hypocalcemia. Over a median follow-up of 16 months, 12 (33%) of the patients remained eucalcemic For analysis purposes patients were separated into 2 separate groups: 29 with attempted complete ablation and 7 with partial ablation of a single remaining gland only. Ten of the complete ablation group (34%) remained eucalcemic. In the partial ablation group only 2 remained eucalcemic, but all had adequately controlled serum calcium levels. Conclusion. PAAP should be considered for hyperparathyroid patients with excessive reoperative morbidity or prohibitive medical comorbidity or those in whom the intent is to partially ablate a single remaining enlarged gland. In these patients close follow-up of serum calcium is required, and repeat treatments may be necessary because recurrence of hypercalcemia is likely.

Original languageEnglish (US)
Pages (from-to)1011-1020
Number of pages10
JournalSurgery
Volume124
Issue number6
DOIs
StatePublished - 1998

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Parathyroid Glands
Primary Hyperparathyroidism
Alcohols
Injections
Comorbidity
Recurrent Laryngeal Nerve Injuries
Calcium
Morbidity
Hypocalcemia
Hypercalcemia
Serum
Patient Selection
Recurrence
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Harman, C. R., Grant, C. S., Hay, I. D., Hurley, D. L., Van Heerden, J. A., Thompson, G. B., ... Angelos, P. (1998). Indications, technique, and efficacy of alcohol injection of enlarged parathyroid glands in patients with primary hyperparathyroidism. Surgery, 124(6), 1011-1020. https://doi.org/10.1067/msy.1998.91826

Indications, technique, and efficacy of alcohol injection of enlarged parathyroid glands in patients with primary hyperparathyroidism. / Harman, C. R.; Grant, C. S.; Hay, Ian D; Hurley, D. L.; Van Heerden, J. A.; Thompson, G. B.; Reading, C. C.; Charboneau, J. W.; Inabnet, W. B.; Danto, L. A.; Angelos, P.

In: Surgery, Vol. 124, No. 6, 1998, p. 1011-1020.

Research output: Contribution to journalArticle

Harman, CR, Grant, CS, Hay, ID, Hurley, DL, Van Heerden, JA, Thompson, GB, Reading, CC, Charboneau, JW, Inabnet, WB, Danto, LA & Angelos, P 1998, 'Indications, technique, and efficacy of alcohol injection of enlarged parathyroid glands in patients with primary hyperparathyroidism', Surgery, vol. 124, no. 6, pp. 1011-1020. https://doi.org/10.1067/msy.1998.91826
Harman, C. R. ; Grant, C. S. ; Hay, Ian D ; Hurley, D. L. ; Van Heerden, J. A. ; Thompson, G. B. ; Reading, C. C. ; Charboneau, J. W. ; Inabnet, W. B. ; Danto, L. A. ; Angelos, P. / Indications, technique, and efficacy of alcohol injection of enlarged parathyroid glands in patients with primary hyperparathyroidism. In: Surgery. 1998 ; Vol. 124, No. 6. pp. 1011-1020.
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abstract = "Background. Percutaneous alcohol ablation of the parathyroid gland (PAAP) has been proposed as an alternative treatment for primary hyperparathyroidism in patients unsuitable for surgery. The current study aimed to determine the (1) selection criteria, (2) associated morbidity, and (3) efficacy of PAAP. Methods. From 1987 to 1998, 36 patients with primary hyperparathyroidism (mean age 65 years) underwent PAAP. The indications for PAAP were (1) medical comorbidity, (2) technically unsafe reoperative surgery, (3) partial ablation of a single remaining gland, and (4) patient choice. Results. There were no long-term complications. Two patients had temporary recurrent laryngeal nerve injury and 4 had temporary hypocalcemia. Over a median follow-up of 16 months, 12 (33{\%}) of the patients remained eucalcemic For analysis purposes patients were separated into 2 separate groups: 29 with attempted complete ablation and 7 with partial ablation of a single remaining gland only. Ten of the complete ablation group (34{\%}) remained eucalcemic. In the partial ablation group only 2 remained eucalcemic, but all had adequately controlled serum calcium levels. Conclusion. PAAP should be considered for hyperparathyroid patients with excessive reoperative morbidity or prohibitive medical comorbidity or those in whom the intent is to partially ablate a single remaining enlarged gland. In these patients close follow-up of serum calcium is required, and repeat treatments may be necessary because recurrence of hypercalcemia is likely.",
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AU - Harman, C. R.

AU - Grant, C. S.

AU - Hay, Ian D

AU - Hurley, D. L.

AU - Van Heerden, J. A.

AU - Thompson, G. B.

AU - Reading, C. C.

AU - Charboneau, J. W.

AU - Inabnet, W. B.

AU - Danto, L. A.

AU - Angelos, P.

PY - 1998

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N2 - Background. Percutaneous alcohol ablation of the parathyroid gland (PAAP) has been proposed as an alternative treatment for primary hyperparathyroidism in patients unsuitable for surgery. The current study aimed to determine the (1) selection criteria, (2) associated morbidity, and (3) efficacy of PAAP. Methods. From 1987 to 1998, 36 patients with primary hyperparathyroidism (mean age 65 years) underwent PAAP. The indications for PAAP were (1) medical comorbidity, (2) technically unsafe reoperative surgery, (3) partial ablation of a single remaining gland, and (4) patient choice. Results. There were no long-term complications. Two patients had temporary recurrent laryngeal nerve injury and 4 had temporary hypocalcemia. Over a median follow-up of 16 months, 12 (33%) of the patients remained eucalcemic For analysis purposes patients were separated into 2 separate groups: 29 with attempted complete ablation and 7 with partial ablation of a single remaining gland only. Ten of the complete ablation group (34%) remained eucalcemic. In the partial ablation group only 2 remained eucalcemic, but all had adequately controlled serum calcium levels. Conclusion. PAAP should be considered for hyperparathyroid patients with excessive reoperative morbidity or prohibitive medical comorbidity or those in whom the intent is to partially ablate a single remaining enlarged gland. In these patients close follow-up of serum calcium is required, and repeat treatments may be necessary because recurrence of hypercalcemia is likely.

AB - Background. Percutaneous alcohol ablation of the parathyroid gland (PAAP) has been proposed as an alternative treatment for primary hyperparathyroidism in patients unsuitable for surgery. The current study aimed to determine the (1) selection criteria, (2) associated morbidity, and (3) efficacy of PAAP. Methods. From 1987 to 1998, 36 patients with primary hyperparathyroidism (mean age 65 years) underwent PAAP. The indications for PAAP were (1) medical comorbidity, (2) technically unsafe reoperative surgery, (3) partial ablation of a single remaining gland, and (4) patient choice. Results. There were no long-term complications. Two patients had temporary recurrent laryngeal nerve injury and 4 had temporary hypocalcemia. Over a median follow-up of 16 months, 12 (33%) of the patients remained eucalcemic For analysis purposes patients were separated into 2 separate groups: 29 with attempted complete ablation and 7 with partial ablation of a single remaining gland only. Ten of the complete ablation group (34%) remained eucalcemic. In the partial ablation group only 2 remained eucalcemic, but all had adequately controlled serum calcium levels. Conclusion. PAAP should be considered for hyperparathyroid patients with excessive reoperative morbidity or prohibitive medical comorbidity or those in whom the intent is to partially ablate a single remaining enlarged gland. In these patients close follow-up of serum calcium is required, and repeat treatments may be necessary because recurrence of hypercalcemia is likely.

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