Use of a steerable needle for CT-guided nerve plexus blockade
Demonstrate the use of a new steerable needle for CT-guided neural plexus blockade to avoid traversing the kidneys.
Materials and methods
Retrospective evaluation of 23 consecutive CT-guided neural plexus blockade procedures in which a new steerable needle was used in the last 13 and compared with the prior 10 procedures in which a standard needle was used.
Use of the steerable needle was beneficial to reach the target area without traversing a kidney or other organs in 6/13 (46%) procedures; in the other 7 procedures there was no benefit. A kidney was traversed in 0/13 procedures performed with the steerable needle. In contrast, a kidney was traversed in 4/10 (40%) procedures using a standard needle (P = 0.02). There was no significant difference in clinical benefit (P = 1.00) or complications (P = 0.56) between procedures using the steerable needle versus a standard needle. Three complications were observed (1 major and 2 minor) felt to be related to the injection and not the needle type.
The utility of a steerable 21-gauge needle during neural plexus blockades was found to allow for avoidance of the kidneys when compared to a standard (non-steerable) needle. Interventional radiologists may find this needle and its future iterations useful for neural blockades, as well as other procedures, when intervening structures need to be avoided.
Level of evidence
Level 3, Non-randomized controlled cohort.
KeywordsNerve block Pain management Palliation
Inferior vena cava
Funding was provided by Mayo Clinic.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
For this type of study formal consent is not required.
Does not apply.
J.S.K. designed the study and gathered the data. J.S.K. and N.Z. analyzed the data. All authors vouch for the data and the analysis, wrote the paper, and decided to publish the paper. No study sponsor. No pertinent disclosures.