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Transcatheter arterial chemoembolization of hepatocellular carcinoma with hepatic arteriovenous shunt after temporary balloon occlusion of hepatic vein

Authors
 Jong Hyeog Lee  ;  Je Hwan Won  ;  Byung-chul Kang  ;  Do Yun Lee  ;  Jong Yoon Won  ;  Sung Il Park 
Citation
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.18(3) : 377-382, 2007 
Journal Title
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 1051-0443 
Issue Date
2007
MeSH
Arteriovenous Shunt, Surgical/methods* ; Balloon Occlusion/methods* ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/therapy* ; Catheterization, Peripheral/methods* ; Chemoembolization, Therapeutic/methods* ; Combined Modality Therapy ; Female ; Humans ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/therapy* ; Male ; Middle Aged ; Portal Vein/diagnostic imaging* ; Radiography ; Retrospective Studies ; Treatment Outcome
Abstract
PURPOSE: Hepatocellular carcinoma with hepatic artery to hepatic vein (AV) shunt has increased risk of pulmonary complications during transcatheter arterial chemoembolization (TACE). The purpose of this study is to assess temporary balloon occlusion as a means of preventing pulmonary complications during TACE of hepatocellular carcinoma with AV shunt. MATERIALS AND METHODS: Eleven hepatocellular carcinoma patients (M: F = 9:2; mean age, 48 years) with angiographically evident AV shunt underwent TACE with occlusion of the shunt-draining hepatic veins using temporary occlusion balloon catheters. All tumors were in the right lobe, and all AV shunts were between the right hepatic artery and right hepatic vein. The occlusion balloon was inserted via femoral (n = 6) or jugular (n = 5) venous access. The balloon diameter ranged from 8.5 to 11.5 mm and time of ballooning was 3 to 15 minutes (mean, 9.5 minutes). TACE was performed using emulsion of iodized oil and doxorubicin, followed by Gelfoam embolization. The balloon was deflated immediately after chemoembolization, and physical examination and chest radiography were performed. Follow-up computed tomography was performed within 2 weeks after TACE to evaluate the result and pulmonary complications. RESULTS: The technical success rate was 100%. There was no symptom, sign, or radiographic evidence of pulmonary complication. Follow-up computed tomography revealed complete iodized oil uptake by the tumor in eight patients and incomplete uptake by the tumor in three patients. There was no iodized oil uptake in the lungs. CONCLUSIONS: Temporary balloon occlusion of the hepatic vein in hepatocellular carcinoma with AV shunt allowed completion of TACE using conventional method while preventing pulmonary complications.
Full Text
http://www.sciencedirect.com/science/article/pii/S1051044307000103
DOI
10.1016/j.jvir.2007.01.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Park, Sung Il(박성일)
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/22282913/96720
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