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Supplemental Transcatheter Arterial Chemoembolization Through a Collateral Omental Artery: Treatment for Hepatocellular Carcinoma

Authors
 Jong Yun Won  ;  Do Yun Lee  ;  Sang Joon Park  ;  Sang-Hyun Suh  ;  Hyung Sik Yoo  ;  Myeong-Jin Kim  ;  Sung Il Park  ;  Jong Tae Lee 
Citation
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.26(2) : 136-140, 2003 
Journal Title
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 0174-1551 
Issue Date
2003
MeSH
Aged ; Antibiotics, Antineoplastic/administration & dosage ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/therapy* ; Catheters, Indwelling ; Chemoembolization, Therapeutic* ; Collateral Circulation/drug effects ; Contrast Media/administration & dosage ; Contrast Media/metabolism ; Disease Progression ; Doxorubicin/administration & dosage ; Female ; Follow-Up Studies ; Gastroepiploic Artery/surgery ; Hepatic Artery/diagnostic imaging ; Hepatic Artery/surgery ; Humans ; Iodized Oil/administration & dosage ; Iodized Oil/metabolism ; Korea ; Liver Neoplasms/diagnosis ; Liver Neoplasms/mortality ; Liver Neoplasms/therapy* ; Male ; Middle Aged ; Omentum/blood supply* ; Omentum/diagnostic imaging ; Omentum/pathology ; Survival Analysis ; Tomography, X-Ray Computed ; Treatment Outcome ; alpha-Fetoproteins/administration & dosage
Keywords
Liver neopla는 ; chemotherapeutic infusion Liver neopla는 ; blood supply Hepatic arteries ; chemotherapeutic infusion
Abstract
PURPOSE: To evaluate the therapeutic efficacy and safety of supplemental transcatheter arterial chemoembolization (TACE) through the extrahepatic collateral omental artery (OA) for the treatment of hepatocellular carcinoma (HCC). METHODS: We studied 21 patients with extrahepatic collaterals of the OA, among 1,512 patients with HCC who had undergone angiography. HCCs supplied by collateral OAs were located at: segment IV in seven, segment V in five, segment III in three, segment VI in three and segment VIII in three patients (Couinaud classification of segments). On preoperative CT scans, every HCC was abutting the liver surface. Adjacent omental infiltration or engorgement was noted in 11 patients. Celiac and hepatic arteriograms showed hypertrophy of the feeding OA in all patients. TACE of the OA was performed in 19 patients with an emulsion of iodized oil and doxorubicin hydrochloride. Embolization with gelatin sponge particles was added in five patients. RESULTS: Collaterals of the OA to the HCC were found on the first to seventeenth sessions of TACE. On follow-up CT scans, five patients showed complete uptake of iodized oil in the tumor. Partial uptake of iodized oil was noted in 13 patients and no uptake in one patient. There was no serious complication that related to the omental embolization, such as omental or bowel ischemia. The cumulative survival rates from the time of the TACE of the OA were 81% at 6 months and 68% at 12 months. CONCLUSION: TACE of the OA is safe and has a potential therapeutic effect in the treatment of HCC.
Full Text
http://link.springer.com/article/10.1007%2Fs00270-002-2629-y
DOI
10.1007/s00270-002-2629-y
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Do Yun(이도연)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/113443
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