Background & Aims
One of the hypotheses for the pathophysiology of complex regional pain syndrome (CRPS) is that the ascending autonomic nervous system can impact blood vessels through a phenomenon known as sympathetic coupling. Sympathetic coupling is an abnormal interaction between sympathetic nerves and blood vessels, resulting in the dysregulation of vascular tone and blood flow. This dysregulation can lead to vascular structural changes and alterations in temperature within the affected area.
In this study, angiography was performed in CRPS patients to evaluate vascular abnormalities and perfusion, and embolization or reperfusion was performed according to the angiography results. The purpose of this study is to report the results of angiography, compare them with Digital Infrared Thermographic Imaging (DITI) and three-phase bone scan (TPBS) and evaluate the changes in symptoms after intervention in CRPS patients.
Methods
Retrospectively, we enrolled a group of 5 patients diagnosed with Complex Regional Pain Syndrome (CRPS) according to the Budapest criteria, who had undergone angiography, DITI and conducted TPBS.
Results
Based on the angiography results, three out of the five patients showed decreased vascular perfusion, while two patients showed increased staining.
Reperfusion using eglandin was performed in patients with poor vascular perfusion, and embolization with imipenem/cilastatin was performed in patients with increased abnormal staining. No significant changes in pain were observed in all patients before and after the procedure. Additionally, the comparison of the results from angiography, DITI, and TPBS did not show similar patterns.
Conclusions
Abnormal staining and reduced perfusion were found in the angiography of CPRS patients, and there was no pain improvement by the intervention of angiography.
References
1. Schlereth, Tanja, Peter D. Drummond, and Frank Birklein. “Inflammation in CRPS: role of the sympathetic supply.” Autonomic Neuroscience 182 (2014): 102-107.
2. Harden, R. Norman, et al. “Validation of proposed diagnostic criteria (the “Budapest Criteria”) for complex regional pain syndrome.” Pain 150.2 (2010): 268-274.
3. Mesaroli, Giulia, et al. “Screening and diagnostic tools for complex regional pain syndrome: a systematic review.” Pain 162.5 (2021): 1295.
Presenting Author
Seong-Yeol Kim
Poster Authors
Gi-Wook Kim
MD, Ph.D
Jeonbuk National University Medical School
Lead Author
Seong Yeol Kim
Jeonbuk National University Hospital
Lead Author
Sung Woon Baik
Jeonbuk National University Medical School
Lead Author
Da-Sol Kim (MD
Ph.D)
Jeonbuk National University Medical School
Lead Author
Yu Hui Won (MD
Ph.D)
Jeonbuk National University Medical School
Lead Author
Sung-Hee Park (MD
Ph.D)
Jeonbuk National University Medical School
Lead Author
Myoung-Hwan Ko (MD
Ph.D)
Jeonbuk National University Medical School
Lead Author
Jeong-Hwan Seo (MD
Ph.D)
Jeonbuk National University Medical School
Lead Author
Topics
- Treatment/Management: Interventional Therapies – Other