Thanks to interventional radiology, migraines may have met their match

Nearly 20% of American adults suffer with chronic daily migraines and turn to various pills as their first line of relief. A new, minimally invasive treatment designed and tested by interventional radiologists may offer an effective alternative with zero side effects.

The new approach was presented Sunday at the Society of Interventional Radiology's Annual Scientific Meeting in Atlanta.

In a pre-conference press briefing, lead researcher Kenneth Mandato, MD, said his paper has a formal title but could just as accurately be named “a clear, simple, alternative to traditional headache treatment with little risk and significant benefit.”

Mandato explained how he and his team at Albany Medical Center in New York have been using basic fluoroscopy to guide the insertion of a spaghetti-sized catheter into the nasal passages of migraine sufferers. When the catheter reaches a cluster of nerves called the sphenopalatine ganglion, or SPG, the physician administers 4% lidocaine while the patient inhales through the nose.

An analysis of 112 participating patients showed an average pre-procedure pain score of 8.25 on a scale of 1 (very little pain) to 10 (severe pain). One day after treatment, pain had decreased to an average of 4.10—and the score had only notched up a little, to 5.25, by a month later. That’s nearly a 40% reduction in pain, Mandato noted, adding that the procedure requires no sedation.

Best of all, he said, some 88% of the 112 patients reported needing less or even none of their headache medications after receiving the treatment.

But isn’t lidocaine a temporary numbing agent, not a long-term solution? Yes, said Mandato, answering his own question and adding that he would draw an analogy with heart care. “A cardiac defibrillator doesn’t treat cardiac artery disease, but it reestablishes a normal electrical rhythm that can last,” he said. “Like other migraine therapy options, our treatment is a temporary solution. If needed, it can be safely repeated to offer patients continued relief.”

Mandato said his group is exploring the possibility of conducting a large, randomized, blinded study to put the innovative treatment to the full test.

For more on Mandato’s paper, “Image-Guided Sphenopalatine Ganglion Blocks: An IR Solution for Chronic Headaches,” click here. For more on the proceedings at the Society of Interventional Radiology’s annual meeting, click here.