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Sample records for transcatheter arterial infusion

  1. Therapeutic effect of transcatheter arterial infusion chemotherapy in the treatment of advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Lin Junhua; Song Mingzhi; Zhang Yuanyuan; Xu Yiyu; Chen Jing

    2001-01-01

    Objective: To evaluate the clinical efficacy of transcatheter arterial infusion (TAI) or transcatheter arterial chemo-embolization (TACE) in the treatment of advanced pancreatic cancer. Methods: 36 cases of advanced pancreatic cancer were divided into two groups, 18 cases were treated with TAI or TACE (group A), other 18 cases were treated with systemic chemotherapy (group B). Results: The clinical benefit response rate of the group A was 55.6% (10/18) and that of the group B was 16.7%(3/18), respectively (P 0.05). Conclusions: In the transcatheter arterial infusion group, no survival advantage could be demonstrated when compared with the controls, but TAI could effectively increase clinical benefit response and improve the quality of life of advanced pancreatic cancer

  2. Transcatheter Arterial Infusion of Autologous CD133+ Cells for Diabetic Peripheral Artery Disease

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    Xiaoping Zhang

    2016-01-01

    Full Text Available Microvascular lesion in diabetic peripheral arterial disease (PAD still cannot be resolved by current surgical and interventional technique. Endothelial cells have the therapeutic potential to cure microvascular lesion. To evaluate the efficacy and immune-regulatory impact of intra-arterial infusion of autologous CD133+ cells, we recruited 53 patients with diabetic PAD (27 of CD133+ group and 26 of control group. CD133+ cells enriched from patients’ PB-MNCs were reinfused intra-arterially. The ulcer healing followed up till 18 months was 100% (3/3 in CD133+ group and 60% (3/5 in control group. The amputation rate was 0 (0/27 in CD133+ group and 11.54% (3/26 in control group. Compared with the control group, TcPO2 and ABI showed obvious improvement at 18 months and significant increasing VEGF and decreasing IL-6 level in the CD133+ group within 4 weeks. A reducing trend of proangiogenesis and anti-inflammatory regulation function at 4 weeks after the cells infusion was also found. These results indicated that autologous CD133+ cell treatment can effectively improve the perfusion of morbid limb and exert proangiogenesis and anti-inflammatory immune-regulatory impacts by paracrine on tissue microenvironment. The CD133+ progenitor cell therapy may be repeated at a fixed interval according to cell life span and immune-regulatory function.

  3. Changes in Hepatic Blood Flow During Transcatheter Arterial Infusion with Heated Saline in Hepatic VX2 Tumor

    International Nuclear Information System (INIS)

    Cao Wei; Li Jing; Wu Zhiqun; Zhou Changxi; Liu Xi; Wan Yi; Duan Yunyou

    2013-01-01

    Purpose. This study evaluates the influence of transcatheter arterial infusion with heated saline on hepatic arterial and portal venous blood flows to tumor and normal hepatic tissues in a rabbit VX2 tumor model. Methods. All animal experiments were approved by the institutional animal care and use committee. Twenty rabbits with VX2 liver tumors were divided into the following two groups: (a) the treated group (n = 10), which received a 60 mL transarterial injection of 60 °C saline via the hepatic artery; (b) the control group (n = 10), which received a 60 mL injection of 37 °C saline via the hepatic artery. Using ultrasonography, the blood flows in both the portal vein and hepatic artery were measured, and the changes in the hemodynamic indices were recorded before and immediately after the injection. The changes in the tumor and normal liver tissues of the two groups were histopathologically examined by hematoxylin and eosin staining after the injection. Results. After the transcatheter arterial heated infusion, there was a decrease in the hepatic arterial blood flow to the tumor tissue, a significant decrease in the hepatic artery mean velocity (P < 0.05), and a significant increase in the resistance index (P < 0.05). On hematoxylin and eosin staining, there were no obvious signs of tissue destruction in the normal liver tissue or the tumor tissue after heated perfusion, and coagulated blood plasma was observed in the cavities of intratumoral blood vessels in the treated group. Conclusions. The changes in tumor blood flow in the rabbit VX2 tumor model were presumably caused by microthrombi in the tumor vessels, and the portal vein likely mediated the heat loss in normal liver tissue during the transarterial heated infusion.

  4. Changes in Hepatic Blood Flow During Transcatheter Arterial Infusion with Heated Saline in Hepatic VX2 Tumor

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    Cao Wei, E-mail: cawe-001@163.com [Tangdu Hospital, The Fourth Military Medical University, Department of Interventional Radiology (China); Li Jing, E-mail: lijing02@fmmu.edu.cn [Tangdu Hospital, The Fourth Military Medical University, Department of Burn and Plastic Surgery (China); Wu Zhiqun, E-mail: zhiqunwu@fmmu.edu.cn [Tangdu Hospital, The Fourth Military Medical University, Department of Interventional Radiology (China); Zhou Changxi, E-mail: changxizhou@163.com [Chinese PLA General Hospital, Department of Respiratory Disease (China); Liu Xi, E-mail: xiliu@fmmu.edu.cn [Tangdu Hospital, The Fourth Military Medical University, Department of Ultrasound Diagnostics (China); Wan Yi, E-mail: yiwan@163.com [The Fourth Military Medical University, Department of Health Statistics, Institute for Health Informatics (China); Duan Yunyou, E-mail: yunyouduan@fmmu.edu.cn [Tangdu Hospital, The Fourth Military Medical University, Department of Ultrasound Diagnostics (China)

    2013-06-15

    Purpose. This study evaluates the influence of transcatheter arterial infusion with heated saline on hepatic arterial and portal venous blood flows to tumor and normal hepatic tissues in a rabbit VX2 tumor model. Methods. All animal experiments were approved by the institutional animal care and use committee. Twenty rabbits with VX2 liver tumors were divided into the following two groups: (a) the treated group (n = 10), which received a 60 mL transarterial injection of 60 Degree-Sign C saline via the hepatic artery; (b) the control group (n = 10), which received a 60 mL injection of 37 Degree-Sign C saline via the hepatic artery. Using ultrasonography, the blood flows in both the portal vein and hepatic artery were measured, and the changes in the hemodynamic indices were recorded before and immediately after the injection. The changes in the tumor and normal liver tissues of the two groups were histopathologically examined by hematoxylin and eosin staining after the injection. Results. After the transcatheter arterial heated infusion, there was a decrease in the hepatic arterial blood flow to the tumor tissue, a significant decrease in the hepatic artery mean velocity (P < 0.05), and a significant increase in the resistance index (P < 0.05). On hematoxylin and eosin staining, there were no obvious signs of tissue destruction in the normal liver tissue or the tumor tissue after heated perfusion, and coagulated blood plasma was observed in the cavities of intratumoral blood vessels in the treated group. Conclusions. The changes in tumor blood flow in the rabbit VX2 tumor model were presumably caused by microthrombi in the tumor vessels, and the portal vein likely mediated the heat loss in normal liver tissue during the transarterial heated infusion.

  5. Bronchial arterial infusion versus bronchial combined pulmonary arterial infusion for pulmonary metastatic tumors

    International Nuclear Information System (INIS)

    Dong Sheng; Dong Weihua; Jia Ningyang; Zhang Dianbo; Xiao Xiangsheng

    2008-01-01

    Objective: To evaluate the pulmonary metastatic tumor response to different ways of transcatheter arterial infusion. Methods: Thirty-five patients with pulmonary metastatic tumors were randomized divided into two groups: 15 patients with 49 lesions treated with bronchial arterial infusion (BAI) and 20 patients with 65 lesions treated with bronchial arterial infusion (BM)combined with pulmonary arterial infusion (PAI). The therapeutic response was assessed by the WHO evaluation criteria. Results: The total effective rate(CR + PR) of BAI was 65.3% (32/49), PAI + BAI was 61.5%(40/65) showing no statistical difference. The median survival time of BAI was 9 mo, BAI + PAI was 11.5 mo, demonstrating no statistical significance. Conclusions: BAI should be the primary treatment for pulmonary metastatic tumor. (authors)

  6. Transcatheter Coil Embolization of Splenic Artery Aneurysm

    International Nuclear Information System (INIS)

    Yamamoto, Satoshi; Hirota, Shozo; Maeda, Hiroaki; Achiwa, Sachiko; Arai, Keisuke; Kobayashi, Kaoru; Nakao, Norio

    2008-01-01

    The purpose of this study was to evaluate clinical results and technical problems of transcatheter coil embolization for splenic artery aneurysm. Subjects were 16 patients (8 men, 8 women; age range, 40-80 years) who underwent transcatheter embolization for splenic artery aneurysm (14 true aneurysms, 2 false aneurysms) at one of our hospitals during the period January 1997 through July 2005. Two aneurysms (12.5%) were diagnosed at the time of rupture. Multiple splenic aneurysms were found in seven patients. Aneurysms were classified by site as proximal (or strictly ostial) (n = 3), middle (n = 3), or hilar (n = 10). The indication for transcatheter arterial embolization was a false or true aneurysm 20 mm in diameter. Embolic materials were fibered coils and interlocking detachable coils. Embolization was performed by the isolation technique, the packing technique, or both. Technically, all aneurysms were devascularized without severe complications. Embolized aneurysms were 6-40 mm in diameter (mean, 25 mm). Overall, the primary technical success rate was 88% (14 of 16 patients). In the remaining 2 patients (12.5%), partial recanalization occurred, and re-embolization was performed. The secondary technical success rate was 100%. Seven (44%) of the 16 study patients suffered partial splenic infarction. Intrasplenic branching originating from the aneurysm was observed in five patients. We conclude that transcatheter coil embolization should be the initial treatment of choice for splenic artery aneurysm

  7. Transcatheter arterial embolization for traumatic bleeding control

    International Nuclear Information System (INIS)

    Ryu, Choon Wook; Lee, Sang Kwon; Suh, Kyung Jin; Kim, Tae Heon; Kim, Yong Joo; Kang, Duck Sik

    1989-01-01

    Angiography is essential for the detection of bleeding vessels in traumatic vascular injury. Immediately after the diagnosis, transcatheter embolization can be performed for the control of bleeding effectively and easily with proper use of embolic materials. Transcatheter embolization is believed to be the treatment of choice when emergency control is needed, where surgical approach is difficult and in those who are poor candidate for surgery. We have tried bleeding control in 18 cases of trauma over recent 4 years. The results were as follows; 1. Causes of bleeding(cases): Blunt or penetrating trauma (10), latrogenic trauma (8), (Postoperative (5), Needle biopsy (2), Percutaneous hepatic procedure (1)) 2. Embolized vessels: Renal artery branches (8), Hepatic artery branches (2), Arteries supplying chest wall (2), External carotid artery branches (3), Internal carotid artery (1), Circumflex humeral artery (1), Internal iliac artery branches (1). 3. Embolic agents: Gelfoam cubes (16), Stainless steel coils (3), Detachable latex balloon (1). 4. Successful bleeding control was achieved in 17 cases and reduction of the amount of bleeding in one case without significant complications

  8. Hepatocellular carcinoma: treatment with transcatheter arterial chemoembolization

    International Nuclear Information System (INIS)

    Acunas, Buelent; Rozanes, Izzet

    1999-01-01

    This article presents a review of the literature regarding the use of transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC). There have been two different approaches to the treatment: (a) percutaneous tumor ablation methods which can be divided into injectable and thermal methods; percutaneous ethanol injection (PEI) is the most widely used method, and (b) TACE. PEI is the treatment of choice for single HCCs smaller or equal to 3 cm in size. For patients with large HCCs combined TACE and PEI is probably the most effective nonsurgical treatment. In the presence of multiple HCC nodules, TACE remains the treatment of choice

  9. Application of transcatheter arterial embolization in the intractable epistaxis

    International Nuclear Information System (INIS)

    Huang Zhaodong; Li Mingjun; Zhang Chuanwen

    2005-01-01

    Objective: To evaluate the value of transcatheter arterial embolization (TAE) in the treatment of intractable epistaxis. Methods: TAE using gel form or polyvinyl alcohol (PVA) particles of forty-one patients with intractable epistaxis were undertaken by the femoral artery approach, through selective catheterization of involved maxillary artery or the bleeding arteries for the stoppage of bleeding. Results: Of the forty-one patient, 39 cases were cured by once TAE and the other 2 with recurrent bleeding on the next day after the TAE, to whom a second interventional treatment full filled the requirement. Conclusions: Transcatheter arterial embolization is a simple, safe and effective treatment for the intractable epistaxis. (authors)

  10. Clinical evaluation of preoperative arterial infusion chemotherapy and surgical operation for colorectal carcinoma

    International Nuclear Information System (INIS)

    Yuan Jianhua; Zhao Zhongsheng; Deng Gaoli; Hu Tingyang; Yu Wenqiang; Chen Fanghong; Luo Zuyan; Ru Guoqing; Dong Quanjin; Tu Shiliang

    2003-01-01

    Objective: To investigate the clinical values of preoperative arterial infusion chemotherapy and surgical operation for colorectal carcinoma. Methods: 66 patients with colorectal carcinoma were subjected to percutaneous femoral artery catheterization by Seldinger's technique with infusion of anti-cancer drugs. The resection was performed 5-30 days after the arterial infusion (mean 12 days). In 50 surgical specimens of the 66 cases, histological findings were evaluated including the density and distribution of the apoptosis cells under the observation by DNA nick end labelling technique. Of which 22 specimens before arterial infusion chemotherapy (got from biopsy of preoperation) and 25 normal mucosa (got from normal surgical specimens) were used as controls. Results: The total histological response rate was 100% with grade I in 20 cases, grade II in 21 cases, grade III in 9 cases. The densities of the apoptosis cells were 31.47 ± 5.58 before arterial infusion chemotherapy, 76.69 ± 17.12 after arterial infusion chemotherapy and 8.01 ± 3.39 in normal mucosa. The density of the apoptosis cells after arterial infusion chemotherapy was significantly higher than that before arterial infusion chemotherapy (P 2 =4.696, P>0.30). There were no significant differences in the apoptosis of adenocarcinoma during different pathological stages (F=0.001376, P>0.05). Conclusions: Peroperative transcatheter arterial infusion chemotherapy resulting in apoptosis of adenocarcinoma, can raise the radical operation rate, and prolong survival rate for colorectal carcinoma patients

  11. Transcatheter arterial embolization for upper gastrointestinal tract bleeding.

    Science.gov (United States)

    Širvinskas, Audrius; Smolskas, Edgaras; Mikelis, Kipras; Brimienė, Vilma; Brimas, Gintautas

    2017-12-01

    Transcatheter arterial embolization is a possible treatment for patients with recurrent bleeding from the upper gastrointestinal tract after failed endoscopic management and is also an alternative to surgical treatment. To analyze the outcomes of transcatheter arterial embolization and identify the clinical and technical factors that influenced the rates of morbidity and mortality. A retrospective analysis was carried out, based on the data of 36 patients who underwent transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding in 2013 to 2015 in our center. An analysis was performed between early rebleeding rates, mortality and the following factors: patient sex, age, number of units of packed red blood cells and packed plasma administered to the patients, length of hospital stay, therapeutic or prophylactic embolization. The technical success rate of the embolization procedure was 100%. There were 15 (41.70%) therapeutic embolizations and 21 (58.3%) prophylactic embolizations. There was a 77.8% clinical success rate. Following embolization, 10 (27.80%) patients had repeated bleeding and 9 (25.0%) patients died. Significant associations were found between rebleeding and prophylactic embolization (OR = 10.53; p = 0.04) and between mortality and prophylactic embolization (OR = 10.53; p = 0.04) and units of packed red blood cells (OR = 1.25; p < 0.01). In our experience, transcatheter arterial embolization is a safe treatment method for acute nonvariceal upper gastrointestinal bleeding and a possible alternative to surgery for high-risk patients.

  12. Transcatheter arterial embolization for congenital renal arteriovenous malformation

    International Nuclear Information System (INIS)

    Zhou Jun; Hu Tingyang; Yuan Jianhua; Yu Wenqiang

    2008-01-01

    Objective: To evaluate the effectiveness of transcatheter arterial embolization for congenital renal arteriovenous malformation. Methods: Seven cases of congenital renal arteriovenous malformation causing gross hematuria were retrospectively studied. All of 7 cases were demonstrated by means of angiography and then the catheter was placed superselectively into the involved arterial end of the malformation undertaking embolization with gelfoam, dehydrated ethanol, coils, etc. Results: All the malformations of the 7 cases were successfully embolized with stoppage of gross hematuria within 24 hours. No serious complications occurred except lumbago, fever, gastrointestinal reaction for one week. There was no recurrence of haematuria and the renal function was also normal in all cases during the follow-up for 36 to 98 months. Conclusions: Transcatheter renal arterial angiography and embolization are the important and effective management for the diagnosis and treatment of congenital renal arteriovenous malformation. (authors)

  13. Neurofibromatosis Type 1: Transcatheter Arterial Embolization for Ruptured Occipital Arterial Aneurysms

    International Nuclear Information System (INIS)

    Kanematsu, Masayuki; Kato, Hiroki; Kondo, Hiroshi; Goshima, Satoshi; Tsuge, Yusuke; Kojima, Toshiaki; Watanabe, Haruo

    2011-01-01

    Two cases of ruptured aneurysms in the posterior cervical regions associated with type-1 neurofibromatosis treated by transcatheter embolization are reported. Patients presented with acute onset of swelling and pain in the affected areas. Emergently performed contrast-enhanced CT demonstrated aneurysms and large hematomas widespread in the posterior cervical regions. Angiography revealed aneurysms and extravasations of the occipital artery. Patients were successfully treated by percutaneous transcatheter arterial microcoil embolization. Transcatheter arterial embolization therapy was found to be an effective method for treating aneurysmal rupture in the posterior cervical regions occurring in association with type-1 neurofibromatosis. A literature review revealed that rupture of an occipital arterial aneurysm, in the setting of neurofibromatosis type 1, has not been reported previously.

  14. Transcatheter Arterial Embolization of Cystic Artery Pseudoaneurysm in Acalculous Cholecystitis: A Case Report

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    Lee, Hyung Ook; Lee, Young Hwan [Dept. of Radiology, Daegu Catholic University College of Medicine, Daegu (Korea, Republic of); Kim, Young Hwan [Dept. of Diagnostic Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-04-15

    A pseudoaneurysm of the cystic artery is a rare complication of cholecystitis, and is manifested by hemobilia or hematemesis. An early diagnosis is required for the successful treatment by cholecystectomy and ligation of the cystic artery. Herein, we report a case of a pseudoaneurysm of the cystic artery diagnosed by color Doppler ultrasonography and CT, and successfully treated by transcatheter arterial embolization with N-butyl cyanoacrylate in a high-risk surgical patient.

  15. The effect of transcatheter arterial embolisation for nonvariceal upper gastrointestinal bleeding

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Duvnjak, Stevo

    2010-01-01

    The aim of this investigation was to evaluate the clinical efficacy and safety of transcatheter arterial embolisation with coils for nonvariceal upper gastrointestinal (GI) bleeding after failed endoscopic therapy.......The aim of this investigation was to evaluate the clinical efficacy and safety of transcatheter arterial embolisation with coils for nonvariceal upper gastrointestinal (GI) bleeding after failed endoscopic therapy....

  16. Prognostic factors in transcatheter arterial chemoembolization of hepatocellular carcinoma : analysis of more than 3 year survivors

    International Nuclear Information System (INIS)

    Seo, Heung Suk

    1999-01-01

    To determine which prognostic factors contribute to long-term survival after transcatheter arterial chemoembolization(TACE) of hepatocellular carcinoma. In 100 patients who expired within one year and 84 who survived or have survived for more than 3 years after TACE, prognostic factors were retrospectively evaluated. TACE was accomplished by hepatic arterial infusion of a suspension of Lipiodol and anticancer drugs(Mitomycin-C and Adriamycin), either alone or followed by gelfoam embolization. Fisher's exact test of probability was used to determine which prognostic factors were statistically significant. Statistically significant prognostic factors were as follows : Child classification(p 0.05). The prognosis of patients with hepatocellular carcinoma treated by TACE was affected favorably by good liver function(Child classification A), low alpha-fetoprotein value, nodular or massive-type tumor, patent main and first-order portal vein, and hypervascular tumor

  17. Transcatheter arterial embolization of a pseudoaneurysm of gastroduodenal artery: a case report

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    Han, Young Min; Kang, Sung Soo; Lee, Jeong Min; Chung, Jin Young; Lee, Sang Yong; Chung, Gyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National University School of Medicine, Chonju (Korea, Republic of)

    1997-01-01

    Gastroduodenal artery pseudoaneurysm is a relatively rare and potentionally life-threatening complication of chronic pancreatitis, which is thought to occur because of autodigestion of arterial walls by pancreatic enzymes. Embolotherapy should probably be the first method of treatment, since surgical treatment carries a high risk of mortality and morbidity. We report the case of 30-year-old male with gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis which was successfully treated by transcatheter embolization using Gianturco spring coils.

  18. Transcatheter arterial embolization of a pseudoaneurysm of gastroduodenal artery: a case report

    International Nuclear Information System (INIS)

    Han, Young Min; Kang, Sung Soo; Lee, Jeong Min; Chung, Jin Young; Lee, Sang Yong; Chung, Gyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul

    1997-01-01

    Gastroduodenal artery pseudoaneurysm is a relatively rare and potentionally life-threatening complication of chronic pancreatitis, which is thought to occur because of autodigestion of arterial walls by pancreatic enzymes. Embolotherapy should probably be the first method of treatment, since surgical treatment carries a high risk of mortality and morbidity. We report the case of 30-year-old male with gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis which was successfully treated by transcatheter embolization using Gianturco spring coils

  19. Recanalization of Splenic Artery Aneurysm After Transcatheter Arterial Embolization Using N-Butyl Cyanoacrylate

    International Nuclear Information System (INIS)

    Matsumoto, Keiji; Ushijima, Yasuhiro; Tajima, Tsuyoshi; Nishie, Akihiro; Hirakawa, Masakazu; Ishigami, Kousei; Yamaji, Yukiko; Honda, Hiroshi

    2010-01-01

    A 65-year-old woman who had been diagnosed as having microscopic polyangiitis developed sudden abdominal pain and entered a state of shock. Abdominal CT showed massive hemoperitoneum, and emergent angiography revealed a ruptured splenic artery aneurysm. After direct catheterization attempts failed due to tortuous vessels and angiospasm, transcatheter arterial embolization using an n-butyl cyanoacrylate (NBCA)-lipiodol mixture was successfully performed. Fifty days later, the patient developed sudden abdominal pain again. Repeated angiography demonstrated recanalization of the splenic artery and splenic artery aneurysm. This time, the recanalized aneurysm was embolized using metallic coils with the isolation method. Physicians should keep in mind that recanalization can occur after transcatheter arterial embolization using N-butyl cyanoacrylate, which has been used as a permanent embolic agent.

  20. Treatment of primany hepatic carcinoma with three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization

    International Nuclear Information System (INIS)

    Wu Li; Wen Xiaoping; Huang Wei

    2006-01-01

    Objective: To evaluate the effects of three-dimensional conformal radiation therapy (3DCRT) combined with transcatheter arterial chemoembolization (TACE) on stage m/IV primary hepatic carcinoma. Methods: Eighty cases of stage III/IV primary hepatic carcinoma were randomly divided into two groups: 40 cases treated with three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization (3DCRT + TACE group) and 40 cases treated with three-dimensional conformal radiation therapy associated with hepatic arterial infusion chemotherapy (3DCRT +HAI group). Results: The response rates were 75% and 45% in 3DCRT + TACE group and 3DCRT + HAI group, respectively; and the difference between the two groups was statistically significant (P 0.05), The 0.5-, 1- and 2-year survival rates were 73% , 45% and 28% in 3DCRT + TACE group, and 45%, 25% and 13% in 3DCRT + HAI group, respectively; and the difference between the two groups was statistically significant (P 0.05). Conclusion: Three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization improved prognosis of stage III/IV primary hepatic carcinoma. (authors)

  1. Evaluation of emergency transcatheter arterial embolization in intractable postpartum hemorrhage

    International Nuclear Information System (INIS)

    Qi Weihong; Wang Song; Zhan Ying

    2008-01-01

    Objective: To assess the efficacy and safety of emergency transcatheter arterial embolization in the management of intractable postpartum hemorrhage. Methods: Twenty-five patients with intractable postpartum hemorrhage were undertaken superselective catheterization into the bilateral internal iliac arteries or uterial arteries to find the causes and sites of bleeding through DSA and then followed by arterial embolization with gelfoam particles. Result: All of the 25 patients with obstetrical bleeding were successfully controlled by TAE, the procedure lasted for 25-60 min, (mean 42.5 ± 4.6 min); with both catheterization and bleeding halt successful rates of 100%. Comparison of hemoglobin and heartbeat before and after the procedure showed significance (t=29.49, P<0.01; t=16.51, P<0.01). The uterus showed reintegration on time and menstruation resumed in all patients. Conclusions: Emergency arterial embolization is a safe and effective means for control of intractable postpartum hemorrhage, providing less trauma and no severe complications, especially as an unique management for fetal postpartum hemorrhage. (authors)

  2. The suppression effect of the intrahepatic recurrence of transcatheter arterial chemoembolization with cisplatin in the hepatocellular carcinoma patients

    International Nuclear Information System (INIS)

    Moon, Tae Yong; Lee, Suck Hong; Kim, Byung Soo; Kim, Yong Woo

    1997-01-01

    To compare the suppressive effects in hepatocellular carcinoma patients of transhepatic arterial chemoembolization by the infusion of adriamycin-lipiodol emulsion and of this plus 10ml of cisplatin solution. In a total of 151 cases, the frequency of intrahepatic recurrence was compared with follow-up angiographic findings after the first and second transhepatic arterial chemoembolization with adriamycin-lipiodol emulsion and adriamycin-lipiodol emulsion plus 10ml of cisplatin solution, respectively. Among 46 patients whose first single infusion was after mean 119 days, the recurrence rate was 22% ; for 42 who were given their first multiple infusion after mean 76 days this rate was 5% ; for 35 whose second single infusion was administered after mean 147 days, the rate was 34%, and among 28 whose second multiple infusion was after mean 110 days, the rate was 43%. During the first trial of transcatheter arterial chemoembolization with adriamycinlipiodol plus cisplatin solution, hepatocellular carcinoma recurred much less frequently, but during the second trial with cisplatin, recurrence was not suppresed

  3. Efficacy of Transcatheter Arterial Embolization in the Traumatic Injury

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    Park, Dae Hong; Kim, Jeong Ho; Byun, Sung Su; Kim, Hyung Sik [Dept. of Radiology, Gachon University School of Medicine, Gil Hospital, Incheon (Korea, Republic of)

    2012-09-15

    This study evaluated technical and clinical outcomes and identified factors associated with clinical success in trauma patients that underwent transcatheter arterial embolization (TAE) in a single regional hospital. A retrospective study was performed of 106 patients with a variety of trauma who were suspected of active arterial bleeding and underwent angiography. Technical success was defined as non-visualization of extravasation and pseudoaneurysm in injured arteries. Clinical success was defined as the patient was not expired within 30 days from the date of TAE. Electronic medical records were reviewed. The risk factors between groups of clinical success and failure were analyzed statistically. Technical and clinical success rates of TAE were 96% (102/106) and 70% (74/106) respectively. Of the factors we assessed, age, older than 60 years, systolic blood pressure and heart rate at admission and after TAE, and combined brain injury were statistically significant (p < 0.05). Old age, low systolic blood pressure after TAE, and combined brain injury were significant predictors of poor prognosis in multivariate analysis. TAE is an effective treatment for active arterial bleeding of the traumatic injury patient.

  4. Efficacy of Transcatheter Arterial Embolization in the Traumatic Injury

    International Nuclear Information System (INIS)

    Park, Dae Hong; Kim, Jeong Ho; Byun, Sung Su; Kim, Hyung Sik

    2012-01-01

    This study evaluated technical and clinical outcomes and identified factors associated with clinical success in trauma patients that underwent transcatheter arterial embolization (TAE) in a single regional hospital. A retrospective study was performed of 106 patients with a variety of trauma who were suspected of active arterial bleeding and underwent angiography. Technical success was defined as non-visualization of extravasation and pseudoaneurysm in injured arteries. Clinical success was defined as the patient was not expired within 30 days from the date of TAE. Electronic medical records were reviewed. The risk factors between groups of clinical success and failure were analyzed statistically. Technical and clinical success rates of TAE were 96% (102/106) and 70% (74/106) respectively. Of the factors we assessed, age, older than 60 years, systolic blood pressure and heart rate at admission and after TAE, and combined brain injury were statistically significant (p < 0.05). Old age, low systolic blood pressure after TAE, and combined brain injury were significant predictors of poor prognosis in multivariate analysis. TAE is an effective treatment for active arterial bleeding of the traumatic injury patient.

  5. Transcatheter arterial ethanol embolization for congenital renal arteriovenous malformations

    International Nuclear Information System (INIS)

    Wang Jingbing; Wang Han; An Xiao; Wang Linchuan; Gao Liqiang; Zhou Zhiguo; Zhang Guixiang

    2010-01-01

    Objective: To discuss the effect and safety of trans-microcatheter arterial embolization with ethanol for the treatment of congenital renal arteriovenous malformations. Methods: Clinical data of 11 patients with congenital renal arteriovenous malformations manifested mainly as gross hematuria were retrospectively analyzed. Selective renal angiography was performed in all 11 patients. After the diagnosis was confirmed, super-selective catheterization of the diseased arteries was carried out and the trans-microcatheter arterial embolization with ethanol was conducted. Results: A total of 12 procedures were completed in 11 patients. The ethanol dose used in one procedure was 5-25 ml. Successful embolization of the congenital renal arteriovenous malformations was obtained in all patients. The gross hematuria disappeared within 24-48 hours after the treatment. Lumbago at treated side, low fever, abdominal distension, nausea, vomiting, etc. occurred within one week and no other serious complications developed. During the follow-up period lasting for 4-96 months, no recurrence of hematuria was observed and the renal function remained normal. Conclusion: Transcatheter arterial ethanol embolization is an economic, safe and effective treatment for congenital renal arteriovenous malformations. (authors)

  6. An intractable case of lower gastrointestinal hemorrhage due to radiation colitis. Usefulness of transcatheter arterial embolization

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    Inoue, Koichi; Koyama, Tukasa [Yoka Hospital, Hyogo (Japan); Sugamura, Kenji; Ogawa, Toshihide [Tottori Univ., Yonago (Japan). Faculty of Medicine

    2003-05-01

    We tried transcatheter arterial embolization for lower gastrointestinal hemorrhage due to radiation colitis. In this case, colostomy and endoscopic therapy were not effective. We succeeded in arresting the hemorrhage without any complications. Transcatheter embolization is a low-invasive and safe method of treatment. For prevention of inflammation and iatrogenic abscess formation, we repeated this therapy and we tried arterial injection of antibiotics and steroid. And so, this therapy is one of the effective methods. (author)

  7. Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Soyer, Philippe; Fargeaudou, Yann; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Abdominal Imaging, Paris cedex 10 (France); Morel, Olivier [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Obstetrics, Paris cedex 10 (France)

    2008-06-15

    The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm. (orig.)

  8. Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Soyer, Philippe; Fargeaudou, Yann; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland; Morel, Olivier

    2008-01-01

    The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm. (orig.)

  9. Prognostic factors in transcatheter arterial chemoembolization of hepatocellular carcinoma : analysis of more than 3 year survivors

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Heung Suk [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-06-01

    To determine which prognostic factors contribute to long-term survival after transcatheter arterial chemoembolization(TACE) of hepatocellular carcinoma. In 100 patients who expired within one year and 84 who survived or have survived for more than 3 years after TACE, prognostic factors were retrospectively evaluated. TACE was accomplished by hepatic arterial infusion of a suspension of Lipiodol and anticancer drugs(Mitomycin-C and Adriamycin), either alone or followed by gelfoam embolization. Fisher's exact test of probability was used to determine which prognostic factors were statistically significant. Statistically significant prognostic factors were as follows : Child classification(p<0.01), alpha-fetoprotein value(p<0.05), type of tumor(p<0.01), portal vein status(p<0.01), and vascularity of the tumor(p<0.05). HBsAg, tumor size, and method of chemoembolization were not statistically significant(p>0.05). The prognosis of patients with hepatocellular carcinoma treated by TACE was affected favorably by good liver function(Child classification A), low alpha-fetoprotein value, nodular or massive-type tumor, patent main and first-order portal vein, and hypervascular tumor.

  10. Uterine arterial methotrexate infusion and embolization in the treatment of uterine adenomyosis

    International Nuclear Information System (INIS)

    Xie Jingyan; Wang Suzheng; Chen Jingfang; Xuan Yinghua; Lou Wensheng; Gu Jianping

    2008-01-01

    Objective: To study the efficacy of treating different types of uterine adenomyosis with transcatheter local infusion of methotrexate (MTX) combined with uterine arterial embolization under guidance of digital subtraction angiography (DSA). Methods: 33 cases were primarily screened out according to clinical symptoms and color Doppler and then further diagnosis as diffuse or local adenomyosis were undertaken with super selective uterine arterial angiography. The patients were then treated with uterine arterial local infusion (50 mg MTX)and embolization with PVA microsphere (diameter 450-650 μm), individually. Finally, the comparison between the preoperative and postoperative menstruation volumes, the degrees of dysmenorrheal, uterine sizes and the levels of sexual hormones of diffuse and local adenomyosis was carried out. Results: The uterine arterial local infusion of MTX combined with embolization showed no chemotherapeutic side effects. In all cases, there were decrease of menstruation amount, alleviated dysmenorrhea, reduction of uterine size, and the efficacy was more evident in diffuse adenomyosis (P<0.05). Conclusions: Micro-invasive interventional technique combined with drug therapy is promising for diffuse and local adenomyosis especially for the former. (authors)

  11. Transcatheter arterial embolization for bone metastases from hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Uemura, Akihiro; Fujimoto, Hajime; Osaka, Iwao; Yasuda, Shigeo; Goto, Nobuaki; Shinozaki, Masami; Ito, Hisao

    2001-01-01

    The objective of this study was to determine which of the following three methods is the most effective for the treatment of bone metastases from hepatocellular carcinoma (HCC): transcatheter arterial embolization (TAE); combination of TAE and external radiotherapy; or external radiotherapy alone. Thirty-nine metastatic bone lesions from HCC in 33 patients were retrospectively reviewed. Each lesion underwent either TAE alone (group A, n=11), TAE followed by radiotherapy (group B, n=17), or radiotherapy alone (group C, n=11). They were evaluated on the following subjects: pain relief; improvement of daily activities; and complications. Each treatment was effective for pain relief (89-94%) and improvement of daily activities (73-82%). The mean time interval from the beginning of each treatment to the onset of initial pain relief was 4.7 days in group A, 4.8 days in group B, and 15 days in group C. Recurrence of the pain after the initial pain relief was noted in 75% in group A, 20% in group B, and 88% in group C. Pyrexia and local pain commonly occurred after TAE. In conclusion, TAE is effective in relieving pain immediately and in improving the patients' daily activities. The combination of TAE and radiotherapy is recommended for permanent pain relief. (orig.)

  12. Transcatheter arterial chemoembolization of hepatocellular carcinoma with portal vein invasion

    International Nuclear Information System (INIS)

    Lee, Young Rahn; Lee, Ki Yeol; Cho, Seong Beom; Cha, In Ho; Chung, Kyoo Byung

    1993-01-01

    Transcatheter arterial chemoembolization(TACE) is an imperative method for the management of inoperable hepatocellular carcinoma(HCC). It is well known that primary HCC frequently invades the portal venous system and forms a tumor thrombus obstructing the portal blood flow which makes unfavorable prognosis of patient. We retrospectively reviewed 58 patients who reviewed TACE(minimum 3 times) of HCC invading into portal venous system. Group 1(n=29) which showed peripheral portal vein invasion had better clinical and laboratory response. Group 2(n=17) which showed first order portal branch invasion had similar response to Group 3(n=12), which had main portal invasion. Group 1 showed no difference in survival time between TAC and TACE, but, in Group 2 and 3, embolization with chemotherapy made longer survival than chemotherapy only. Clinical level of AFP was meaningful in Group 1 and 2 as decreasing value. Our results provides that careful selection of TAE and case by case Coil/Gelfoam embolization can improve the mean survival and clinical response when HCC evidently invades portal venous system

  13. Transcatheter arterial embolization for hepatoma; I. Short-term evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Heung Suk; Koh, Byung Hee; Cho, On Koo; Hahm, Chang Kok; Rhee, Jong Chul; Lee, Min Ho; Kee, Choon Suhk [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    1985-12-15

    Anticancer effect and complications were evaluated after transcatheter arterial embolization (TAE) in 12 patients with hepatocellular carcinoma until 2 weeks and 4 weeks after TAE, respectively. The results were as follows; 1. Serum alpha-fetoprotein value decreased in 7 out of 9 patients with high value prior to TAE. 2. Loss of enhancement and better definition on enhanced computed tomography (CT) were seen in the tumors in all caes, and low density areas in 9/10.Gas bubbles were seen in low-density areas in 4/10 and high density areas caused by lipiodol in 6/10. 3. Post-embolization syndrome was developed in most patients but improved clinically within a week after TAE. 4. On laboratory examination, impairment of liver function was developed in most patients but improved within 4 weeks after TAE. 5. Complications on CT included splenic infarction and thickening of wall of the gallbladder, which didn't require specific treatment. The authors conclude that TAE for hepatocellular carcinoma reveals apparent anticancer effect on short-term evaluation, and resultant complications are transient and improved by conservative treatment.

  14. Transcatheter arterial embolization for hepatoma; I. Short-term evaluation

    International Nuclear Information System (INIS)

    Seo, Heung Suk; Koh, Byung Hee; Cho, On Koo; Hahm, Chang Kok; Rhee, Jong Chul; Lee, Min Ho; Kee, Choon Suhk

    1985-01-01

    Anticancer effect and complications were evaluated after transcatheter arterial embolization (TAE) in 12 patients with hepatocellular carcinoma until 2 weeks and 4 weeks after TAE, respectively. The results were as follows; 1. Serum alpha-fetoprotein value decreased in 7 out of 9 patients with high value prior to TAE. 2. Loss of enhancement and better definition on enhanced computed tomography (CT) were seen in the tumors in all caes, and low density areas in 9/10.Gas bubbles were seen in low-density areas in 4/10 and high density areas caused by lipiodol in 6/10. 3. Post-embolization syndrome was developed in most patients but improved clinically within a week after TAE. 4. On laboratory examination, impairment of liver function was developed in most patients but improved within 4 weeks after TAE. 5. Complications on CT included splenic infarction and thickening of wall of the gallbladder, which didn't require specific treatment. The authors conclude that TAE for hepatocellular carcinoma reveals apparent anticancer effect on short-term evaluation, and resultant complications are transient and improved by conservative treatment

  15. Transcatheter Arterial Chemoembolization Based on Hepatic Hemodynamics for Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Satoru Murata

    2013-01-01

    Full Text Available Hepatocellular carcinoma (HCC is the sixth most common cancer and the third leading cause of cancer-related deaths in the world. The Barcelona Clinic Liver Cancer (BCLC classification has recently emerged as the standard classification system for clinical management of patients with HCC. According to the BCLC staging system, curative therapies (resection, transplantation, and percutaneous ablation can improve survival in HCC patients diagnosed at an early stage and offer potential long-term curative effects. Patients with intermediate-stage HCC benefit from transcatheter arterial chemoembolization (TACE, and those diagnosed at an advanced stage receive sorafenib, a multikinase inhibitor, or conservative therapy. Most patients receive palliative or conservative therapy only, and approximately 50% of patients with HCC are candidates for systemic therapy. TACE is often recommended for advanced-stage HCC patients all over the world because these patients desire therapy that is more effective than systemic chemotherapy or conservative treatment. This paper aims to summarize both the published data and important ongoing studies for TACE and to discuss technical improvements in TACE for advanced-stage HCC.

  16. Transcatheter Arterial Embolization for Gastrointestinal Bleeding Secondary to Gastrointestinal Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Lin [Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Department of Radiology (China); Shin, Ji Hoon, E-mail: jhshin@amc.seoul.kr; Han, Kichang; Tsauo, Jiaywei; Yoon, Hyun-Ki; Ko, Gi-Young [University of Ulsan, College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology (Korea, Republic of); Shin, Jong-Soo [Kyunghee University, College of Medicine, Kangdong Kyunghee University Hospital, Department of Radiology (Korea, Republic of); Sung, Kyu-Bo [University of Ulsan, College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology (Korea, Republic of)

    2016-11-15

    PurposeTo evaluate the effectiveness of transcatheter arterial embolization (TAE) for gastrointestinal (GI) bleeding caused by GI lymphoma.Materials and MethodsThe medical records of 11 patients who underwent TAE for GI bleeding caused by GI lymphoma between 2001 and 2015 were reviewed retrospectively.ResultsA total of 20 TAE procedures were performed. On angiography, contrast extravasation, and both contrast extravasation and tumor staining were seen in 95 % (19/20) and 5 % (1/20) of the procedures, respectively. The most frequently embolized arteries were jejunal (n = 13) and ileal (n = 5) branches. Technical and clinical success rates were 100 % (20/20) and 27 % (3/11), respectively. The causes of clinical failure in eight patients were rebleeding at new sites. In four patients who underwent repeat angiography, the bleeding focus was new each time. Three patients underwent small bowel resection due to rebleeding after one (n = 2) or four (n = 1) times of TAEs. Another two patients underwent small bowel resection due to small bowel ischemia/perforation after three or four times of TAEs. The 30-day mortality rate was 18 % due to hypovolemic shock (n = 1) and multiorgan failure (n = 1).ConclusionAngiogram with TAE shows limited therapeutic efficacy to manage GI lymphoma-related bleeding due to high rebleeding at new sites. Although TAE can be an initial hemostatic measure, surgery should be considered for rebleeding due to possible bowel ischemic complication after repeated TAE procedures.

  17. Prognostic factors in the treatment of locally advanced hepatocellular carcinoma with radiotherapy and arterial infusion

    International Nuclear Information System (INIS)

    Wang, Y.; Jin, Y.; Zhang, Z.

    2000-01-01

    Prognostic factors in the treatment of local advanced hepatocellular carcinoma with radiotherapy, transcatheter arterial embolization and arterial infusion. The treatment effects of radiotherapy and combination modality therapy for the local advanced hepatocellular carcinoma (HCC) were retrospectively reviewed. Three hundred and fifty-six patients of HCC (187 recurrent cases after surgical resection) were treated by: radiotherapy only ; bi-therapeutic method: hepatic artery ligation (HAL) and/or hepatic artery embolization (HAE) plus radiotherapy; and tri-therapeutic method (bi-therapeutic method plus hepatic artery infusion) from 1975 to 1996. Kaplan-Meier method has been used to evaluate the survival rates. There were no significant differences among these three treatment groups in the symptom relied rate, but the mean relief time period was much shorter in radiotherapy alone group (2.5 vs 44 months, P 0.05). There were evident differences in five-year survivals among these three treatment groups: 0 % for radiotherapy alone, 22.8 % for bi-therapeutic method and 38.8 % for tri-therapeutic method (P < 0.01). The prognosis was influenced by Okuda classification. Non-resectable local advanced HCC can be treated by the combination modality therapy, including radiotherapy, with a quite high cure rate. Radiotherapy alone can relief the symptoms. (authors)

  18. Influence of transcatheter hepatic artery embolization using iodized oil on radiofrequency ablation of hepatic neoplasms

    International Nuclear Information System (INIS)

    Du Xilin; Ma Qingjiu; Wang Yiqing; Wang Zhimin; Zhang Hongxin

    2004-01-01

    Objective: To observe the effect of iodized oil on radiofrequency thermal ablation (RFA) of hepatic neoplasms by using a cluster array of ten separate electrodes. Methods: The patients were divided into 2 groups, group A with transcatheter hepatic artery embolization, group B without transcatheter hepatic artery embolization. All patients were undergone radiofrequency ablation of hepatic neoplasms. Results: The time of RFA for group A was (9 ± 2.1) minutes, showing the diameter of necrosis of (5.3 ± 1.4) cm. The time of RFA for group B was (16 ± 4. 6) minutes demonstrating the diameter of necrosis of (3.5 ± 1.8) cm (P<0.01). Conclusions: These findings suggest that radiofrequency thermal ablation of hepatic neoplasms with transcatheter hepatic artery embolization using iodized oil might improve the safety and synergic effect

  19. Lumbar artery pseudoaneurysm and arteriovenous fistula as a complication of laparoscopic splenectomy: treatment by transcatheter embolization

    International Nuclear Information System (INIS)

    Maleux, G.; Wilms, G.; Vermylen, J.

    2002-01-01

    Iatrogenic injury of a lumbar artery is very rare and mostly causes retroperitoneal hemorrhage. We report a case of a lumbar artery pseudoaneurysm and a concomitant arteriovenous fistula complicating laparoscopic splenectomy and provoking renal colic-like flank pain due to mass effect on the left ureter. Definitive treatment of both vascular lesions was obtained after percutaneous transcatheter embolization of several lumbar arteries. Control computed tomography scan 3 months after embolization showed almost complete resorption of the retroperitoneal hematoma. (orig.)

  20. Lumbar artery pseudoaneurysm and arteriovenous fistula as a complication of laparoscopic splenectomy: treatment by transcatheter embolization

    Energy Technology Data Exchange (ETDEWEB)

    Maleux, G.; Wilms, G. [Department of Radiology, University Hospitals, Leuven (Belgium); Vermylen, J. [Department of Internal Medicine-Vascular Diseases, University Hospitals, Leuven (Belgium)

    2002-06-01

    Iatrogenic injury of a lumbar artery is very rare and mostly causes retroperitoneal hemorrhage. We report a case of a lumbar artery pseudoaneurysm and a concomitant arteriovenous fistula complicating laparoscopic splenectomy and provoking renal colic-like flank pain due to mass effect on the left ureter. Definitive treatment of both vascular lesions was obtained after percutaneous transcatheter embolization of several lumbar arteries. Control computed tomography scan 3 months after embolization showed almost complete resorption of the retroperitoneal hematoma. (orig.)

  1. Transcatheter Arterial Embolization of Arterial Esophageal Bleeding with the Use of N-Butyl Cyanoacrylate

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Hoon; Kim, Hyo Cheol; Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung [Seoul National University Hospita, Seoul (Korea, Republic of)

    2009-08-15

    To evaluate the clinical efficacy and safety of a transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for the treatment of arterial esophageal bleeding. Between August 2000 and April 2008, five patients diagnosed with arterial esophageal bleeding by conventional angiography, CT angiography or endoscopy, underwent a TAE with NBCA. We mixed NBCA with iodized oil at ratios of 1:1 to 1:4 to supply radiopacity and achieve a proper polymerization time. After embolization, we evaluated the angiographic and clinical success, recurrent bleeding, and procedure-related complications. The bleeding esophageal artery directly originated from the aorta in four patients and from the left inferior phrenic artery in one patient. Although four patients had an underlying coagulopathy at the time of the TAE, angiographic and clinical success was achieved in all five patients. In addition, no procedurerelated complications such as esophageal infarction were observed during this study. NBCA can be an effective and feasible embolic agent in patients with active arterial esophageal bleeding, even with pre-existing coagulopathy.

  2. Transcatheter Arterial Embolization of Arterial Esophageal Bleeding with the Use of N-Butyl Cyanoacrylate

    International Nuclear Information System (INIS)

    Park, Ji Hoon; Kim, Hyo Cheol; Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung

    2009-01-01

    To evaluate the clinical efficacy and safety of a transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for the treatment of arterial esophageal bleeding. Between August 2000 and April 2008, five patients diagnosed with arterial esophageal bleeding by conventional angiography, CT angiography or endoscopy, underwent a TAE with NBCA. We mixed NBCA with iodized oil at ratios of 1:1 to 1:4 to supply radiopacity and achieve a proper polymerization time. After embolization, we evaluated the angiographic and clinical success, recurrent bleeding, and procedure-related complications. The bleeding esophageal artery directly originated from the aorta in four patients and from the left inferior phrenic artery in one patient. Although four patients had an underlying coagulopathy at the time of the TAE, angiographic and clinical success was achieved in all five patients. In addition, no procedurerelated complications such as esophageal infarction were observed during this study. NBCA can be an effective and feasible embolic agent in patients with active arterial esophageal bleeding, even with pre-existing coagulopathy

  3. Transcatheter arterial chemoembolization of liver metastasis of gastrointestinal leiomyosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Won, Hyung Jin; Chung, Jin Wook; Kim, Tae Kyoung; Han Dae Hee; Kim, Sun Ho; Cheon, Jung Eun; Han, Joon Koo; Park, Jae Hyung [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    To evaluate the usefulness of transcatheter arterial chemoembolization (TACE) in the management of gastrointestinal leiomyosarcoma metastatic to the liver. Ten patients with gastrointestinal leiomyosarcoma and hepatic metastasis underwent TACE after surgical resection of the primary tumor. All of the leiomyosarcomas originated from the stomach(n=3D5), duodenum (n=3D1) or jejunum(n=3D4), and the interval between primary tumor resection and hepatic metastasis was 1-120(mean 26) months. Using an emulsion of 3-20mL of Lipiodol and 15-60mg of doxorubicin. TACE was performed, and in five patients, gelfoam embolization was added. Therapeutic response was evaluated by follow-up CT, and nine patients underwent repeated TACE (range:2-9 times;interval:1-9 months). On celiac arteriography, all cases showed hypervascular tumor staining. As an initial therapeutic response based on CT assessment, more than 50% regression of the tumor (partial remission) was achieved in seven patients, and in the remaining three, regression was 20-30%(stable disease); neither complete remission nor progression was seen. With regard to long-term survival, five patients died at 5, 8, 14, 20 and 49 (median, 19) months after initial TACE. The remaining five, in whom follow-up has extended for 13-54 months, are still alive. Overall, survival time ranged from 5-54(median, 19) months, and except for postembolization syndrome, there was no specific complication. The period of durable tumor regression before progression ranged from 6 to 54 (median, 17) months. TACE can be a safe and effective method for the palliation of gastrointestinal leiomyosarcoma metastatic to the liver.=20.

  4. Evaluation of hepatic atrophy after transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Chung, Hwan Hoon; Lee, Mee Ran; Oh, Min Cheol; Park, Chul Min; Seol, Hae Young; Cha, In Ho

    1995-01-01

    Hepatic atrophy has been recognized as a complication of hepatic and biliary disease but we have often found it in follow up CT after transcatheter arterial embolization (TACE). The purpose of this study is to evaluate the characteristics of hepatic atrophy after TACE. Of 53 patients who had TACE. We evaluated the relationship between the incidence of hepatic atrophy and the number of TACE, and also evaluated the average number of TACE in patients with hepatic atrophy. Of 20 patients who had received more than average number of TACE for development of hepatic atrophy (2 times with portal vein obstruction, 2.7 times without portal vein obstruction in this study), we evaluated the relationship between the lipiodol uptake pattern of tumor and the incidence of hepatic atrophy. There were 8 cases of hepatic atrophy (3 with portal vein obstruction, 5 without portal vein obstruction), average number for development of hepatic atrophy were 2.5 times. As the number of TACE were increased, the incidence of hepatic atrophy were also increased. Of 20 patients who received more than average number of TACE for development of hepatic atrophy, we noted 6 cases of hepatic atrophy in 11 patients with dense homogenous lipiodol uptake pattern of tumor and noted only 1 case of hepatic atrophy in 9 patient with inhomogenous lipiodol uptake pattern. Hepatic atrophy was one of the CT findings after TACE even without portal vein obstruction. Average number of TACE was 2.5 times and risk factors for development of hepatic atrophy were portal vein obstruction, increased number of TACE, and dense homogenous lipiodol uptake pattern of tumor

  5. Clinical implications of bile duct injury after transcatheter arterial chemoembolization

    International Nuclear Information System (INIS)

    Wang Maoqiang; Tang Wenjie; Lin Hanying; Ye Huiyi; Dai Guanghai; Wang Zhiqiang

    2005-01-01

    Objective: To evaluate the incidence, risk factors , and clinical course of bile duct injury after transcatheter arterial chemoembolization (TACE) for treatment of hepatic malignancy. Methods: A total of 1240 consecutive patients with hepatic malignancies underwent 2680 TACE procedures. None of these patients were found to have any radiographic evidence of biliary abnormalities pre-TACE. Eighteen patients developed bile duct injuries at 3 weeks to 3 months after TACE. A retrospective review of medical records and imaging studies were carried out to evaluate the occurrence of TACE-induced bile duct injury, the clinical outcome, and the statistical significance of potential predisposing factors. Results: The TACE-induced bile duct injuries occurred in 13 of 148 patients with liver metastatic tumors (8.8%), 5 of 1092 patients with HCC (0.5%). Biliary injuries, including focal (n=4) and multiple intrahepatic bile duct dilatation (n=8), and cystic lesion or biloma (n=6), were identified on the follow-up imaging studies after TACE. Three patients with multiple bile duct injuries had mild jaundice at the presentation, two of them responded well to the conservative treatment, one died of irreversible deterioration of liver function at 2 weeks after the onset of jaundice. Four patients with a large biloma had associated serious bacterial infections; 3 of which were treated with percutaneous catheter drainage and antibiotics, 2 of them died of purulent peritonitis due to rupture of the cystic lesions and 1 cured with antibiotic. The remaining 11 patients were asymptomatic. The mortality related to the biliary injury occurred in 3 patients (16.7%). The incidences of bile duct injury were higher in patients with metastatic tumors in non-cirrhotic livers than in patients with hepatocellular carcinoma associated with cirrhosis (P<0.01), higher in patient with hypovascular lesions (P<0.01), and higher in patients using an emulsion of lipiodol-platinum for selective embolization

  6. Angiographic manifestation and transcatheter arterial embolization of proper esophageal artery in hemoptysis

    International Nuclear Information System (INIS)

    Jiang Sen; Zhu Xiaohua; Sun Xiwen; Zhi Wenxiang; Jie Bing; You Zhengqian; Yu Dong; Peng Gang

    2008-01-01

    Objective: To investigate the angiographic manifestation of the proper esophageal artery (PEA), the high risk factors for the presence of the anomalous PEA in hemoptysis and to evaluate the safety of transcatheter arterial embolization (TAE) of the PEA using gelatin sponge (GS). Methods: Selective esophageal arteriography was performed in forty-three patients with hemoptysis, including 15 cases of pulmonary tuberculosis, 18 cases of bronchiectasis, 7 cases of posttuberculous bronchiectasis and three cases of lung cancer. One case experienced failure of bronchial arterial embolization. The angiographic manifestation of the PEAs was studied. The complications of the procedure and clinical results were observed in the patients who underwent TAE using GS. Results: Thirty-nine PEAs were catheterized selectively in 37 patients (86.0%). Eighteen anomalous PEAs (46.2%) were catheterized selectively in 17 patients (45.9%). The anomalous PEAs showed tortuosity, dilatation, hyperplasia, shunting with pulmonary artery and anastomosis with the bronchial artery. All lesions involved basal segment of inferior pulmonary lobar. Bronchiectasis was the most frequent disease for PEA abnormality. No complications occurred and satisfactory curative effect was achieved with TAE of the anomalous PEAs. Conclusions: It is necessary to perform selective proper esophageal arteriography when the lesion involves basal segment of inferior pulmonary lobar in hemoptysis. Supplemental TAE of the anomalous PEA using GS is safe and valuable in the management of hemoptysis. (authors)

  7. Successful transcatheter closure of coronary artery fistula in a child with single coronary artery: a heavy load and a long road.

    Science.gov (United States)

    Phasalkar, Manjunath; Thakkar, Bhavesh; Poptani, Vishal

    2013-07-01

    Single coronary artery is an uncommon variation of the coronary circulation. After transposition of great arteries, coronary artery fistulas are the most common associated cardiac anomalies in these patients. Transcatheter closure of coronary artery fistula (CAF) involving single coronary artery is a challenging intervention. In the absence of contralateral coronary artery, a complex anatomy of the CAF and a large myocardial perfusion territory of the dominant circulation pose an additional risk during interventional procedure. We report our experience of a successful transcatheter closure of a coronary artery fistula in a patient with single coronary artery. Copyright © 2013 Wiley Periodicals, Inc.

  8. Study of the additional filter in transcatheter hepatic arterial embolization

    International Nuclear Information System (INIS)

    Hitomi, Go; Arao, Shinichi; Tomomitsu, Tatsushi

    2010-01-01

    It is well known that Interventional Radiology (IVR) is useful. However, the patient dose in IVR is increasing because of the prolongation of fluoroscopic time and the increase in the number of radiographies in recent years. We studied the adequacy of the additional filter for the decrease of the skin surface dose in patients with hepatocellular carcinoma of transcatheter arterial embolization (TAE). In 20 patients (15 men and 5 women, average age: 66.9 and 72.0 years old) who had undergone TAE, we estimated the skin surface dose from the records of their exposure condition (tube voltage, tube current, time, and field size of image intensifier) and the results of the phantom experiment with 2 kinds of additional filter. The estimated skin surface dose of the patient was 1.75±0.84 with the additional filter of 1.5 mm thickness of aluminum (1.5 mmAl), 1.46±0.67 Gy with 0.03 mm thickness tantalum (0.03 mmTa) and 1.17±0.55 Gy with 0.06 mm thickness of tantalum (0.06 mmTa). Against a skin surface dose of 1.5 mmAl, the dose reduction of 16.7% was shown in 0.03 mmTa and 33.2% in 0.06 mmTa. With a digital subtraction angiography (DSA) phantom of iodine density 0.5 and 1.0 and 2.0 mgI/ml, DSA images were acquisitioned at tube voltage 70, 80 and 90 kV to compare the detectability of contrast media in 0.06 mmTa with 1.5 mmAl. To evaluate the detectability of contrast media in 0.06 mmTa in 1.5 mmAl, receiver operating characteristic (ROC) analysis was performed with the pixel value of the phantom image. The area under the ROC curve in a 1.5 mmAl filter and the 0.06 mmTa filter provided with each contrast media density and each tube voltage was approximately a constant value. It was suggested that there was no differences in the detectability of contrast media in both additional filters. In conclusion, the skin surface dose of the patient was able to be reduced 33.2% without decreasing contrast media detectability by changing the additional filter from 1.5 mmAl to 0.06 mm

  9. Pulsatile versus steady infusions for hepatic artery chemotherapy

    International Nuclear Information System (INIS)

    Kim, E.E.; Haynie, T.P.; Wright, K.C.; Chaynsangavej, C.; Gianturco, C.; Lamki, L.; Wallace, S.

    1984-01-01

    Hepatic artery chemotherapy for unresectable liver tumors requires an even distribution of the drugs in the tumor or vascular bed. This cannot be determined angiographically because the drugs are infused at a much lower rate than the contrast media. It is easy, however, to determine the quality of the perfusion by injecting a small volume of Tc-99m MAA in one of the side ports while chemotherapeutic agent is being infused at the same rate. Usually this shows a uniform, satisfactory distribution of isotope. Occasionally, however, some areas fail to receive Tc-99m in spite of what appears to be a good position of the catheter tip. Since ''streaming'' of the infused drugs has been blamed for their uneven distribution, the authors decided to compare the usual steady flow infusions with infusions made pulsatile by the addition of a pulsing device (Gianturco Pump) attached to the infusion tubing. Eighty-three patients were studied with steady as well as pulsatile infusions. In 16 of these patients the perfusion pattern was definitely changed by the pulsatile infusion. In one patient the pulsatile mode resulted in an unwanted gastric perfusion. In 5 patients the distribution was improved in one hepatic lobe and in 10 patients it was improved in both lobes. These results show that hepatic artery perfusions can occasionally be improved by pulsing the infusate. However, pulsing can produce the unwanted perfusion of extra-hepatic areas

  10. Clinical value of arteriography in postpartum hemorrhage by transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Wang Kai; Jiang Guomin; Zhao Jinwei; Huang Wenhua; Liu Yizhi; Jin Yonghai

    2010-01-01

    Objective: To analyze the arterial supply in postpartum hemorrhage and to evaluate the clinical value of arteriography in transcatheter arterial embolization (TAE) for treating postpartum hemorrhage. Methods: The arteriography of 37 patients with postpartum hemorrhage was analyzed. TAE were performed after the bleeding artery was identified. Post TAE angiography was performed to confirm the success of embolization. Results: The bleeding artery in atonic uterus and abnormal placenta was the uterine artery. The bleeding artery in birth canal laceration is mainly non-uterine artery. Postpartum hemorrhage was successfully controlled in all 37 patients without sever complication of TAE. Conclusion: Arteriography in postpartum hemorrhage can demonstrate the bleeding artery and is potential collaterals allowing adequate embolization without complication. (authors)

  11. Hepatocellular carcinoma with extensive hepatic artery injury: transcatheter arterial chemoembolization through collaterals after coil embolizatoin of gastric arteries

    International Nuclear Information System (INIS)

    Kim, Gab Choul; Yoon, Hyun Ki; Hwang, Jae Cheol; Lee, Duck Hee; Song, Ho Young; Suh, Dong Jin; Lee, Yung Sang; Chung, Young Hwa; Sung, Gyu Bo; Ko, Ki Young

    1999-01-01

    To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE) after coil embolization of the gastroduodenal artery in hepatocellular carcinoma cases with multiple collateral arteries caused by proper hepatic artery injury. Between March 1997 and November 1998, a prospective trial of transcatheter arterial chemoembolization (TACE) was performed through collaterals from the gastroduodenal artery of 31 hepatocellular carcinoma patients with extensive proper hepatic artery injury due to repeated TACE. Among this number, 16 (group A) underwent TACE after coil embolization of the right gastric and gastroduodenal artery. The other 15 patients (group B) underwent TACE without coil embolization. The two groups had the same TNM stage and Clild-Pugh status. During the follow-up period, group A underwent additional TACE 3.3 times, and group B 2.8 times. The therapeutic effect of TACE was evaluated with computed tomography and by measuring alpha-fetoprotein levels. Complications were evaluated by means of gastrofibroscopy, laboratory data, and evaluation of the patients' clinical symptoms. The results obtained after six months and one year were compared within and between each group. At six months follow-up, CT findings had improved or were unchanged in 11 patients(69 %) in group A, and four patients(27 %) in group B(p = 0.032). In ten patients in each group, the level of alpha-fetoprotein was above 200 ng/ml. Its level was decreased in five patients(50 %) and three patients(30 %), respectively. The six-month survival rate was 81 % (13/16) in group A and 67% (10/15) in group B (p 0.43), while the one-year survival figures for these two groups were 50 % (8/16) and 20 % (3/15), respectively(p = 0.135). In group A, the CT findings were steady in five out of eight patients(63 %), while in groupB, CT findings showed that tumors with increased alpha-fetoprotein levels had increased in size and/or number. In group A, it was found that in two (33 %) of six

  12. Hepatocellular carcinoma with extensive hepatic artery injury: transcatheter arterial chemoembolization through collaterals after coil embolizatoin of gastric arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gab Choul; Yoon, Hyun Ki; Hwang, Jae Cheol; Lee, Duck Hee; Song, Ho Young; Suh, Dong Jin; Lee, Yung Sang; Chung, Young Hwa; Sung, Gyu Bo [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Ko, Ki Young [Catholic Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE) after coil embolization of the gastroduodenal artery in hepatocellular carcinoma cases with multiple collateral arteries caused by proper hepatic artery injury. Between March 1997 and November 1998, a prospective trial of transcatheter arterial chemoembolization (TACE) was performed through collaterals from the gastroduodenal artery of 31 hepatocellular carcinoma patients with extensive proper hepatic artery injury due to repeated TACE. Among this number, 16 (group A) underwent TACE after coil embolization of the right gastric and gastroduodenal artery. The other 15 patients (group B) underwent TACE without coil embolization. The two groups had the same TNM stage and Clild-Pugh status. During the follow-up period, group A underwent additional TACE 3.3 times, and group B 2.8 times. The therapeutic effect of TACE was evaluated with computed tomography and by measuring alpha-fetoprotein levels. Complications were evaluated by means of gastrofibroscopy, laboratory data, and evaluation of the patients' clinical symptoms. The results obtained after six months and one year were compared within and between each group. At six months follow-up, CT findings had improved or were unchanged in 11 patients(69 %) in group A, and four patients(27 %) in group B(p = 0.032). In ten patients in each group, the level of alpha-fetoprotein was above 200 ng/ml. Its level was decreased in five patients(50 %) and three patients(30 %), respectively. The six-month survival rate was 81 % (13/16) in group A and 67% (10/15) in group B (p 0.43), while the one-year survival figures for these two groups were 50 % (8/16) and 20 % (3/15), respectively(p = 0.135). In group A, the CT findings were steady in five out of eight patients(63 %), while in groupB, CT findings showed that tumors with increased alpha-fetoprotein levels had increased in size and/or number. In group A, it was found that in two (33 %) of six

  13. Left main coronary artery obstruction by dislodged native-valve calculus after transcatheter aortic valve replacement.

    Science.gov (United States)

    Durmaz, Tahir; Ayhan, Huseyin; Keles, Telat; Aslan, Abdullah Nabi; Erdogan, Kemal Esref; Sari, Cenk; Bilen, Emine; Akcay, Murat; Bozkurt, Engin

    2014-08-01

    Transcatheter aortic valve replacement can be an effective, reliable treatment for severe aortic stenosis in surgically high-risk or ineligible patients. However, various sequelae like coronary artery obstruction can occur, not only in the long term, but also immediately after the procedure. We present the case of a 78-year-old woman whose left main coronary artery became obstructed with calculus 2 hours after the transfemoral implantation of an Edwards Sapien XT aortic valve. Despite percutaneous coronary intervention in that artery, the patient died. This case reminds us that early recognition of acute coronary obstruction and prompt intervention are crucial in patients with aortic stenosis who have undergone transcatheter aortic valve replacement.

  14. Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes.

    Science.gov (United States)

    Loffroy, R; Favelier, S; Pottecher, P; Estivalet, L; Genson, P Y; Gehin, S; Cercueil, J P; Krausé, D

    2015-01-01

    Over the past three decades, transcatheter arterial embolization has become the first-line therapy for the management of acute nonvariceal upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications. Transcatheter arterial embolization is a fast, safe, and effective minimally invasive alternative to surgery, when endoscopic treatment fails to control acute bleeding from the upper gastrointestinal tract. This article describes the role of arterial embolization in the management of acute nonvariceal upper gastrointestinal bleeding and summarizes the literature evidence on the outcomes of endovascular therapy in such a setting. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  15. Massive tumor pulmonary embolism following transcatheter arterial chemoembolization of hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kim, Jeong Ho; Ko, Gi Young; Yoon, Hyun Ki; Sung, Kyu Bo

    2002-01-01

    Pulmonary embolism complicated by transcatheter arterial chemoembolization (TACE) in known to be due to the use of large amount of lipiodol as an embolic agent. To our knowledge, massive tumoral pulmonary embolism following TACE and confirmed by surgery has not been described in the literature. In this report, we detail the cas of a 49-year-old man in whom cyanosis and hypotension developed abruptly on the day of TACE.. Chest CT revealed diffuse low-attenuated lesions in both pulmonary arteries. Histopathological specimens after emergent pulmonary arterial embolectomy confirmed the presence of massive tumor emboli of hepatocellular carcinoma

  16. Massive tumor pulmonary embolism following transcatheter arterial chemoembolization of hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kim, Jeong Ho; Ko, Gi Young; Yoon, Hyun Ki; Sung, Kyu Bo

    2002-01-01

    Pulmonary embolism complicated by transcatheter arterial chemoembolization (TACE) is known to be due to the use of large amount of lipiodol as an embolic agent. To our knowledge, massive tumoral pulmonary embolism following TACE and confirmed by surgery has not been described in the literature. In this report, we detail the case of a 49-year-old man in whom cyanosis and hypotension developed abruptly on the day of TACE. Chest CT revealed diffuse low-attenuated lesions in both pulmonary arteries. Histopathological specimens after emergent pulmonary arterial embolectomy confirmed the presence of massive tumor emboli of hepatocellular carcinoma

  17. Transcatheter Embolization of a Renal Artery Aneurysm Using Ethylene Vinyl Alcohol Copolymer

    International Nuclear Information System (INIS)

    Rautio, Riitta; Haapanen, Arto

    2007-01-01

    Our aim was to treat a clinically silent renal artery aneurysm. The patient was a 76-year-old man with elevated prostate-specific antigen and prostata biopsies with a gradus II-III adenocarcinoma who was incidentally found to have an aneurysm in his right renal artery. We performed a successful transcatheter embolization of the aneurysm using ethylene vinyl alcohol copolymer (Onyx). To avoid migration of the liquid material into the parent artery, a balloon was inflated in the orifice of the neck of the aneurysm while the liquid was injected. Five-month follow-up computed tomography (CT) imaging confirmed total occlusion of the aneurysm

  18. Complications after transcatheter arterial chemoembolization via the inferior phrenic arteries: incidence, risk factors, and prophylaxis

    International Nuclear Information System (INIS)

    Wang Maoqiang; Liu Fengyong; Guan Jun; Gu Xiaofang; Lin Hanying; Wang Zhiqiang

    2004-01-01

    Objective: To investigate the frequency, patterns of the angiographic findings and risk factors for development of complications after transcatheter arterial chemoembolization (TACE) via the inferior phrenic artery (IPA). Methods: One hundred and sixty eight patients with hepatic tumor fed by the IPA underwent a total of 226 procedures of TACE of the IPA, with combined routine TACEO (88.7%) or without (11.3%) the combination of routine TACE of the hepatic artery. TACE of the malignancy was performed with an emulsion of iodized oil and anti-cancer agents and then followed by gelatin sponge particle injection. The complications were assessed on clinical observation, laboratory tests, and computed tomographic (CT) images after TACE of the IPA; and finally were correlated with the angiographic findings of the IPA. Results: The tumor supplied by IPA was noted at initial TACE in 25 (14.9%), at successive TACE in 97 (57.8%), after percutaneous tumor ablation guided by ultrasound in 28 (16.7%), and after hepatic surgery in 18 (10.7%) cases. The abnormal findings on arteriography showed enlargement of the IPA with tumor staining in all cases, dense non-tumor staining in 61 (36.3%), artery-to-artery anastomosis in 62(36.9%), arteriovenous shunts in 12(7.1%) cases. 96.4% of these patients complained of shoulder pain during TACE of the IPA. The cumulative complication rate after the procedure was 8.9%, including hiccup in 13 cases (5.8%), chest pain with cough and mild hemoptysis in 9 (4.0%), phrenoparalysis in 8 (3.5%), angina with abnormal ECG in 4 (1.8%), increasing of CPK, AST, and ALT significantly in 6 (2.7%), transient myeloparalysis in 2 (0.9%), and subphrenic abscess in 2 cases (0.9%). Two patients with the subphrenic abscess were successfully treated with percutaneous catheter drainage and antibiotics. The symptoms of these mild complications subsided with symptomatic treatment. Conclusions: Complications of TACE via the IPA occur in about 9% of the patients and

  19. Infusion MR arteriography during hepatic arterial infusion chemotherapy. Evaluation of clinical usefulness

    International Nuclear Information System (INIS)

    Uchino, Minako; Takizawa, Kenji

    2003-01-01

    We developed a new method of infusion MR arteriography (IMRA) via an implantable port system using an infusion pump for the evaluation of drug distribution during hepatic arterial infusion chemotherapy. The purposes of this study were to optimize the method and evaluate its clinical usefulness. We used 3D-T1 turbo field echo (TFE) as the most suitable sequence for IMRA according to the results of a phantom model experiment. We examined 33 cases of liver cancer that had been treated by arterial infusion chemotherapy via the port system. The following investigations were performed: degree of tumor enhancement, intra- and extra- hepatic perfusion abnormality, and related toxicity. The evaluation of images was performed separately by two radiologists. IMRA provided good images of contrast enhancement, to reveal the perfusion patterns. The treatment response rate in the tumor group with well enhancement was higher than that of the group with poor enhancement (p<0.0001). Extrahepatic perfusion was well visualized and was correlated with toxicity (p<0.0001). IMRA is a useful method to evaluate drug perfusion for the optimization of arterial infusion chemotherapy. (author)

  20. Targeting chemotherapy via arterial infusion for advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Zhi-yu CAO

    2011-10-01

    Full Text Available Objective To evaluate the clinical effects of chemotherapy via arterial infusion in treatment of advanced gastric cancer.Methods Forty-seven patients with advanced gastric cancer were given chemotherapy via arterial infusion.Chemotherapy plan was as follows: 5-Fluorouracil(Fu 500mg/m2,cyclophosphamide(MMX 10mg/m2,Hydroxycamptothecin(HPT 20mg/m2,once per week,2 weeks as a course,a total of 2-3 courses.Results After chemotherapy via arterial infusion,complete remission(CR was achieved in 1 case,partial remission(PR in 28 cases,stabilization of disease(SD in 16 cases,progression of disease(PD was found in 2 cases,and rate with response(CR+PR was 61.7%.Four of 28 PR patients underwent tumorectomy,the pathology revealed the presence of cancer cells around the vascular vessels,manifesting karyopyknosis,karyorrhexis,coagulation and necrosis of cytoplasm,intercellular edema,hyperplasia of fibroblasts,inflammatory cell infiltration,thickening of endothelium,and thrombosis.One,two and three-year survival rates were 70.2%,14.9% and 2.1%,respectively.The average survival period was 17.2 months.Conclusion Targeting chemotherapy via arterial infusion,as a part of the combined treatment,is beneficial to the patients with unresectable advanced gastric cancer.

  1. Transcatheter embolization of celiac artery pseudoaneurysm following pancreatico-duodenectomy for pancreatic cancer. A case report

    International Nuclear Information System (INIS)

    Mori, K.; Yoshioka, H.; Kuramochi, M.; Saida, Y.; Itai, Y.; Murata, S.; Michishita, N.; Oda, T.

    1998-01-01

    A case of transcatheter embolization of a celiac artery pseudoaneurysm in a 70-year-old man is reported. The pseudoaneurysm was considered to be the result of pancreatic anastomotic leakage and an intra-abdominal abscess following pancreaticoduodenectomy with irradiation of 66 Gy for pancreatic carcinoma. To avoid recanalization of the pseudoaneurysm due to retrograde blood flow, first all branches of the celiac artery were embolized with metallic coils, and then the celiac trunk was also occluded. Hepatic arterial flow was preserved by the right hepatic artery arising from the superior mesenteric artery. After the procedure, the patient had no noticeable complications associated with the embolization nor any recurrence of the pancreatic cancer, and he achieved a 2-year survival. (orig.)

  2. Transcatheter embolization of celiac artery pseudoaneurysm following pancreatico-duodenectomy for pancreatic cancer. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Mori, K.; Yoshioka, H.; Kuramochi, M.; Saida, Y.; Itai, Y. [Dept. of Radiology, Tsukuba Univ. Hospital (Japan); Murata, S. [Dept. of Diagnostic Radiology, Univ. Hospital, Malmoe (Sweden); Michishita, N. [Dept. of Radiology, Tsuchiura Kyodo Hospital (Japan); Oda, T. [Dept. of Surgery, Tsukuba Univ. Hospital (Japan)

    1998-11-01

    A case of transcatheter embolization of a celiac artery pseudoaneurysm in a 70-year-old man is reported. The pseudoaneurysm was considered to be the result of pancreatic anastomotic leakage and an intra-abdominal abscess following pancreaticoduodenectomy with irradiation of 66 Gy for pancreatic carcinoma. To avoid recanalization of the pseudoaneurysm due to retrograde blood flow, first all branches of the celiac artery were embolized with metallic coils, and then the celiac trunk was also occluded. Hepatic arterial flow was preserved by the right hepatic artery arising from the superior mesenteric artery. After the procedure, the patient had no noticeable complications associated with the embolization nor any recurrence of the pancreatic cancer, and he achieved a 2-year survival. (orig.)

  3. Rupture of hepatocellular carcinoma following transcatheter arterial chemoembolization: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hyo Jin; Lee, Byung Hoon; Hwang, Yoon Joon; Kim, Su Young; Lee, Ji Young [Ilsan Paik Hospital/Inje Univ. School of Medicine, Goyang (Korea, Republic of); Han, Yoon Hee [Seonam Hospital/Ewha Womans Univ. School of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    Transcatheter arterial chemoembolization (TACE) is known to be an effective palliative treatment for unresectable hepatocellular carcinoma (HCC). Serious complications, such as neutropenic sepsis and hepatic decompensation, are well known. A HCC rupture following TACE is a rare complication; however, it can be life threatening if it occurs. In a 75 year old male patient who subsequently developed capsular rupture of the lipiodol laden mass and several free intraperitoneal chemoembolization agents with hemoperitoneum, we report a case of a ruptured HCC that superficially located arterial enhancing and early wash out mass in the right hepatic dome following TACE.

  4. The efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury

    International Nuclear Information System (INIS)

    Kwack, Kyu Sung; Kim, Young Ju; Lee, Myung Sub; Kim, Dong Jin; Hong, In Soo

    2000-01-01

    To evaluate the efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury after blunt abdominal trauma. We retrospectively analyzed the results of transcatheter arterial embolization in 23 patients who suffered splenic injury after blunt abdominal trauma. Fourteen of the patients were male, and 9 were female; 13 were adults, and 10 were children. Transcatheter arterial embolization was performed in patients with hypotension, tachycardia, evidence of hemodynamic instability due, for example, to low levels of Hgb and Hct, or those who needed fluid therapy or blood transfusion. After embolization the patients' progress was monitored by CT scanning, abdominal sonography, or 99m Tc-sulfur colloid scintigraphy. The degree of splenic injury was classified according to the system devised by Mirvis et al.; nine cases were CT grade III, and 14 were grade IV. After demonstrating angiographically the site of contrast leakage, embolization was performed; for this, a coil only was used in 16 cases, gelfoam only in four, and both coil and gelfoam in three. There were three sites of vascular embolization: 16 procedures were performed in the proximal part of the main trunk of the splenic artery, four in a superselected branch of this same artery, and three in both the splenic artery and one of its superselected branches. Of the 23 cases, 18 recovered without splenectomy after embolization, three adult patients died from coexisting conditions (spinal or cerebral injuries, liver cirrhosis, or pelvic bone fracture) or complications (acute renal failure or disseminated intravascular coagulation). Due to co-existing pancreatic and mesenteric vessel injury, two of the adult patients who underwent TAE also underwent delayed surgery; intraoperatively, there was no evidence of splenic rebleeding. In all patients who did not undergo surgery, follow-up observation revealed a decreased volume of hemoperitoneum, increased uptake of radionuclide in

  5. The efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury

    Energy Technology Data Exchange (ETDEWEB)

    Kwack, Kyu Sung; Kim, Young Ju; Lee, Myung Sub; Kim, Dong Jin; Hong, In Soo [Wonju Christian Hospital, College of Medicine, Yonsei University, Wonju (Korea, Republic of)

    2000-07-01

    To evaluate the efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury after blunt abdominal trauma. We retrospectively analyzed the results of transcatheter arterial embolization in 23 patients who suffered splenic injury after blunt abdominal trauma. Fourteen of the patients were male, and 9 were female; 13 were adults, and 10 were children. Transcatheter arterial embolization was performed in patients with hypotension, tachycardia, evidence of hemodynamic instability due, for example, to low levels of Hgb and Hct, or those who needed fluid therapy or blood transfusion. After embolization the patients' progress was monitored by CT scanning, abdominal sonography, or {sup 99m}Tc-sulfur colloid scintigraphy. The degree of splenic injury was classified according to the system devised by Mirvis et al.; nine cases were CT grade III, and 14 were grade IV. After demonstrating angiographically the site of contrast leakage, embolization was performed; for this, a coil only was used in 16 cases, gelfoam only in four, and both coil and gelfoam in three. There were three sites of vascular embolization: 16 procedures were performed in the proximal part of the main trunk of the splenic artery, four in a superselected branch of this same artery, and three in both the splenic artery and one of its superselected branches. Of the 23 cases, 18 recovered without splenectomy after embolization, three adult patients died from coexisting conditions (spinal or cerebral injuries, liver cirrhosis, or pelvic bone fracture) or complications (acute renal failure or disseminated intravascular coagulation). Due to co-existing pancreatic and mesenteric vessel injury, two of the adult patients who underwent TAE also underwent delayed surgery; intraoperatively, there was no evidence of splenic rebleeding. In all patients who did not undergo surgery, follow-up observation revealed a decreased volume of hemoperitoneum, increased uptake of

  6. The value of multislice spiral CT in transcatheter arterial chemoembolization of the hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Li Zhigang; Zhao Junjing; Shi Gaofeng; Li Shunzong; Han Pengyin; Yang Guang; Liang Guoqing; Wang Hongguang; Huang Jingxiang

    2006-01-01

    Objective: To evaluate the value of multislice spiral CT (MSCT) in transcatheter arterial chemoembolization of the hepatocellular carcinoma. Methods: MSCT were performed in 54 cases of HCC before interventional procedure. CT findings of hepatic artery phase, portal venous phase and hepatic venous phase were observed respectively. CTA were done in 12 cases, the anatomy of celiac artery and its branches were observed. The schemes of interventional therapy were worked out according to the findings of MSCT. The demonstration of lesions and its complications were compared between CT and DSA. Reconstruction of celiac artery branches used the technique of VRT, MIP or MPR. Results: MSCT showed 225 lesions, 10 cases tumor thrombosis of portal vein, 1 case hepatic arteriovenous shunt, and 13 cases hepatic arterioportal shunt. Positive rate of MSCT in showing number of tumor lesions, tumor thrombosis in portal vein was slightly higher than that of DSA, but there was no significant difference (P>0.05). Showing of 3D reconstruction of celiac artery branches in CTA is better than that in DSA, Showing of angles between celiac artery and abdominal aorta in MSCT is more convenient than that in DSA. MSCT showed 5 cases hepatic artery original abnormality. The results were in accord with that in DSA. Five cases were demonstrated of multiple supply blood vessels of tumor in MSCT, It was slightly lower than that of DSA. Conclusion: MSCT is of importance for guidance of transcatheter arterial chemoembolization of the hepatocellular carcinoma, delay time of CT scan is the key to the showing of lesions and blood vessels. (authors)

  7. The efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury

    International Nuclear Information System (INIS)

    Park, Si Kyun; Kim, Young Ju; Kwon, Taek Sang; Kim, Jong Jin; Ko, Sung Min; Sung, Ki Joon

    1998-01-01

    The purpose of this study is to evaluate the efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury. The results of transcatheter splenic arterial embolization in nine children who suffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated by CT, and the findings were evaluated according to the classification of Mirvis et al.; two patients were grade 3 and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if a patient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintain hemodynamic stability; or (2) rapid Hb/Hct decrease; or (3) both. Splenic function was subsequently estimated according to the results of 09m Tc-sulfur colloid scintigraphy and/or CT scanning. TAE was successful in all nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil. Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches. Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. TAE of the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injury in children, and can preserve splenic function. (author). 18 refs., 2 tabs., 3 figs

  8. The efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury

    Energy Technology Data Exchange (ETDEWEB)

    Park, Si Kyun; Kim, Young Ju; Kwon, Taek Sang; Kim, Jong Jin; Ko, Sung Min; Sung, Ki Joon [Yonsei University, Wonju (Korea, Republic of). Wonju Coll. of Medicine

    1998-06-01

    The purpose of this study is to evaluate the efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury. The results of transcatheter splenic arterial embolization in nine children who suffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated by CT, and the findings were evaluated according to the classification of Mirvis et al.; two patients were grade 3 and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if a patient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintain hemodynamic stability; or (2) rapid Hb/Hct decrease; or (3) both. Splenic function was subsequently estimated according to the results of {sup 09m}Tc-sulfur colloid scintigraphy and/or CT scanning. TAE was successful in all nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil. Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches. Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. TAE of the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injury in children, and can preserve splenic function. (author). 18 refs., 2 tabs., 3 figs.

  9. Emergency percutaneous transcatheter embolisation of acute arterial haemorrhage.

    LENUS (Irish Health Repository)

    Keeling, A N

    2010-09-01

    The purpose of this study was to review indications, source of haemorrhage, method of embolisation and clinical outcome in patients referred to Interventional Radiology for the emergency management of acute arterial haemorrhage.

  10. The Analysis of Efficacy and Failure Factors of Uterine Artery Methotrexate Infusion and Embolization in Treatment of Cesarean Scar Pregnancy

    Directory of Open Access Journals (Sweden)

    Xiao An

    2013-01-01

    Full Text Available Objectives. This study observes therapeutic efficacy of uterine artery embolization combined with MTX infusion which terminates cesarean scar pregnancy (CSP and induces three factors which probably relate to failure. Methods. Twenty-three CSP patients were treated with combined uterine artery MTX infusion and embolization. Among them six patients with severe hemorrhage were immediately treated with interventional operation. Clinical effects were estimated by symptoms, serum -hCG, ultrasound, and MR. Results. Interventional treatments were technologically successful in 22 patients except one. Immediate hemostasis was achieved in all 6 patients with massive colporrhagia. No occurrence of infection and uterine necrosis was observed, but 12 women suffered abdominal pains. Nineteen patients’ uteri were preserved, whereas four underwent hysterectomy eventually. Conclusions. Transcatheter arterial chemoembolization is effective to treat high-risk CSP in preference to hysterectomy. To achieve more successful outcomes, three factors should be highlighted: adequate MTX dosage, appropriate embolic material, and complete embolization of target arteries that supply blood to embryo in the scar.

  11. Transcatheter Coil Embolization of an Aneurysm of the Pancreatico-duodenal Artery with Occluded Celiac Trunk

    International Nuclear Information System (INIS)

    Weber, C.H.; Pfeifer, K.J.; Tato, F.; Reiser, M.; Rieger, J.

    2005-01-01

    We report on a case of a wide-necked aneurysm of the pancreatico-duodenal artery with occlusion of the celiac trunk in an asymptomatic patient. The aneurysm was considered to be at high risk of rupture. Successful embolization after interdisciplinary consultation was followed with color-coded duplex ultrasound (CCDS) demonstrating significant flow reduction. Three weeks later CCDS and angiography demonstrated exclusion of the aneurysm and a patent arterial supply of the liver and spleen fed by superior mesenteric artery (SMA) collaterals. The patient has done well so far, without major adverse clinical events or evidence for tissue necrosis of the liver, pancreas or spleen. Discussion of the case and review of the literature indicate that transcatheter embolization is the therapy of choice even in complicated cases

  12. Imaging and transcatheter arterial embolization for traumatic splenic injuries: review of the literature.

    Science.gov (United States)

    Raikhlin, Antony; Baerlocher, Mark Otto; Asch, Murray R; Myers, Andy

    2008-12-01

    The spleen is the most commonly injured visceral organ in blunt abdominal trauma in both adults and children. Nonoperative management is the current standard of practice for patients who are hemodynamically stable. However, simple observation alone has been reported to have a failure rate as high as 34%; the rate is even higher among patients with high-grade splenic injuries (American Association for the Surgery of Trauma [AAST] grade III-V). Over the past decade, angiography with transcatheter splenic artery embolization, an alternative nonoperative treatment for splenic injuries, has increased splenic salvage rates to as high as 97%. With the help of splenic artery embolization, success rates of more than 80% have also been described for high-grade splenic injuries. We discuss the role of computed tomography and transcatheter splenic artery embolization in the diagnosis and treatment of blunt splenic trauma. We review technical considerations, indications, efficacy and complication rates. We also propose an algorithm to guide the use of angiography and splenic embolization in patients with traumatic splenic injury.

  13. Deep Circumflex Iliac Artery-Related Hemoperitoneum Formation After Surgical Drain Placement: Successful Transcatheter Embolization

    International Nuclear Information System (INIS)

    Park, Sang Woo; Chang, Seong-Hwan; Yun, Ik Jin; Lee, Hae Won

    2010-01-01

    A 53-year-old woman with liver cirrhosis and hepatocellular carcinoma underwent living donor liver transplantation. After transplantation, her hemoglobin and hematocrit levels decreased to 6.3 g/dl and 18.5%, respectively, during the course of 3 days. A contrast-enhanced abdominal computed axial tomography (CAT) scan showed a hemoperitoneum in the right perihepatic space with no evidence of abdominal wall hematoma or pseudoaneurysm formation. An angiogram of the deep circumflex iliac artery (DCIA) showed extravasation of contrast media along the surgical drain, which had been inserted during the transplantation procedure. Transcatheter embolization of the branches of the DCIA was successfully performed using N-butyl cyanoacrylate.

  14. Extrahepatic Blood Supply to Hepatocellular Carcinoma: Angiographic Demonstration and Transcatheter Arterial Chemoembolization

    International Nuclear Information System (INIS)

    Miyayama, Shiro; Matsui, Osamu; Taki, Keiichi; Minami, Tetsuya; Ryu, Yasuji; Ito, Chiharu; Nakamura, Koichi; Inoue, Dai; Notsumata, Kazuo; Toya, Daisyu; Tanaka, Nobuyoshi; Mitsui, Takeshi

    2006-01-01

    Purpose. To evaluate the incidence of each extrahepatic collateral pathway to hepatocellular carcinoma (HCC) and to assess technical success rates and complications of transcatheter arterial chemoembolization (TACE) through each collateral. Methods. We retrospective evaluated extrahepatic collateral pathways to HCC on angiography in 386 procedures on 181 consecutive patients. One hundred and seventy patients had previously undergone TACE. TACE through extrahepatic collaterals using iodized oil and gelatin sponge particles was performed when a catheter was advanced into the tumor-feeding branch to avoid nontarget embolization. Results. A single collateral was revealed in 275 TACE procedures, two were revealed in 74, and three or more were revealed in 34. Incidences of collateral source to HCC were 83% from the right inferior phrenic artery (IPA), 24% from the cystic artery, 13% from the omental artery, 12% from the right renal capsular artery (RCA) and left IPA, 8% from the right internal mammary artery (IMA) and right intercostal artery (ICA), and 7% from the right inferior adrenal artery (IAA). Technical success rates of TACE were 53% in the right ICA, 70% in the cystic artery, 74% in the omental artery, 93% in the left IPA, 96% in the right IPA, and 100% in the right RCA, right IMA, and right IAA. Complications included skin necrosis after TACE through the right IMA (n = 1), cholecystitis after TACE through the cystic artery (n = 1), and ulcer formation after TACE through the right gastric artery (n = 1), in addition to pleural effusion and basal atelectasis after TACE through the IPA and IMA. Conclusion. Our study suggests that TACE through extrahepatic collaterals is possible with high success rates, and is also relatively safe

  15. Post-Operative hemorrhage after myomectomy: Safety and efficacy of transcatheter uterine artery embolization

    International Nuclear Information System (INIS)

    Wan, Alvin Yu Hon; Shin, Ji Hoon; Yoon, Hyun Ki; Ko, Gi Young; Park, Sang Gik; Seong, Nak Jong; Yoon, Chang Jin

    2014-01-01

    To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage. We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted. The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients. Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.

  16. Transcatheter lipiodol chemo-embolization of the inferior phrenic artery in hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Chen Fanghong; Luo Zuyan; Yuan Jianhua; Yu Wenqiang; Cai Xuexiang; Hu Tingyang; Liu Zijiang

    2002-01-01

    Objective: To evaluate the efficacy of transcatheter lipiodol chemo-embolization therapy (TOCE) for HCC via inferior phrenic artery (IPA) and to analyse the location of the tumor feeding inferior phrenic artery. Methods: Twenty-five cases of HCC underwent the procedure of TOCE via the IPA, as well as the hepatic artery using Seldinger's method. The patterns of tumor growth included huge type in 12 cases, solitary nodular type in 8 cases and multiple nodular type in 5 cases. Hepatic artery and inferior phrenic artery chemo-embolization were performed in all cases. Results: Inferior phrenic artery originated from celiac trunk in 16 cases (64%); abdomen aorta around celiac trunk in 8(32%). The site-sort tumors supplied by IPA in right lobe (VII, VIII segment) were 23 cases and left lobe (IV segment) 2 cases. The cumulative survival rates of IPA chemo-embolization for hepatocellular carcinoma were 84%(1 year) and 68%(2 years). No severe complications occurred. Conclusions: TOCE of the IPA is a safe and effective method in the management of HCC supplied by IPA. When the tumor site is adjacent to diaphragm, hepatic ligaments or bare area, may arouse the blood supply by IPA, especially in no tumor staining or staining defect in hepatic artery angiography but tumor enhancement on CT, and increase of the level of serum α-fetoprotein

  17. Blood Pressure and Arterial Load After Transcatheter Aortic Valve Replacement for Aortic Stenosis.

    Science.gov (United States)

    Lindman, Brian R; Otto, Catherine M; Douglas, Pamela S; Hahn, Rebecca T; Elmariah, Sammy; Weissman, Neil J; Stewart, William J; Ayele, Girma M; Zhang, Feifan; Zajarias, Alan; Maniar, Hersh S; Jilaihawi, Hasan; Blackstone, Eugene; Chinnakondepalli, Khaja M; Tuzcu, E Murat; Leon, Martin B; Pibarot, Philippe

    2017-07-01

    After aortic valve replacement, left ventricular afterload is often characterized by the residual valve obstruction. Our objective was to determine whether higher systemic arterial afterload-as reflected in blood pressure, pulsatile and resistive load-is associated with adverse clinical outcomes after transcatheter aortic valve replacement (TAVR). Total, pulsatile, and resistive arterial load were measured in 2141 patients with severe aortic stenosis treated with TAVR in the PARTNER I trial (Placement of Aortic Transcatheter Valve) who had systolic blood pressure (SBP) and an echocardiogram obtained 30 days after TAVR. The primary end point was 30-day to 1-year all-cause mortality. Lower SBP at 30 days after TAVR was associated with higher mortality (20.0% for SBP 100-129 mm Hg versus 12.0% for SBP 130-170 mm Hg; P <0.001). This association remained significant after adjustment, was consistent across subgroups, and confirmed in sensitivity analyses. In adjusted models that included SBP, higher total and pulsatile arterial load were associated with increased mortality ( P <0.001 for all), but resistive load was not. Patients with low 30-day SBP and high pulsatile load had a 3-fold higher mortality than those with high 30-day SBP and low pulsatile load (26.1% versus 8.1%; hazard ratio, 3.62; 95% confidence interval, 2.36-5.55). Even after relief of valve obstruction in patients with aortic stenosis, there is an independent association between post-TAVR blood pressure, systemic arterial load, and mortality. Blood pressure goals in patients with a history of aortic stenosis may need to be redefined. Increased pulsatile arterial load, rather than blood pressure, may be a target for adjunctive medical therapy to improve outcomes after TAVR. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00530894. © 2017 American Heart Association, Inc.

  18. Renal damage induced by dosorubicin-lipiodol emulsion infused into rabbit renal artery : comparison with CT and histologic findings

    International Nuclear Information System (INIS)

    Kim, Jin Gyoo; Moon, Tae Young; Lee, Suck Hong; Kim, Byung Soo; Choi, Sang Yul; Park, Choong Hoon

    1998-01-01

    The purpose of this study is to evaluate the utility of renal CT scanning and to histologically correlate renal damage induced by renal arterial infusion of 0.2 ml/kg of doxorubicin-lipiodol emulsion. Renal CT scans of 20 rabbit kidneys were obtained 15 days after transcatheter arterial chemoembolization and were classified into four grades, as follows: grade 0 - no fleck, grade 1 - one to three nodular flecks; grade 2 - four or more nodular flecks, or one semilunar fleck; and grade 3 - two or more semilunar flecks. The percentage of histological section occupied by lesion was determined using squared paper, and compared with the grades determined on the basis of CT. The histologic findings were interstitial inflammatory cell infiltration, intratubular lipiodol droplets, dystrophic calcification, and and cellular necrosis. The mean sizes of grade 0, 1, 2 and 3 histological lesions were 2.2 % (n=5), 4.5 % (n=4), 21.9 % (n=7), and 24% (n=4), respectively. Grades 0 and 1 accounted for nine cases (3.2%), while grades 2 and 3 accounted for 11 (22.6%); this difference was statistically significant (p<0.01). CT findings showing nodular or semilunar flecks 15 days after infusion into the renal artery of doxorubicin-lipiodol emulsion correlate with the size of the damaged kidney, as seen on histological specimens. (author). 19 refs., 3 tabs., 5 figs

  19. Stabilization of a percutaneously implanted port catheter system for hepatic artery chemotherapy infusion

    International Nuclear Information System (INIS)

    Shindoh, Noboru; Ozaki, Yutaka; Kyogoku, Shinsuke; Yamana, Daigo; Sumi, Yukiharu; Katayama, Hitoshi

    1999-01-01

    A port catheter system for hepatic artery infusion chemotherapy was implanted percutaneously via the left subclavian artery in 41 patients for treatment of unresectable liver metastases. The catheter tip was inserted into the gastroduodenal artery (GDA), the end hole was occluded with a guidewire fragment, and a side-hole for infusion was positioned at the bifurcation of the proper hepatic artery and the GDA. The GDA was embolized with steel coils around the infusion catheter tip via a transfemoral catheter. This procedure is designed to reduce the incidence of hepatic artery occlusion and infusion catheter dislocation.

  20. Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

    Energy Technology Data Exchange (ETDEWEB)

    Soyer, Philippe, E-mail: philippe.soyer@lrb.aphp.fr; Dohan, Anthony, E-mail: anthony.dohan@lrb.aphp.fr; Dautry, Raphael, E-mail: raphael-dautry@yahoo.fr; Guerrache, Youcef, E-mail: docyoucef05@yahoo.fr [Hôpital Lariboisière-AP-HP, Department of Abdominal and Interventional Imaging (France); Ricbourg, Aude, E-mail: aude.ricbourg@lrb.aphp.fr [Hôpital Lariboisière-AP-HP, Department of Obstetrics and Gynecology (France); Gayat, Etienne, E-mail: etienne.gayat@lrb.aphp.fr [Diderot-Paris 7, Université-Sorbonne Paris-Cité (France); Boudiaf, Mourad, E-mail: mourad.boudiaf@lrb.aphp.fr; Sirol, Marc, E-mail: marc.sirol@lrb.aphp.fr; Ledref, Olivier, E-mail: olivier.ledref@lrb.aphp.fr [Hôpital Lariboisière-AP-HP, Department of Abdominal and Interventional Imaging (France)

    2015-10-15

    Postpartum hemorrhage (PPH) is a potentially life-threatening condition, which needs multidisciplinary management. Uterine atony represents up to 80 % of all causes of PPH. Transcatheter arterial embolization (TAE) has now a well-established role in the management of severe PPH. TAE allows stopping the bleeding in 90 % of women with severe PHH, obviating surgery. Pledgets of gelatin sponge as torpedoes are commonly used for safe TAE, and coils, glue, and microspheres have been primarily used in specific situations such as arterial rupture, pseudoaneurysm, and arteriovenous fistula. TAE is a minimally invasive procedure with a low rate of complications, which preserves future fertility. Knowledge of causes of PPH, potential risks, and limitations of TAE is essential for a timely decision, optimizing TAE, preventing irreversible complications, avoiding hysterectomy, and ultimately preserving fertility.

  1. Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

    International Nuclear Information System (INIS)

    Soyer, Philippe; Dohan, Anthony; Dautry, Raphael; Guerrache, Youcef; Ricbourg, Aude; Gayat, Etienne; Boudiaf, Mourad; Sirol, Marc; Ledref, Olivier

    2015-01-01

    Postpartum hemorrhage (PPH) is a potentially life-threatening condition, which needs multidisciplinary management. Uterine atony represents up to 80 % of all causes of PPH. Transcatheter arterial embolization (TAE) has now a well-established role in the management of severe PPH. TAE allows stopping the bleeding in 90 % of women with severe PHH, obviating surgery. Pledgets of gelatin sponge as torpedoes are commonly used for safe TAE, and coils, glue, and microspheres have been primarily used in specific situations such as arterial rupture, pseudoaneurysm, and arteriovenous fistula. TAE is a minimally invasive procedure with a low rate of complications, which preserves future fertility. Knowledge of causes of PPH, potential risks, and limitations of TAE is essential for a timely decision, optimizing TAE, preventing irreversible complications, avoiding hysterectomy, and ultimately preserving fertility

  2. A Case of Traumatic Mesenteric Bleeding Controlled by only Transcatheter Arterial Embolization

    International Nuclear Information System (INIS)

    Asayama, Yoshiki; Matsumoto, Shunichi; Isoda, Takuro; Kunitake, Naonobu; Nakashima, Hideaki

    2005-01-01

    We report a case of mesenteric hematoma following blunt abdominal trauma that was successfully treated with transcatheter arterial embolization (TAE) and did not require surgical repair. A 43-year-old man with blunt abdominal trauma caused in a factory accident was admitted with a stable general condition and laboratory data. On CT examination, a large mesenteric hematoma with extravasation of contrast media was observed. TAE was first attempted to control the bleeding. A superior mesenteric angiogram showed extravasation of contrast medium from a branch of the ileocolic artery and obstruction of the cecal branch. After successful TAE using microcoils, the distal portion of the cecal branch was still preserved via collateral circulation. No abdominal symptoms have occurred during the 7 months following TAE. In mesenteric injury cases with limited intestinal damage, TAE may therefore be a reasonable alternative to emergent laparotomy

  3. Blunt splenic injury in a child with situs inversus totalis treated with transcatheter arterial embolization

    Directory of Open Access Journals (Sweden)

    Naoki Hashizume

    2016-10-01

    Full Text Available We report the first case of blunt splenic rupture in a child with situs inversus totalis treated with transcatheter arterial embolization (TAE. A 12-year-old girl fell roughly 4 feet onto the pavement while riding her bicycle. Contrast-enhanced computed tomography revealed situs inversus totalis, a massive hemorrhage in the abdominal cavity, and a ruptured spleen with extravasation. Arteriography showed that the internal organs were located opposite their normal positioning. TAE was carried out with gelfoam and a micro coils at the branch of the upper lobe of the splenic artery. TAE is effective for blunt splenic injury with extravasation in a child with situs inversus. In TAE, there is no technical difference about situs inversus excepted mirror image of abdominal vascular formation.

  4. Transcatheter arterial embolization is the first-line therapy of choice in peptic ulcer bleeding not responding to endoscopic therapy

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jakobsen, Mark; Nielsen, Michael Milek

    2015-01-01

    Abstract Objective. In 5-10% of patients with peptic ulcer bleeding (PUB) it is impossible to achieve endoscopic hemostasis because of severe bleeding. These patients have traditionally been treated surgically. Transcatheter arterial embolization (TAE) may, however, be associated with a better ou...

  5. Transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization for the treatment of hepatic metastases from colorectal carcinoma

    International Nuclear Information System (INIS)

    Wang Xuan; Chen Xiaofei

    2009-01-01

    Objective: To evaluate the clinical efficacy of transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization in the treatment of hepatic metastases from colorectal carcinoma. Methods: Sixty-eight cases with hepatic metastases from colorectal carcinoma were equally and randomly divided into two groups. The patients in study group were treated with transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization, while the patients in control group were treated with conventional (normal temperature) transcatheter hepatic arterial chemotherapy lipiodol embolization. Results: The effective rate of study group and control group was 65%(22/34) and 32%(11/34) respectively, the difference between two groups was statistically significant (P<0.05). No significant difference in the postoperative changes of hepatic function tests was found between the two groups. The survival rate at 6,12,18 and 24 months after the treatment was 100%, 82%, 44% and 18% respectively in study group, while it was 91%, 47%, 15% and 6% respectively in control group. Conclusion: Transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization is an effective and safe treatment for the hepatic metastases from colorectal carcinoma and has no obvious damage to the hepatic function. (authors)

  6. Early mechanism of action of arterially infused ethanol: an experimental study on the influence of infusion speed

    International Nuclear Information System (INIS)

    Han, Joon Koo

    1988-01-01

    Abdominal aortography and histopathologic examination after absolute ethanol infusion at fast (0.4cc/sec) and slow speed (0.04cc/sec) were performed on 16 rats (2 controls. 7 fast infusion group. 7 slow infusion group). Angiographic and histopathologic findings were correlated and the findings of slow and fast infusion groups were studied. The results are as follows: 1. Histopathologic findings of the fast infusion group revealed wide area of glomerular and tubular collapses, obliteration of the free space between the Bowmann's capsule and glomerulus, sloughing and loss of the endothelium, fresh thrombi attached to the wall, and cleavage of the muscle layer of the arteries. 2. Angiographic findings of the fast infusion group revealed luminal irregularity, early obstruction of the aorta and the renal arteries, and delayed circulation time. 3. Histopathologic findings of the slow infusion group revealed degenerated, coalesced red blood cell packed in the glomeruli, focal areas of severe glomerular and tubular damage on relatively normal background, endothelial and muscular damage of the arteries. 4. Angiographic findings of the slow infusion group revealed focal perfusion defect of the kidney, delayed circulation time, and mild luminal irregularity, but there was no obstruction of the major arteries. 5. In conclusion, author believes that endothelial damage and thrombus formation from the damaged vessel wall, as well as direct cytotoxicity and in situ emboli formation play a significant role in the embolic effect of absolute ethanol.

  7. Hepatic artery infusion (HAI) for hepatic metastases in combination with hepatic resection and hepatic radiation

    International Nuclear Information System (INIS)

    Merrick, H.W.; Dobelbower, R.R.; Ringleint, J.F.; Skeel, R.T.

    1986-01-01

    Renewed interest in hepatic artery infusion has been stimulated by the development of a totally implantable pump which eliminates many of the problems encountered by the external pumps and catheters. As the potential benefit of hepatic artery infusion would be greater if either all gross disease were removed by prior resection, or alternatively, if non-resectable disease were irradiated in conjunction with hepatic artery infusion, the authors initiated a phase I-II trial to evaluate combined modality therapy

  8. Intravascular trans-catheter fibrinolysis in acute arterial obstructions

    International Nuclear Information System (INIS)

    Roversi, R.; Rossi, C.; Ricci, S.; Gemelli, G.; Ciliberti, M.A.

    1987-01-01

    The author's experiences is reported on intravascular fibrinolytic therapy with urokinase in acute arterial obstructions. Thirty-eight patients were treated, from 1983 to 1986, for acute thrombosis and/or thromboembolization, 22 of which developed on an atherosclerotic lesion, and 10 on a surgical stenotic by-pass graft. A complete vascular recanalization has been obtained, at the end of the procedure, in 69,4% of the cases, 77,7% had a definite final clinical improvement. The results correspond to the medium statistical of the various casistics analyzed for comparison. Surgery has been performed on 27,7% of the patients. Complication have been observed in 8% of the cases. IAF technique is of greatest value in the treatment of those lesions; better results have been obtained with intra-thrombus injection of the drug (as emphasized by many authors) in association with PTA and surgery. A close cooperation between interventional radiology, vascular surgery and angiology is therefore necessary in this field

  9. Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Okuno, Yuji, E-mail: how-lowlow@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan); Korchi, Amine Mohamed, E-mail: amine.korchi@gmail.com [Geneva University Hospitals, Department of Diagnostic and Interventional Radiology (Switzerland); Shinjo, Takuma, E-mail: shin.takuma@a7.keio.jp [Keio University, Institute for Integrated Sports Medicine, School of Medicine (Japan); Kato, Shojiro, E-mail: shojiro7@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan)

    2015-04-15

    PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function.

  10. Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

    International Nuclear Information System (INIS)

    Okuno, Yuji; Korchi, Amine Mohamed; Shinjo, Takuma; Kato, Shojiro

    2015-01-01

    PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function

  11. Emergency transcatheter arterial embolization for critical massive bleeding due to duodenal bulb ulcer

    International Nuclear Information System (INIS)

    Li Qiang; Li Yiyun; Zhao Chunmei

    2011-01-01

    Objective: To evaluate the efficacy and feasibility of emergency transcatheter arterial embolization (ETAE) in treating critical massive bleeding due to duodenal bulb ulcer. Methods: ETAE was carried out in seven patients with acute massive bleeding due to endoscopically-proved duodenal bulb ulcer, who failed to respond conservative measures and were critically ill clinically. Super-selective catheterization of gastroduodenal artery or right gastroepiploic artery was performed, which was followed by arterial angiography to identify the bleeding site. According to the angiographic findings, ETAE with Gelfoam particles and coils was carried out. After the operation medical management was given and endoscopy re-examination was conducted. All the patients were follow up for 3∼6 months. Results: Angiographically, gastroduodenal artery bleeding was detected in all seven patients. ETAE was successfully accomplished in all cases. Complete clinical effectiveness was obtained in six patients while partial effectiveness in one case. No procedure-related complications occurred. Conclusion: For critical massive bleeding due to duodenal bulb ulcer ETAE is a highly effective and safe treatment, which can be regarded as an alternative to surgery. It is worth popularizing this technique in clinical practice. (authors)

  12. Transcatheter Arterial Chemoembolization of Liver Tumors: Effects of Embolization Protocol on Injectable Volume of Chemotherapy and Subsequent Arterial Patency

    International Nuclear Information System (INIS)

    Geschwind, Jean-Francois H.; Ramsey, Douglas E.; Wal, B.C.H. van der; Kobeiter, Hicham; Juluru, Krishna; Hartnell, George G.; Choti, Michael A.

    2003-01-01

    The purpose of this study was to determine whether transcatheter arterial chemoembolization (TACE) protocol affects the total volume of chemotherapy injected into the liver as well as subsequent arterial patency. A total of 160 patients with primary or secondary liver cancer were treated with 3 different chemoembolization protocols at a single institution. Data were analyzed retrospectively.Group 1 (n = 36) consisted of slurry of chemotherapy,oil and polyvinyl alcohol particles (PVA), group 2 (n =91), chemotherapy and oil followed by PVA, and group 3(n = 33), chemotherapy and oil followed by Gelfoampledgets. The total volume of chemotherapy injected into the liver was recorded. Arterial patency was determined during subsequent chemoembolizations. The mean percentage of total intended chemotherapydose administered was 54.6% for group 1, 75.3% for group 2, and 80.6% for group 3. Arterial patency at follow-up angiography was 56% for group 1, 74% for group 2, and 81% for group 3. The slurry protocol (group 1) significantly reduced arterial patency and injectable volume of chemotherapy during TACE

  13. Preoperative transcatheter renal artery embolization with absolute alcohol for the treatment of renal carcinoma: a clinical efficacy analysis

    International Nuclear Information System (INIS)

    Shang Mingyi; Wang Guoliang; Han Hongjie; Xi Qian; Huang Zongliang; Tang Junjun; Gao Xiaolong; Wang Peijun; Lu Ying; Xu Weiguo

    2010-01-01

    Objective: To access the effectiveness of preoperative transcatheter renal artery embolization with absolute alcohol performed before nephrectomy in treating renal carcinoma. Methods: Preoperative transcatheter renal artery embolization with absolute alcohol was performed in 32 patients with renal carcinoma. The renal arteries of the diseased side were progressively occluded, from distal small branches to proximal larger ones, and the renal artery trunk was embolized with gelatin sponge. Radical nephrectomy was carried out 2-5 days after the embolization procedure. The resectional rate of the tumor, the blood loss during the surgery and the operation time were recorded and analyzed. Results: Angiography performed immediately after the embolization showed that complete embolization of the main renal artery was achieved in all 32 patients. The resectional rate of the tumor was 100%. During the surgery, shrinkage of tumor, collapse of renal superficial veins and marked perinephric edema were observed. The blood loss during the surgery was much less and the operation time cost was much shorter than a usual nephrectomy did. Conclusion: The preoperative transcatheter renal artery embolization with absolute alcohol is an effective therapeutic means for renal carcinoma, it can definitely reduce the surgical blood loss and shorten the operative time. (authors)

  14. Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults

    International Nuclear Information System (INIS)

    Zhao Shihua; Yan Chaowu; Jiang Shiliang; Xu Zhongying; Huang Lianjun; Ling Jian; Zheng Hong; Wang Cheng; Hu Haibo; Wu Wenhui; Li Shiguo; Dai Ruping

    2006-01-01

    Objective: To evaluate the effect of self-expandable occluder on closure of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PH) in adults. Methods: Twenty-eight adult patients underwent transcatheter closure of PDA at a mean age of (31.3±11.6) years [(18-58) years]. Either Amplatzer duct occluder or domestic device was used in the present study. X-ray, EKG and UCG were repeated in one day, one month, three months, and six months. Results: Twenty of the 28 patients had successful occlusion, and the other 8 patients were given up. In the successful group, the narrowest diameter of PDA was (10.4±2.7) mm [(6-16) mm], the diameter of selected occluder was (15.6±3.2)mm [(10-20) mm] at the end of pulmonary artery. Systemic artery oxygen saturation (SAsat) before and after oxygen inhalation was (93.5±1.8)%, (98.2±1.8)%, respectively (P<0.01). Systolic pulmonary arterial pressure decreased significantly after trial occlusion from (95.5± 24.l) mm Hg to (56.3±18.3) mm Hg (P<0.01); Mean pulmonary arterial pressures decreased significantly from (70.8±18.2) mm Hg to (41.0±13.8 )mm Hg (P<0. 01), too. Six months later UCG showed that the dimensions of left atrium, left ventricle and pulmonary artery attenuated significantly with one exception; X rays showed decreased pulmonary vascularity or cardiac size as well [cardio-thoracic ratio: (59.2±6.6)% vs (54.2±3.3)%, P<0.01]. In given up group, four patients were defined as Eisenmenger syndromes with differential cyanosis. They presented with elevated systolic pulmonary arterial pressure [(110.3±13.9) mm Hg vs (139.5±20.0)mm Hg, P<0.01], or decreased systolic aortic pressure[(116.0±20.2)mm Hg vs (106.3±16.9) mm Hg, P<0.05]after occlusion. The others included two cases with large residual shunt, and two cases with worsening of symptoms. Conclusions: Transcatheter closure of PDA with reversible severe PH is feasible, effective and safe in adults. (authors)

  15. Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults

    Energy Technology Data Exchange (ETDEWEB)

    Shihua, Zhao; Chaowu, Yan; Shiliang, Jiang; Zhongying, Xu; Lianjun, Huang; Jian, Ling; Hong, Zheng; Cheng, Wang; Haibo, Hu; Wenhui, Wu; Shiguo, Li; Ruping, Dai [Department of Radiology, Cardiovascular Inst. and Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing Union Medical College, Beijing (China)

    2006-11-15

    Objective: To evaluate the effect of self-expandable occluder on closure of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PH) in adults. Methods: Twenty-eight adult patients underwent transcatheter closure of PDA at a mean age of (31.3{+-}11.6) years [(18-58) years]. Either Amplatzer duct occluder or domestic device was used in the present study. X-ray, EKG and UCG were repeated in one day, one month, three months, and six months. Results: Twenty of the 28 patients had successful occlusion, and the other 8 patients were given up. In the successful group, the narrowest diameter of PDA was (10.4{+-}2.7) mm [(6-16) mm], the diameter of selected occluder was (15.6{+-}3.2)mm [(10-20) mm] at the end of pulmonary artery. Systemic artery oxygen saturation (SAsat) before and after oxygen inhalation was (93.5{+-}1.8)%, (98.2{+-}1.8)%, respectively (P<0.01). Systolic pulmonary arterial pressure decreased significantly after trial occlusion from (95.5{+-} 24.l) mm Hg to (56.3{+-}18.3) mm Hg (P<0.01); Mean pulmonary arterial pressures decreased significantly from (70.8{+-}18.2) mm Hg to (41.0{+-}13.8 )mm Hg (P<0. 01), too. Six months later UCG showed that the dimensions of left atrium, left ventricle and pulmonary artery attenuated significantly with one exception; X rays showed decreased pulmonary vascularity or cardiac size as well [cardio-thoracic ratio: (59.2{+-}6.6)% vs (54.2{+-}3.3)%, P<0.01]. In given up group, four patients were defined as Eisenmenger syndromes with differential cyanosis. They presented with elevated systolic pulmonary arterial pressure [(110.3{+-}13.9) mm Hg vs (139.5{+-}20.0)mm Hg, P<0.01], or decreased systolic aortic pressure[(116.0{+-}20.2)mm Hg vs (106.3{+-}16.9) mm Hg, P<0.05]after occlusion. The others included two cases with large residual shunt, and two cases with worsening of symptoms. Conclusions: Transcatheter closure of PDA with reversible severe PH is feasible, effective and safe in adults. (authors)

  16. Mixing in the human carotid artery during carotid drug infusion studied with PET

    International Nuclear Information System (INIS)

    Junck, L.; Koeppe, R.A.; Greenberg, H.S.

    1989-01-01

    The safety and efficacy of drug infusion into the carotid artery require adequate mixing of the infused solution with carotid blood. Using positron emission tomography (PET), we studied the mixing of solutions infused into the human carotid artery in seven patients by analyzing the distribution of [15O]H2O infused into the carotid artery and by vein. At four infusion rates ranging from 0.5 to 10 ml/min, the variability in distribution averaged 16.5-17.8% among the pixels in a large volume of interest, without dependence on the infusion rate. The overall correlation between [15O]H2O influx with arterial infusion and [15O]H2O influx with venous injection was 0.78-0.82 at the four infusion rates, with no trend toward higher correlations at the faster infusion rates. The distribution into the anterior, middle, and posterior cerebral artery territories differed from distribution throughout the entire carotid territory by an average of 6.2-9.6% at the four infusion rates, with no trend toward smaller differences at the faster infusion rates. Infusions performed into a vinyl tube simulating the carotid artery indicated that at 0.5 ml/min, the velocity of fluid exiting the catheter makes no apparent contribution to mixing. We conclude that with infusions at the carotid bifurcation, mixing in the human carotid artery is complete or nearly complete over a wide range of infusion rates. The mixing appears to result from the patterns of blood flow within the artery, and not from jet effects at the catheter tip

  17. Effect of transcatheter arterial embolization according to angiographic findings in hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Wang, Chi Hyung; Shim, Hyung Jin; Lee, Jong Ik; Yu, Hyun; Kim, Young Goo; Lee, Jong Beum; Kim, Kun Sang

    1994-01-01

    The purpose of this study is to assess the effect of Transcatheter Arterial Embolization(TAE) according to angiographic findings in hepatocellular carcinoma. We retrospectively reviewed 50 cases who received TAE for unresectable hepatocellular carcinoma. We analyzed the angiographic findings which were correlated with the effect of TAE. The common angiographic findings of the hepatocellular carcinoma were tumor staining, neo vascularity and enlargement of feeding artery. These angiographic findings were classified into grade 0, +1, +2. Effect of TAE were classified into five patterns; good response, partial response, minimal response, no response and more aggravation. In grading of tumor staining, among 50 cases, the grade 0, +1, +2 were seen in 1 case(2%), 14 cases(28%), 35 cases(70%) each. In grading of enlargement of feeding artery, the grade 0, +1, +2 were seen in 7 cases(14%), 19 cases(38%), 24 cases(48%) each. In grading of neo vascularity, the grade 0, +1, +2 were seen in 6 cases(12%), 15 cases(30%), 29 cases(58%) each. This study showed that the higher grade of angiographic finding, the better effect of TAE. A statistically significant difference was found (P<0.005). But the TAE was not effective in some cases (the maximum diameter of mass is over 10cm, portal vein thrombosis or arteriovenous shunt) in spite of high grade. We believe that these angiographic findings (tumor staining, enlargement of feeding artery, neo vascularity) are one of important indices for anticipating the effect of TAE in patients with unresectable hepatocellular carcinoma

  18. Significance of transcatheter arterial embolization in the treatment of pseudoaneurysm complicating pancreatitis

    International Nuclear Information System (INIS)

    Kim, Sang Gyee; Joo, Jung Hyun; Kim, Young Cheol; Kim, Jae Kyu; Jeong, Yong Yeon; Kang, Heoung Keun; Oh, Hee Yeon

    1998-01-01

    To evaluate the significance of transcatheter arterial embolization(TAE) of pseudoaneurysm complicating pancreatitis. This study was based on a retrospective analysis of eight cases, in which TAE for control of pseudoaneurysm complicating pancreatitis was attempted. All patients were males, and were aged between 35 and 65(mean, 47) years. Seven had a history of episodes of chronic pancreatitis and one case was the result of acute pancreatitis. All patients underwent diagnostic angiography and superselective embolization. Arteries in which pseudoaneurysm had occurred were the gastroduodenal (n=3D5), inferior pancreaticoduodenal (n=3D1), superior mesenteric artery root (n=3D1), and the celiac axis (n=3D1). Six cases were treated successfully without complications, but in two, embolization failed due to a wide aneurysmal neck arising from the superior mesenteric artery root and celiac axis. In four successful cases, pseudoaneurysms were completely resolved within three to six months of embolization. One of the other two remained as a pseudocyst, while in the other, also a pseudocyst, surgery was performed. Because TAE in patients with pseudoaneurysm complicating pancreatitis has a high success rate, and also leads to absolute resorption of a pseudocyst, TAE is the preferred pre-surgical treatment mode.=20

  19. Significance of transcatheter arterial embolization in the treatment of pseudoaneurysm complicating pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Gyee; Joo, Jung Hyun; Kim, Young Cheol; Kim, Jae Kyu; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam Univ. School of Medicine, Kwangju (Korea, Republic of); Oh, Hee Yeon [Namkwang Hospital, Kwangju (Korea, Republic of)

    1998-11-01

    To evaluate the significance of transcatheter arterial embolization(TAE) of pseudoaneurysm complicating pancreatitis. This study was based on a retrospective analysis of eight cases, in which TAE for control of pseudoaneurysm complicating pancreatitis was attempted. All patients were males, and were aged between 35 and 65(mean, 47) years. Seven had a history of episodes of chronic pancreatitis and one case was the result of acute pancreatitis. All patients underwent diagnostic angiography and superselective embolization. Arteries in which pseudoaneurysm had occurred were the gastroduodenal (n=3D5), inferior pancreaticoduodenal (n=3D1), superior mesenteric artery root (n=3D1), and the celiac axis (n=3D1). Six cases were treated successfully without complications, but in two, embolization failed due to a wide aneurysmal neck arising from the superior mesenteric artery root and celiac axis. In four successful cases, pseudoaneurysms were completely resolved within three to six months of embolization. One of the other two remained as a pseudocyst, while in the other, also a pseudocyst, surgery was performed. Because TAE in patients with pseudoaneurysm complicating pancreatitis has a high success rate, and also leads to absolute resorption of a pseudocyst, TAE is the preferred pre-surgical treatment mode.=20.

  20. Transcatheter Arterial Embolization for Upper Gastrointestinal Nonvariceal Hemorrhage: Is Empiric Embolization Warranted?

    Energy Technology Data Exchange (ETDEWEB)

    Arrayeh, Elnasif; Fidelman, Nicholas, E-mail: nicholas.fidelman@ucsf.edu; Gordon, Roy L.; LaBerge, Jeanne M.; Kerlan, Robert K. [University of California San Francisco, Department of Radiology (United States); Klimov, Alexander; Bloom, Allan I. [Hadassah Hospital, Department of Radiology (Israel)

    2012-12-15

    Purpose: To determine whether transcatheter arterial embolization performed in the setting of active gastric or duodenal nonvariceal hemorrhage is efficacious when the bleeding source cannot be identified angiographically. Methods: Records of 115 adult patients who underwent visceral angiography for endoscopically documented gastric (50 patients) or duodenal (65 patients) nonvariceal hemorrhage were retrospectively reviewed. Patients were subdivided into three groups according to whether angiographic evidence of arterial hemorrhage was present and whether embolization was performed (group 1 = no abnormality, no embolization; group 2 = no abnormality, embolization performed [empiric embolization]; and group 3 = abnormality present, embolization performed). Thirty-day rates and duration of primary hemostasis and survival were compared.ResultsFor patients with gastric sources of hemorrhage, the rate of primary hemostasis at 30 days after embolization was greater when embolization was performed in the setting of a documented angiographic abnormality than when empiric embolization was performed (67% vs. 42%). The rate of primary hemostasis at 30 days after angiography was greater for patients with duodenal bleeding who either underwent empiric embolization (60%) or embolization in the setting of angiographically documented arterial hemorrhage (58%) compared with patients who only underwent diagnostic angiogram (33%). Patients with duodenal hemorrhage who underwent embolization were less likely to require additional invasive procedures to control rebleeding (p = 0.006). Conclusion: Empiric arterial embolization may be advantageous in patients with a duodenal source of hemorrhage but not in patients with gastric hemorrhage.

  1. Dynamic MR imaging of hepatoma treated by transcatheter arterial embolization therapy

    International Nuclear Information System (INIS)

    Yamashita, Y.; Yoshimatsu, S.; Sumi, M.; Harada, M.; Takahashi, M.

    1993-01-01

    The effect of transcatheter arterial chemo-embolization theory (TACE) for hepatoma was evaluated with dynamic MR imaging with Gd-DTPA in 37 patients (44 tumors). TACE was performed using Lipiodol/cis-platinum and gelatin sponge (or microspheres) as an embolic material. All patients were examined with dynamic CT and MR imaging before and after treatment. On conventional spin echo images, changes of signal intensity after treatment varied regardless of presence of Lipiodol. Dynamic MR imaging revealed changes of tumor vascularity before and after treatment. On histologic correlation, areas of persistent tumor enhancement on dynamic MR imaging corresponded to areas of viable tumor cells while areas of nonenhancement corresponded to areas of necrosis. Dynamic MR imaging was superior in contrast resolution and was not influenced by the presence of Lipiodol compared with dynamic CT, and therefore residual viable tumors were better defined by dynamic MR imaging. (orig.)

  2. Incidentally Detected Inoperable Malignant Pheochromocytoma with Hepatic Metastasis Treated by Transcatheter Arterial Chemoembolization

    Directory of Open Access Journals (Sweden)

    Joong Keun Kim

    2014-12-01

    Full Text Available Malignant pheochromocytoma (PCC is a rare condition. Although the liver is the second most frequent site of metastasis in malignant PCC, no definite treatments have been established. Herein, we report a case of liver metastasis of PCC that was successfully treated by transcatheter arterial chemoembolization (TACE. A 69-year-old man was admitted to the Department of Gastroenterology for evaluation of an incidental hepatic mass in August 2013. He had undergone right adrenalectomy in May 2005 and PCC had been confirmed on the basis of histopathological findings. Liver biopsy was performed, and metastatic PCC was diagnosed. The lesion appeared inoperable because of invasion of the portal vein and metastases in the lymph nodes along the hepatoduodenal ligament. Thus, TACE was performed instead. After TACE, symptoms including dizziness and cold sweating improved, and the patient's serum catecholamine levels decreased. On the basis of this case, we believe that TACE may be a useful treatment for liver metastasis in malignant PCC.

  3. The tumble occurred after transcatheter arterial chemoembolization: an investigation and analysis of its causes

    International Nuclear Information System (INIS)

    Xiao Shuping; Li Xiaofang; Zheng Chuansheng

    2012-01-01

    Objective: To investigate and analyze the cause of the tumble which occurs after transcatheter arterial chemoembolization (TACE), and to discuss its related factors. Methods: During the period from January 2003 to February 2010 in the Department of Interventional Radiology of Union Hospital (Wuhan city), post-TACE tumble occurred in 28 patients. The causes of the tumble were investigated and analyzed. Results: (1) The total number of the tumble occurrence after TACE was declining with the year. (2) Certain relationship existed between the occurrence of post-TACE tumble and the patient's age, drugs used in surgery, unit environment, nurse's shift, etc. Conclusion: Based on the patient's individual condition, intentionally enhancing the perioperative nursing care and adjusting the nurse's shift are very important measures to prevent the occurrence of post-TACE tumble. (authors)

  4. Evaluation on the safety of transcatheter uterine artery embolization for uterine myoma

    International Nuclear Information System (INIS)

    Li Yong; Chen Xiaoming; Du Juan; Zuo Yuewei; Hu Xiaoping; Luo Pengfei

    2005-01-01

    Objective: To observe complications of transcatheter uterine artery embolization (TUAE) for uterine fibroids and to evaluate its long-term safety. Methods: One hundred and ninety-eight women with uterine fibroids were treated by TUAE. The bilateral TUAE were performed using lipiodol-pingyangmycineemulsion (LPE) and gelatin sponge particles in 186 women. Among them, 138 patients were followed up for 1 to 3 year and complications were observed. Results: Complications included ecchymosis and ulceration on buttock (n=1); ulcer of labia minora (n=1); urinary retention (n=12); urinary tract infection (n=1); expelling of necrotic fibroids via vagina (n=5); secondary infection of chocolate cyst of ovary (n=1); increasing in endometrial thickness and calcification (n=1) and amenorrhea (n=2). Conclusion: TUAE is a treatment with long-term safety, while severe complications or sequelae may occur to a few patients, so strict indication should be insisted in patient selection. (authors)

  5. Transcatheter arterial Chemoembolization for infiltrative hepatocellular carcinoma: Clinical safety and efficacy and factors influencing patient survival

    International Nuclear Information System (INIS)

    Han, Kichang; Kim, Jin Hyoung; Yoon, Hee Mang; Kim, Eun Joung; Gwon, Dong Il; Ko, Gi Young; Yoon, Hyun Ki; Ko, Heung Kyu

    2014-01-01

    To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) in patients with infiltrative hepatocellular carcinoma (HCC) and to identify the prognostic factors associated with patient survival. Fifty two patients who underwent TACE for infiltrative HCC were evaluated between 2007 and 2010. The maximum diameter of the tumors ranged from 7 cm to 22 cm (median 15 cm). Of 46 infiltrative HCC patients with portal vein tumor thrombosis, 32 patients received adjuvant radiation therapy for portal vein tumor thrombosis after TACE. The tumor response by European Association for the Study of the Liver criteria was partial in 18%, stable in 47%, and progressive in 35% of the patients. The median survival time was 5.7 months (Kaplan-Meier analysis). The survival rates were 48% at six months, 25% at one year, and 12% at two years. In the multivariable Cox regression analysis, Child-Pugh class (p = 0.02), adjuvant radiotherapy (p 0.003) and tumor response after TACE (p = 0.004) were significant factors associated with patient survival. Major complications occurred in nine patients. The major complication rate was significantly higher in patients with Child-Pugh B than in patients with Child-Pugh A (p = 0.049, x 2 test). Transcatheter arterial chemoembolization can be a safe treatment option in infiltrative HCC patients with Child Pugh class A. Child Pugh class A, radiotherapy for portal vein tumor thrombosis after TACE and tumor response are good prognostic factors for an increased survival after TACE in patients with infiltrative HCCs.

  6. An experimental study on renal arterial and parenchymal change caused by selective renal infusion of epinephrine

    International Nuclear Information System (INIS)

    Jeon, Seok Chol; Yeon, Kyung Mo; Han, Man Chung

    1981-01-01

    Selective infusion of the epinephrine into the renal artery has been used in the field of the diagnostic and the therapeutic radiology for correct diagnosis and effective treatment, respectively. However, administration of overdose of epinephrine may cause serious complication, renal infarction. The study was undertaken to evaluate the sequential change of renal arterial constrictive effect of selective infusion of epinephrine into renal artery and to determine the critical doses of epinephrine producing irreversible renal infarct. A total of 25 rabbits are used, which are divided into 5 groups. Under the general anesthesia is made the selective infusion of various doses of epinephrine into the right renal artery of the rabbits. At the various time interval during and after the epinephrine infusion, renal angiography was done, and 24 hrs. later, gross and microscopic findings of the kidney were observed. The results are as follows; 1. Vasoconstriction of renal artery occurred within 2 mins. infusion, and maximum effect within 5 mins. 2. It seems that there is correlation between the amount of infused epinephrine and the time taken to recover from constriction of renal artery. 3. When epinephrine is infused into the renal artery in the rate of 1 ug/min., renal infarct is not noticed below the level of 10 mins., but correlation between the amount of infused epinephrine and the frequency of renal infarct occurs above 20 mins. infusion

  7. Digital subtraction angiography of inferior gluteal artery through the infusion catheter of chemotherapy for bladder cancer

    International Nuclear Information System (INIS)

    Ishikawa, Satoru; Noguchi, Ryosuke; Kanoh, Shori; Shimazui, Toru; Uchida, Katsunori; Nemoto, Ryosuke; Koiso, Kenkichi

    1987-01-01

    More than fifty patients of invasive bladder cancer had been treated by selective intra-arterial chemotherapy through the inferior or superior gluteal arteries. The distribution of infused drugs had been evaluated by RI-angiography through a thin arterial infusion catheter. This time we performed digital subtraction angiography (DSA) through an infusion catheter in order to know the precise distribution of infused materials in seven patients with locally advanced bladder cancer. Pharmaco-DSA with norepinephrine was also done in four patients. Satisfactory spatial and contrast resolution were gained in four patients and pharmaco-DSA showed better quality. In our experience DSA through intra-arterial infusion catheter was a useful procedure in the evaluation of distribution of infused drugs. (author)

  8. Ischemic Cholangitis Caused by Transcatheter Hepatic Arterial Chemoembolization 10 Months After Resection of the Extrahepatic Bile Duct

    International Nuclear Information System (INIS)

    Hasegawa, Kiyoshi; Kubota, Keiichi; Aoki, Taku; Hirai, Ichiro; Miyazawa, Masashi; Ohtomo, Kuni; Makuuchi, Masatoshi

    2000-01-01

    We report a case of ischemic cholangitis that occurred after transcatheter hepatic arterial chemoembolization (TAE). Ten months prior to TAE the patient had undergone central bisegmentectomy for hepatocellular carcinoma with resection of the extrahepatic bile duct. Eleven days after TAE, he developed suppurative cholangitis and multiple organ failure. Prior surgical ligation of the peribiliary arteries around the extrahepatic bile duct followed by TAE was considered to have played a crucial role in the development of ischemic cholangitis. This case demonstrates the importance of blood flow from the peribiliary arteries for the survival of the biliary epithelium

  9. Transformation of a Ruptured Giant Pulmonary Artery Aneurysm into an Air Cavity After Transcatheter Embolization in a Behcet's Patient

    International Nuclear Information System (INIS)

    Cil, Barbaros E.; Turkbey, Baris; Canyigit, Murat; Kumbasar, Ozlem O.; Celik, Gokhan; Demirkazik, Figen B.

    2006-01-01

    Pulmonary artery aneurysms due to Behcet's disease are mainly seen in young males and very rarely in females. To our knowledge there are only 10 cases reported in the related literature. Emergent transcatheter embolization was performed in a female patient with a known history of Behcet's disease in whom massive hemoptysis developed because of rupture of a giant pulmonary artery aneurysm. At 6-month follow-up, transformation of the aneurysm sac into an air cavity was detected. To our knowledge, such a transformation has never been reported in the literature before. Embolization of the pulmonary artery aneurysm and the mechanism of cavity transformation are reviewed and discussed

  10. Drug selection principles in intra-arterial infusion chemotherapy

    International Nuclear Information System (INIS)

    Wang Gefang; Cheng Yongde

    2009-01-01

    The intra-arterial infusion chemotherapy is an effective treatment for malignant tumors. The following ten principles should be taken into account when the choice of infusion medication is to be made. (1) The tumor-sensitive drugs should be selected. (2) Pay attention to the compatibility of medicines. (3) Select the type of drug compatibility and drug interactions. (4) Concentration-dependent drugs are the drugs of first choice. (5) Pay attention to side effects when anti-cancer drug compatibility is considered.(6) The perfusion anti-cancer drugs exert their killing effect on the tumor cells in their prototype. (7) Pay attention to the administration order of the drugs and the intervals of treatment. (8) The medication should be individualized as the physical condition and tumor's heterogeneity are different from patient to patient. It is one of the fundamental principles to formulate a specific scheme for every given patient. (9) Make full use of the pharmacokinetics features of the anti-cancer drugs in clinical practice. (10) To be familiar with commonly used drugs and common tumor chemotherapeutic formulae is a matter of cardinal significance. (authors)

  11. Feeding Arteries of Primary Tongue Cancers on Intra-arterial Infusion Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kamitani, Takeshi, E-mail: kamitani@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Kawanami, Satoshi, E-mail: kawanami-01@mac.com [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences (Japan); Asayama, Yoshiki, E-mail: asayama@radiol.med.kyushu-u.ac.jp; Matsuo, Yoshio, E-mail: yymatsuo@radiol.med.kyushu-u.ac.jp; Yonezawa, Masato, E-mail: ymasato@radiol.med.kyushu-u.ac.jp; Yamasaki, Yuzo, E-mail: yyama@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Nagao, Michinobu, E-mail: minagao@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences (Japan); Yamanouchi, Torahiko, E-mail: tora0228@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Yabuuchi, Hidetake, E-mail: h-yabu@med.kyushu-u.ac.jp [Kyushu University, Department of Health Sciences, Graduate School of Medical Sciences (Japan); Nakamura, Katsumasa, E-mail: nakam@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Nakashima, Torahiko, E-mail: nakatora@qent.med.kyushu-u.ac.jp [Kyushu University, Department of Otorhinolaryngology, Graduate School of Medical Sciences (Japan); Honda, Hiroshi, E-mail: honda@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan)

    2016-02-15

    PurposeTo evaluate the frequency and the predictive factor of each feeding artery on intra-arterial infusion chemotherapy (IAIC) in primary tongue cancer.Materials and MethodsWe retrospectively evaluated 20 patients who received IAIC for primary tongue cancer. The main and accompanying feeding arteries were identified on super-selective angiography of the branches of the external carotid artery. Tumor diameter, and extension to the contralateral side, tongue extrinsic muscles (TEMs), and lateral mesopharyngeal wall were determined based on magnetic resonance imaging or computed tomography findings.ResultsThe main feeding artery was the ipsilateral lingual artery (LA) in 15 of the 20 examined tumors and the contralateral LA in the other 5. Ten cancers had only one feeding artery, and multiple feeding arteries were detected in the remaining 10. Tumors >4 cm (n = 9), those with extension to the contralateral side (n = 13), and those with extension to TEMs (n = 15) were supplied by significantly larger numbers of feeding arteries compared to tumors without these features (P = 0.01, 0.049, and 0.02, respectively). The frequency of feeding from the contralateral LA was 64 % (9/14) and 17 % (1/6) in tumors with and without extension to the contralateral side, respectively. Feeding from a facial artery (FA) was not detected in tumors ≤4 cm, while 5 of the 9 (56 %) tumors >4 cm were supplied by a FA (P = 0.01).ConclusionA careful search for feeding arteries is required, especially in large tumors with extension to the contralateral side or to TEMs.

  12. Feeding Arteries of Primary Tongue Cancers on Intra-arterial Infusion Chemotherapy.

    Science.gov (United States)

    Kamitani, Takeshi; Kawanami, Satoshi; Asayama, Yoshiki; Matsuo, Yoshio; Yonezawa, Masato; Yamasaki, Yuzo; Nagao, Michinobu; Yamanouchi, Torahiko; Yabuuchi, Hidetake; Nakamura, Katsumasa; Nakashima, Torahiko; Honda, Hiroshi

    2016-02-01

    To evaluate the frequency and the predictive factor of each feeding artery on intra-arterial infusion chemotherapy (IAIC) in primary tongue cancer. We retrospectively evaluated 20 patients who received IAIC for primary tongue cancer. The main and accompanying feeding arteries were identified on super-selective angiography of the branches of the external carotid artery. Tumor diameter, and extension to the contralateral side, tongue extrinsic muscles (TEMs), and lateral mesopharyngeal wall were determined based on magnetic resonance imaging or computed tomography findings. The main feeding artery was the ipsilateral lingual artery (LA) in 15 of the 20 examined tumors and the contralateral LA in the other 5. Ten cancers had only one feeding artery, and multiple feeding arteries were detected in the remaining 10. Tumors >4 cm (n = 9), those with extension to the contralateral side (n = 13), and those with extension to TEMs (n = 15) were supplied by significantly larger numbers of feeding arteries compared to tumors without these features (P = 0.01, 0.049, and 0.02, respectively). The frequency of feeding from the contralateral LA was 64 % (9/14) and 17 % (1/6) in tumors with and without extension to the contralateral side, respectively. Feeding from a facial artery (FA) was not detected in tumors ≤4 cm, while 5 of the 9 (56 %) tumors >4 cm were supplied by a FA (P = 0.01). A careful search for feeding arteries is required, especially in large tumors with extension to the contralateral side or to TEMs.

  13. A Gene-Based Prognostic for Hepatocellular Carcinoma Patient Response to Adjuvant Transcatheter Arterial Chemoembolization | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The gold standard of care for hepatocellular carcinoma patients with intermediate- to locally advanced tumors is transcatheter arterial chemoembolization (TACE), a procedure whereby the tumor is targeted both with local chemotherapy and restriction of local blood supply. NCI scientists have identified a 14-gene signature predictive of response to TACE, and NCI seeks licensees or co-development partners to develop the technology toward commercialization.

  14. Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma

    Science.gov (United States)

    Baek, Yang Hyun; Kim, Kyoung Tae; Lee, Sung Wook; Jeong, Jin Sook; Park, Byeong Ho; Nam, Kyung Jin; Cho, Jin Han; Kim, Young Hoon; Roh, Young Hoon; Lee, Hyung Sik; Choi, Young Min; Han, Sang Young

    2012-01-01

    AIM: To investigate the efficacy of hepatic arterial infusion chemotherapy (HAIC) using floxuridine (FUDR) in patients with advanced hepatocellular carcinoma (HCC) confined to the liver. METHODS: Thirty-four patients who had advanced HCC with unresectability or unsuccessful previous therapy in the absence of extrahepatic metastasis were treated with intra-arterial FUDR chemotherapy at our hospital between March 2005 and May 2008. Among the 34 patients, 9 patients were classified as Child class C, and 18 patients had portal vein tumor thrombus (PVTT). One course of chemotherapy consisted of continuous infusion of FUDR (0.3 mg/kg during day 1-14) and dexamethasone (10 mg on day 1, 4, 7 and 11), and this treatment was repeated every 28 d. RESULTS: Two patients (5.9%) displayed a complete response, and 12 patients (35.3%) had a partial response. The tumor control rate was 61.8%. The median overall survival times were 15.3 mo, 12.4 mo and 4.3 mo for the patients who were classified as Child class A, Child class B and Child class C, respectively (P = 0.0392). The progression-free survival was 12.9 mo, 7.7 mo and 2.6 mo for the patients who were classified as Child class A, Child class B and Child class C, respectively (P = 0.0443). The cumulative survival differed significantly according to the Child-Pugh classification and the presence of PVTT. In addition to hepatic reserve capacity and PVTT, the extent of HCC was an independent factor in determining a poor prognosis. The most common adverse reactions to HAIC were mucositis, diarrhea and peptic ulcer disease, but most of these complications were improved by medical treatment and/or a delay of HAIC. CONCLUSION: The present study demonstrates that intra-arterial FUDR chemotherapy is a safe and effective treatment for advanced HCC that is recalcitrant to other therapeutic modalities, even in patients with advanced cirrhosis. PMID:22807613

  15. Radiation therapy and arterial infusion chemotherapy for advanced gallbladder cancer

    International Nuclear Information System (INIS)

    Hokodate, Hirofumi; Saito, Hiroya; Takeuchi, Shuhei; Horikawa, Masahiro; Takamura, Akio

    2009-01-01

    The standard therapy is not yet established for the unresectable advanced gallbladder cancer (AGC). Here described is the outcome of authors' therapeutic protocol for AGC during the time Jan., 1989-Dec., 2008. Subjects are 73 patients (M 32/F 41, average age 65 y) with AGC of Stage IV. One shot arterial infusion (AI) of EEP regimen (etoposide (VP16)/4'epiadriamycin (EPIR)/cisplatin (CDDP)) is conducted via hepatic artery proper or common at the first angiography and one week later, external radiation therapy (RT), with about 30-50 Gy/6 fractions (actually, 12-61.6 Gy). AI is weekly done with FP regimen (CDDP/5-fluorouracil (FU)) through the reservoir indwelled in the gastroduodenal artery for 6 months where a metal stent for the stegnosis of bile duct is used if necessary after RT, and in recent days, additionally with biweekly CDDP/gemcitabin (GEM) regimen depending on patient's state after FP. As a result, RT is conducted to 62 cases (RT alone 8 cases), AI, 64 (alone, 10), and RT+AI, 54. Response is found to be 49% (CR 7 cases and PR, 28). Survivals 1- and 3-year are 39 and 6%, respectively, and average survival time, 408 days. Survival rate in (RT+AI) is significantly superior to that in AI alone and in RT alone. Prognosis in patients with jaundice, hepatic or duodenal invasion is significantly inferior to those without the symptom, and in non-responded cases, to responded cases. Complications like hepatic abscess are seen in 4 cases at 6 months after treatment. Four actual case-reports are presented in details with their images. Combination of RT+AI is suggested to be of utility for AGC, of which multi-center trial is awaited with addition of newer anti-cancers developed recently. (K.T.)

  16. Demonstration of the dorsal pancreatic artery by CTA to facilitate superselective arterial infusion of stem cells into the pancreas

    International Nuclear Information System (INIS)

    Lin Yuning; Yang Xizhang; Chen Ziqian; Tan Jianming; Zhong Qun; Yang Li; Wu Zhixian

    2012-01-01

    Purpose: To investigate the diagnostic performance of 64-section CTA in the detection of dorsal pancreatic artery before interventional therapy for patients with diabetes. Materials and methods: The study was approved by the institutional ethics committee; written informed consent was obtained. Forty-two consecutive patients with diabetes received an experimental treatment of autologous bone marrow-derived stem cell transplantation by means of infusion into the dorsal pancreatic artery. All cases underwent abdominal CTA before angiography of pancreatic arteries in order to locate the origin and course of dorsal pancreatic artery. Angiography of coeliac artery, splenic artery, common hepatic artery and superior mesenteric artery were performed both in CTA and DSA. Superselective catheterization of dorsal pancreatic artery was carried out for the infusion of stem cell. Sensitivity, specificity and accuracy for the detection of dorsal pancreatic artery with CTA were calculated using DSA images as the reference standard. Results: Thirty-five and thirty-six dorsal pancreatic arteries were detected by CTA and DSA respectively. Dorsal pancreatic artery was not visualized in either CTA or DSA in 5 patients. The sensitivity, specificity and accuracy for CTA were 94.4%, 83.3% and 92.9%. Conclusion: 64-section CTA is accurate for the detection of dorsal pancreatic artery. It may be useful for the facilitation of superselective arterial infusion of stem cells to pancreas.

  17. Transcatheter Arterial Embolization With Spherical Embolic Agent for Pulmonary Metastases From Renal Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Akihiko, E-mail: sekia@igtc.jp; Hori, Shinichi, E-mail: horishin@igtc.jp; Sueyoshi, Satoru, E-mail: sueyoshis@igtc.jp; Hori, Atsushi, E-mail: horiat@igtc.jp; Kono, Michihiko, E-mail: konom@igtc.jp; Murata, Shinichi, E-mail: muratas@igtc.jp; Maeda, Masahiko, E-mail: maedam@igtc.jp [Gate Tower Institute for Image Guided Therapy, Department of Radiology (Japan)

    2013-12-15

    Purpose: This retrospective study aimed to evaluate the safety and local efficacy of transcatheter arterial embolization (TAE) with superabsorbent polymer microspheres (SAP-MS) in patients with pulmonary metastases from renal cell carcinoma (RCC). Methods: Sixteen patients with unresectable pulmonary metastases from RCC refractory to standard therapy were enrolled to undergo TAE with the purpose of mass reduction and/or palliation. The prepared SAP-MS swell to approximately two times larger than their dry-state size (100-150 {mu}m [n = 14], 50-100 {mu}m [n = 2]). Forty-nine pulmonary nodules (lung n = 22, mediastinal lymph node n = 17, and hilar lymph node n = 10) were selected as target lesions for evaluation. Local tumor response was evaluated 3 months after TAE according to Response Evaluation Criteria in Solid Tumors (RECIST; version 1.1). The relationship between tumor enhancement ratio by CT during selective angiography and local tumor response was evaluated. Results: The number of TAE sessions per patient ranged from 1 to 5 (median 2.9). Embolized arteries at initial TAE were bronchial arteries in 14 patients (87.5 %) and nonbronchial systemic arteries in 11 patients (68.8 %). Nodule-based evaluation showed that 5 (10.2 %) nodules had complete response, 17 (34.7 %) had partial response, 15 (30.6 %) had stable disease, and 12 (24.5 %) had progressive disease. The response rate was significantly greater in 22 lesions that had a high tumor enhancement ratio than in 27 lesions that had a slight or moderate ratio (90.9 vs. 7.4 %, p = 0.01). Severe TAE-related adverse events did not occur. Conclusion: TAE with SAP-MS might be a well-tolerated and locally efficacious palliative option for patients with pulmonary metastases from RCC.

  18. Transcatheter Arterial Embolization with N-Butyl-2-Cyanoacrylate in the Management of Spontaneous Hematomas

    Energy Technology Data Exchange (ETDEWEB)

    Ozyer, Umut, E-mail: umutozyer@gmail.com [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)

    2017-01-15

    IntroductionSpontaneous hematoma refractory to conservative management is a potentially serious condition that requires prompt diagnosis and intervention. The purpose of this study was to evaluate the performance of computed tomography (CT) in the treatment planning and to report the effectiveness of transcatheter embolization with N-butyl-2-cyanoacrylate (NBCA).Materials and MethodsForty-one interventions in 38 patients within a 12-year period were evaluated. CT and angiograms were reviewed for the location of the hematoma, the presence of extravasation, and the correlation of CT and angiography findings.ResultsArterial extravasation was present on 34/39 CT scans. Angiograms confirmed the CT scans in 29 cases. Angiograms revealed extravasation in four cases which CT showed venous bleeding (n = 2) or no bleeding (n = 2). Five patients with arterial and 1 patient with venous extravasation on CT images had no extravasation on angiograms. Embolization was performed to all arteries with extravasation on angiograms. Empiric embolization of the corresponding artery on the CT was performed when there was no extravasation on angiograms. Embolization procedures were performed with 15 % NBCA diluted with iodized oil. Technical success was achieved in 40/41 (97.6 %) interventions. Clinical success was achieved in 35 patients with a single, in 1 patient with 2, and in 1 patient with 3 interventions. No complications related to embolization procedure occurred. None of the patients died due to a progression of the hematoma.ConclusionNBCA is an effective and safe embolic agent to treat hematoma refractory to conservative management. Contrast-enhanced CT may provide faster and more effective intervention.Level of Evidence IIIRetrospective.

  19. Transcatheter Arterial Embolization with N-Butyl-2-Cyanoacrylate in the Management of Spontaneous Hematomas.

    Science.gov (United States)

    Ozyer, Umut

    2017-01-01

    Spontaneous hematoma refractory to conservative management is a potentially serious condition that requires prompt diagnosis and intervention. The purpose of this study was to evaluate the performance of computed tomography (CT) in the treatment planning and to report the effectiveness of transcatheter embolization with N-butyl-2-cyanoacrylate (NBCA). Forty-one interventions in 38 patients within a 12-year period were evaluated. CT and angiograms were reviewed for the location of the hematoma, the presence of extravasation, and the correlation of CT and angiography findings. Arterial extravasation was present on 34/39 CT scans. Angiograms confirmed the CT scans in 29 cases. Angiograms revealed extravasation in four cases which CT showed venous bleeding (n = 2) or no bleeding (n = 2). Five patients with arterial and 1 patient with venous extravasation on CT images had no extravasation on angiograms. Embolization was performed to all arteries with extravasation on angiograms. Empiric embolization of the corresponding artery on the CT was performed when there was no extravasation on angiograms. Embolization procedures were performed with 15 % NBCA diluted with iodized oil. Technical success was achieved in 40/41 (97.6 %) interventions. Clinical success was achieved in 35 patients with a single, in 1 patient with 2, and in 1 patient with 3 interventions. No complications related to embolization procedure occurred. None of the patients died due to a progression of the hematoma. NBCA is an effective and safe embolic agent to treat hematoma refractory to conservative management. Contrast-enhanced CT may provide faster and more effective intervention. Retrospective.

  20. Analysis of amenorrhea after transcatheter uterine artery embolization for uterine fibroids

    International Nuclear Information System (INIS)

    Chen Xiaoming; Li Yong; Lu Ligong; Hu Baoshan; Luo Pengfei; Du Juan; Zuo Yuewei; Hu Xiaoping; Hong Danhua

    2005-01-01

    Objective: To investigate the causes of amenorrhea after transcatheter uterine artery embolization (TUAE) for uterine fibroids. Methods: Two hundreds thirty-one cases of uterine fibroids with the range of age from 29 to 51 years (mean, 39.5 years) underwent TUAE between April 1999 and May 2004. TUAE was performed by injecting lipiodol-pingyangmycine emulsion (LPE) into bilateral uterine arteries, followed by administration of gelatin sponge particles in 186 of 231 patients. LPE was prepared with pingyangmycine 8-16 mg and ultra fluid lipiodol 6-20 ml. Results: Amenorrhea occurred in 2 of 231 (0.87%) patients respectively at 3 and 4 months after TUAE. Premature ovarian failure was proved to be etiology of amenorrhea in one patient because her serum estradiol (E 2 ) became decreased and serum follicle-stimulating hormone (FSH) level increased. This woman had normal amenorrhea later after receiving estrogen-progestogen sepuential therapy for 12 months. Another patient's amenorrhea was proved to be associated with endometrial atrophy after TUAE by hysteroscope. Conclusion: Amenorrhea caused by premature ovarian failure and endometrial atrophy may occur in a tiny minority of women undergoing TUAE. (authors)

  1. Transcatheter arterial embolization as therapy of renal angiomyolipomas: The evolution in 15 years of experience

    International Nuclear Information System (INIS)

    Chatziioannou, A.; Gargas, D.; Malagari, K.; Kornezos, I.; Ioannidis, I.; Primetis, E.; Moschouris, H.; Gouliamos, A.; Mourikis, D.

    2012-01-01

    Objective: This study aims at presenting the evolution of the embolization technique in treating renal angiomyolipomas (AMLs) either diagnosed in patients with acute bleeding or discovered accidentally. Methods: Ten patients with renal AMLs have been through thirteen selective transcatheter arterial embolizations for 15 years. Two patients had tuberous sclerosis complex (TSC) with bilateral tumors and were embolized twice. Four embolic materials were employed: PVA particles, Gianturco coils, microspheres and microcoils. Catheterization was achieved by means of 5F Cobra 2 catheters and coaxial microcatheter systems. Results: On an emergency basis, embolization was a first-line treatment. In one case, surgery was necessary; in two patients, a second embolization was performed. When treatment was preventive, a single embolization proved to be sufficient, as well. There was no significant deterioration of the serum creatinine levels in the post-embolization period. Conclusion: Selective arterial embolization is a rather safe and effective technique to treat AMLs both urgently and preventively. Different embolic materials can be employed. Microspheres and microcatheters stand for new promising materials

  2. Usefulness of dynamic MR imaging for the evaluation of transcatheter arterial embolization for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kyomasu, Yoshinori; Nakayama, Masafumi; Kawakami, Mutsumi; Mashima, Yasuoki; Ichinose, Akira; Endou, Kazuo; Chiba, Kazuo; Tanno, Munehiko; Yamada, Hideo

    1992-01-01

    Thirteen patients with hepatocellular carcinoma (HCC) were studied with dynamic MR imaging in addition to conventional T 1 - and T 2 -weighted and enhanced T 1 -weighted images before and after the treatment of HCC by transcatheter arterial embolization (TAE). Dynamic MR imaging was performed using GRASS (gradient recalled acquisition in the steady state) sequences. The imaging was started at 10 seconds after rapid injection of Gd-diethylenetriaminepentaacetic acid (Gd-DTPA) with 6s breath hold. Thereafter about 12 images were obtained during 6s breath-holding with 20 seconds intervals. On T 1 - and T 2 -weighted images, signal intensity at the tumor tended to increase during the early period after TAE and to decrease later. Intensities of the HCC, however, were heterogeneous. Differentiation among embolic area, necrosis, viable cells and recurrent area, was often difficult only by conventional images. Dynamic GRASS images could clearly demonstrate an embolic area as a region without contrast enhancement. While recurrent tumor could be diagnosed as an area with early enhancement at the arterial phase. Development of the collateral circulation and dominancy of tumor feeding vessels after TAE could also be deduced on dynamic MR images together with enhanced T 1 -weighted images. The dynamic MR imaging was concluded to be a potentially useful procedure for the clinical evaluation of HCC after TAE. (author)

  3. Transcatheter Arterial Embolization of Nonvariceal Upper Gastrointestinal Bleeding with N-Butyl Cyanoacrylate

    International Nuclear Information System (INIS)

    Jae, Hwan Jun; Chung, Jin Wook; Jung, Ah Young; Lee, Whal; Park, Jae Hyung

    2007-01-01

    To evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with N-Butyl Cyanoacrylate (NBCA) for nonvariceal upper gastrointestinal bleeding. Between March 1999 and December 2002, TAE for nonvariceal upper gastrointestinal bleeding was performed in 93 patients. The endoscopic approach had failed or was discarded as an approach for control of bleeding in all study patients. Among the 93 patients NBCA was used as the primary embolic material for TAE in 32 patients (28 men, four women; mean age, 59.1 years). The indications for choosing NBCA as the embolic material were: inability to advance the microcatheter to the bleeding site and effective wedging of the microcatheter into the bleeding artery. TAE was performed using 1:1 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure related complications and clinical outcomes were evaluated. The angiographic and clinical success rates were 100% and 91% (29/32), respectively. There were no serious ischemic complications. Recurrent bleeding occurred in three patients (9%) and they were managed with emergency surgery (n = 1) and with a successful second TAE (n = 2). Eighteen patients (56%) had a coagulopathy at the time of TAE and the clinical success rate in this group of patients was 83% (15/18). TAE with NBCA is a highly effective and safe treatment modality for nonvariceal upper gastrointestinal bleeding, especially when it is not possible to advance the microcatheter to the bleeding site and when the patient has a coagulopathy

  4. Transcatheter Arterial Embolization of Nonvariceal Upper Gastrointestinal Bleeding with N-Butyl Cyanoacrylate

    Energy Technology Data Exchange (ETDEWEB)

    Jae, Hwan Jun; Chung, Jin Wook; Jung, Ah Young; Lee, Whal; Park, Jae Hyung [Seoul National University Hospital, Institute of Radiation Medicine, Seoul (Korea, Republic of)

    2007-02-15

    To evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with N-Butyl Cyanoacrylate (NBCA) for nonvariceal upper gastrointestinal bleeding. Between March 1999 and December 2002, TAE for nonvariceal upper gastrointestinal bleeding was performed in 93 patients. The endoscopic approach had failed or was discarded as an approach for control of bleeding in all study patients. Among the 93 patients NBCA was used as the primary embolic material for TAE in 32 patients (28 men, four women; mean age, 59.1 years). The indications for choosing NBCA as the embolic material were: inability to advance the microcatheter to the bleeding site and effective wedging of the microcatheter into the bleeding artery. TAE was performed using 1:1 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure related complications and clinical outcomes were evaluated. The angiographic and clinical success rates were 100% and 91% (29/32), respectively. There were no serious ischemic complications. Recurrent bleeding occurred in three patients (9%) and they were managed with emergency surgery (n = 1) and with a successful second TAE (n = 2). Eighteen patients (56%) had a coagulopathy at the time of TAE and the clinical success rate in this group of patients was 83% (15/18). TAE with NBCA is a highly effective and safe treatment modality for nonvariceal upper gastrointestinal bleeding, especially when it is not possible to advance the microcatheter to the bleeding site and when the patient has a coagulopathy.

  5. Patent ductus arteriosus with persistent pulmonary artery hypertension after transcatheter closure.

    Science.gov (United States)

    Feng, Jianqi; Kong, Xiangqing; Sheng, Yanhui; Yang, Rong

    2016-01-01

    To observe the change in pulmonary artery systolic pressure (PASP) of patients with persistent pulmonary arterial hypertension (PAH) after patent ductus arteriosus (PDA) occlusion. After occlusion of PDA in patients with PAH, some patients still tend to suffer from persistent PAH. A chest X-ray, an electrocardiogram, and an echocardiogram were performed on nine patients at 24 hours, 1 and 6 months, and 1 year serially. There was a significant fall ( P 0.05). During the follow up, there was a further fall in the PASP in five patients (No 1, 5, 6, 7, and 8). Four patients (No 2, 3, 4, and 8) showed the evidence of worsening PAH and were treated with sildenafil. Patient 2 died from acute right heart failure after a period of 11 months from the time of transcatheter closure, triggered by pulmonary infection. Some patients with borderline hemodynamic data with PDA and PAH can deteriorate or keep sustained PAH after PDA closure. The treatment of permanent closure to these patients must be cautious.

  6. Spinal cord injury after conducting transcatheter arterial chemoembolization for costal metastasis of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Sang Jung Park

    2012-09-01

    Full Text Available Transcatheter arterial chemoembolization (TACE has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained.

  7. Development of extrahepatic arterial blood supply to the liver during hepatic arterial infusion chemotherapy

    International Nuclear Information System (INIS)

    Seki, H.; Kimura, M.; Yoshimura, N.; Yamamoto, S.; Ozaki, T.; Sakai, K.

    1998-01-01

    The aim of this study was to evaluate the correlation of development of the collateral circulation to the liver during hepatic arterial infusion chemotherapy (HAIC) with the presence of hepatic tumours adjacent to the hepatic surface, and with pretreatment occlusion of aberrant hepatic arteries. In 102 patients with unresectable malignant hepatic tumours treated with HAIC using an implantable port system, development of collaterals to the liver was assessed with CT arteriography using the implantable port and pre- and postoperative angiography. Aberrant hepatic arteries, if present, were occluded prior to treatment for hepatic arterial redistribution. Collaterals to the liver were seen in 29 patients, who had 35 areas with collateral perfusion: 22 areas were in the right posterosuperior area, 6 in the left peripheral area and 7 in the right or left lobar area. Collaterals were revealed more frequently in patients with hepatic tumours adjacent to the hepatic surface than in those without hepatic tumours in peripheral areas in the liver (p < 0.0001). In addition, collaterals developed more frequently in patients with an aberrant hepatic arterial anatomy compared with those with conventional anatomy (p = 0.0007). Our results indicated that patients with hepatic tumours adjacent to the hepatic surface and with pretreatment occlusion of aberrant hepatic arteries had the potential to develop collaterals to the liver during HAIC. (orig.)

  8. Transcatheter Splenic Artery Occlusion for Treatment of Splenic Artery Steal Syndrome After Orthotopic Liver Transplantation

    International Nuclear Information System (INIS)

    Uflacker, Renan; Selby, J. Bayne; Chavin, Kenneth; Rogers, Jeffrey; Baliga, Prabhakar

    2002-01-01

    Purpose: To review some aspects of the problem of splenic artery steal syndrome as cause of ischemia in transplanted livers and treatment by selective splenic artery occlusion. Materials and Methods: Eleven liver transplant patients from a group of 350 patients, nine men and two women,ranging in age from 40 years to 61 years (mean 52 years), presented with biochemical evidences of liver ischemia and failure, ranging from one to 60 days following orthotopic liver transplantation. Diagnosis of splenic artery steal syndrome was suspected by elevated enzymes, Doppler ultrasound and confirmed by celiac angiogram. Patients with confirmed hepatic artery thrombosis before angiography were excluded from the study. Embolization with Gianturco coils was performed. Results: All patients were treated by splenic artery embolization with Gianturco coils. The 11 patients improved clinically within 24 hours of the procedure with significant change in the biochemical and clinical parameters. Followup ranged from one month to two years. One of the 11 patient initially improved, but developed hepatic artery thrombosis within 24 hours of the embolic treatment,requiring surgical repair. Conclusion: Splenicartery steal syndrome following liver transplantation surgery can be diagnosed by celiac angiography, and effectively treated by splenic artery embolization with coils. Embolization is one of the treatments available, it is minimally invasive, and leads to immediate clinical improvement. Hepatic artery thrombosis is a possible complication of the procedure

  9. Clinical Analysis of Pulmonary Lipiodol Embolism in Patients with Hepatic Carcinoma after Transcatheter Arterial Chemoembolization

    Directory of Open Access Journals (Sweden)

    Wen-jin JIANG

    2015-03-01

    Full Text Available Objective:To explore the clinical manifestations, therapeutic methods and preventive measures of pulmonary lipiodol embolism (PLE induced by transcatheter arterial chemoembolization (TACE so as to improve the cognition and management of PLE. Methods:A total of 2 613 patients with hepatic cancer without history of pulmonary disease who were treated with TACE in our hospital from Sept., 2004 to Mar., 2013 were selected. The clinical manifestations, therapeutic methods and preventing measures of the 9 patients who were accompanied with PLE were observed to analyze the pre-operative hepatic computed tomography (CT and chest X-ray, intra-operative contrast examination, dosage of lipiodol and chemotherapeutic drugs, clinical manifestation and therapeutic progression as well as the postoperative follow-up.Results: Nine patients accompanied by PLE had different-severity cough, hemoptysis and progressive dyspnea, and chest X-ray and/or CT showed flaky high-density radiography. After treated with oxygen inhalation, bronchus expansion and inflammation alleviation, 8 patients were improved but 1 died. Of the 8 patients, 2 were given ventilator to assist breath, and the clinical symptoms of 8 patients disappeared within 3-15 d. The re-examined chest X-ray showed normal after 20-60 d follow-up observation. Additionally, 6 patients were with nidus diameter ≥10 cm, 6 with hepatic artery-vein fistula and 7 with lipiodol dosage ≥20 mL.Conclusion: PLE often occurs in patients with giant hepatic carcinoma accompanied by hepatic artery-vein fistula, whose lipiodol dosage is ≥20 mL. Accurate and correct management during operation can effectively reduce the development of PLE.

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

    International Nuclear Information System (INIS)

    Won, Jong Yun; Lee, Do Yun; Lee, Jong Tae; Park, Sung Il; Kim, Myeong-Jin; Yoo, Hyung Sik; Suh, Sang-Hyun; Park, Sang Joon

    2003-01-01

    Purpose: To evaluate the therapeutic efficacy and safety of supplemental transcatheter arterialchemoembolization (TACE) through the extrahepatic collateral omentalartery (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

  11. Tumor and liver drug uptake following hepatic artery and portal vein infusion

    International Nuclear Information System (INIS)

    Sigurdson, E.R.; Ridge, J.A.; Kemeny, N.; Daly, J.M.

    1987-01-01

    Anatomic dye injection studies of the blood supply of colorectal hepatic metastases suggest that tumors are supplied predominantly by the hepatic artery. Using 13 N amino acids with dynamic gamma camera imaging in patients with colorectal hepatic metastases, it has been shown that hepatic artery infusion results in a significantly greater nutrient delivery to tumor compared with portal vein infusion. However, direct measurements of drug levels in tumor following hepatic artery and portal vein infusion in humans have not previously been reported. Patients with metastatic colorectal cancer confined to the liver received fluorodeoxyuridine (FUdR) through the hepatic artery or through the portal vein. All patients had previously failed systemic chemotherapy. Five patients with hepatic artery catheters were matched (by age, serum lactic dehydrogenase levels, percent hepatic replacement, and tumor size) with five patients with portal vein catheters. At operation, 3 H-FUdR (1 microCi/kg) and /sup 99m/Tc-macroaggregated albumin (MAA) (6 mCi) were injected into the hepatic artery or portal vein. Liver and tumor biopsies were obtained two and five minutes later. 3 H and /sup 99m/Tc were measured per gram tissue by scintillation and gamma counting. The mean liver levels following hepatic artery infusion (23.9 +/- 11.4 nmol/g) and portal vein infusion (18.4 +/- 14.5 nmol/g) did not differ. However, the mean tumor FUdR level following hepatic artery infusion was 12.4 +/- 12.2 nmol/g, compared with a mean tumor FUdR level following portal vein infusion of 0.8 +/- 0.7 nmol/g (P less than .01). This low level of tumor drug uptake after portal vein infusion of FUdR predicts minimal tumor response to treatment via this route. Thus, regional chemotherapy for established colorectal hepatic metastases should be administered through the hepatic artery

  12. An unusual case of coronary artery compression that did not preclude successful transcatheter pulmonary valve placement.

    Science.gov (United States)

    Schwartz, Matthew C; Felix, Donald; Iacono, Karen; Nykanen, David

    2018-04-16

    During transcatheter pulmonary valve placement, coronary compression observed during simultaneous right ventricular outflow tract angioplasty and coronary angiography typically contraindicates valve implantation. We present a unique patient with tetralogy of Fallot who underwent successful transcatheter Melody valve placement despite coronary compression observed during right ventricular outflow tract balloon angioplasty. © 2018 Wiley Periodicals, Inc.

  13. Current status, questions and challenges of transcatheter uterine artery embolization for the treatment of uterine fibroids

    International Nuclear Information System (INIS)

    Chen Xiaoming; Luo Pengfei

    2006-01-01

    Current status, questions and challenges of transcatheter uterine artery embolization (UAE) in the treatment of uterine fibroids were summarized and analysed. It has been proved that UAE presents a good effectiveness in controlling the symptoms and shrinkage of fibroid and uterine volumes during follow-up of 4 to 6.9 years domestically and abroad, but relapse of the fibroid may however occur in 2 years or longer after UAE. Generally speaking, UAE is safe in the treatment of uterine fibroids but has a possibility of serious complications. UAE has no damage on normal uterine tissues but may affect pregnancy and delivery of patients significantly later on the cause of hypoxia and inertia of uterus. UAE may cause amenorrhea in the minority of women with ovarian failure and endometrium atrophy. The current questions are how to improve long-term efficiency to reduce relapse of tumor and to insure the safety of UAE. It is our further task to exploit more new effective and safe embolic agents by using animal and clinical study on the basic knowledge of pathology, pharmacology, biochemistry, endocrinology and molecular biology. (authors)

  14. Combined transcatheter arterial chemoembolization and percutaneous ethanol injection for treatment of hepatocellular carcinoma: preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Seong Tae; Ahn, Bo Young; Song, Kyung Sup; Kim, Choon Yul; Shinn, Kyung Sub; Chung, Kyu Won [Catholic University Medical College, Seoul (Korea, Republic of)

    1995-01-15

    Transcatheter arterial chemoembolization (TACE) and subsequent percutaneous ethanol injection (PEI) was attempted in 8 patients with 9 hepatocellular carcinoma (HCCs) for complete tumor necrosis of HCCs less than 5 cm in greatest diameter. PEI was performed with 2-8 ml of absolute (99.9%) ethanol two weeks after TACE under CT or ultrasound guidance. For each patient PEI was done twice to four times within 4-10 days of each procedure. After completion of a series of PEI, follow up examination (range: 3 months-1.5 year period) was done with angiography, CT or ultrasound and correlated with serum alpha-fetoprotein (AFP) level. On follow up angiograms, the lesions completely disappeared or decreased in size without tumor vessels or staining in 5 of 6 patients. On follow up CT of 6 patients, the lipiodol-laden HCCs were surrounded by non-enhancing low density and the lesion sizes were slightly decreased or not changed. These are suggestive of necrosis of tumor itself and adjacent liver parenchyma. The tumors could not be detected on follow up ultrasound examination in 2 patients. Serum AFP was decreased in 7 patients and was well corresponded to the results of imaging modalities. The authors concluded that the combined TACE and PEI is an appropriate treatment for small HCCs having high surgical risks.

  15. Serum YKL-40 independently predicts outcome after transcatheter arterial chemoembolization of hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Cheng-Bao Zhu

    Full Text Available Transcatheter arterial chemoembolization (TACE is the most widely used treatment option for unresectable hepatocellular carcinoma (HCC. Elevated serum YKL-40 level has been shown to predict poor prognosis in HCC patients undergoing resection. This study was designed to validate the prognostic significance of serum YKL-40 in patients with HCC undergoing TACE treatment.Serum YKL-40 level was determined by enzyme-linked immunosorbent assay. Overall survival (OS was evaluated with the Kaplan-Meier method and compared by the log-rank test. Multivariate study with Cox proportional hazard model was used to evaluate independent prognostic variables of OS.The median pretreatment serum YKL-40 in HCC patients with was significantly higher than that in healthy controls (P<0.001. The YKL-40 could predict survival precisely either in a dichotomized or continuous fashion (P<0.001 and P = 0.001, respectively. Multivariate Cox regression analysis indicated that serum YKL-40 was an independent prognostic factor for OS in HCC patients (P = 0.001. In further stratified analyses, YKL-40 could discriminate the outcomes of patients with low and high alpha-fetoprotein (AFP level (P = 0.006 and 0.016, respectively. Furthermore, the combination of serum YKL-40 and AFP had more capacity to predict patients' outcomes.Serum YKL-40 was demonstrated to be an independent prognostic biomarker in HCC patients treated with TACE. Our results need confirmation in an independent study.

  16. Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations

    Energy Technology Data Exchange (ETDEWEB)

    Picel, Andrew C., E-mail: apicel@ucsd.edu [University of California, San Diego, Department of Radiology (United States); Koo, Sonya J. [University of Texas Southwestern Medical Center, Department of Radiology (United States); Roberts, Anne C. [University of California, San Diego, Department of Radiology (United States)

    2016-08-15

    PurposeThe purpose of the study was to evaluate the technique and outcomes of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for the treatment of acquired uterine arteriovenous malformations (AVMs).Materials and methodsA retrospective review identified five women treated for suspected acquired uterine AVMs with TAE at our institution. Four women (80 %) presented with heavy or intermittent vaginal bleeding after obstetric manipulation. One woman (20 %) was treated for an incidental AVM discovered on ultrasound after an uncomplicated cesarean section. Three women underwent one embolization procedure and two women required two procedures. Embolization material included NBCA in six procedures (80 %) and gelatin sponge in one procedure (20 %).ResultsEmbolization resulted in angiographic stasis of flow in all seven procedures. Four women (80 %) presented with vaginal bleeding which was improved after treatment. One woman returned 24 days after unilateral embolization with recurrent bleeding, which resolved after retreatment. One woman underwent two treatments for an asymptomatic lesion identified on ultrasound. There were no major complications. Three women (60 %) experienced mild postembolization pelvic pain that was controlled with non-steroidal anti-inflammatory drugs. Three women (60 %) had pregnancies and deliveries after embolization.ConclusionsTAE is a safe alternative to surgical therapy for acquired uterine AVMs with the potential to maintain fertility. Experience from this case series suggests that NBCA provides predictable and effective occlusion.

  17. Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations

    International Nuclear Information System (INIS)

    Picel, Andrew C.; Koo, Sonya J.; Roberts, Anne C.

    2016-01-01

    PurposeThe purpose of the study was to evaluate the technique and outcomes of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for the treatment of acquired uterine arteriovenous malformations (AVMs).Materials and methodsA retrospective review identified five women treated for suspected acquired uterine AVMs with TAE at our institution. Four women (80 %) presented with heavy or intermittent vaginal bleeding after obstetric manipulation. One woman (20 %) was treated for an incidental AVM discovered on ultrasound after an uncomplicated cesarean section. Three women underwent one embolization procedure and two women required two procedures. Embolization material included NBCA in six procedures (80 %) and gelatin sponge in one procedure (20 %).ResultsEmbolization resulted in angiographic stasis of flow in all seven procedures. Four women (80 %) presented with vaginal bleeding which was improved after treatment. One woman returned 24 days after unilateral embolization with recurrent bleeding, which resolved after retreatment. One woman underwent two treatments for an asymptomatic lesion identified on ultrasound. There were no major complications. Three women (60 %) experienced mild postembolization pelvic pain that was controlled with non-steroidal anti-inflammatory drugs. Three women (60 %) had pregnancies and deliveries after embolization.ConclusionsTAE is a safe alternative to surgical therapy for acquired uterine AVMs with the potential to maintain fertility. Experience from this case series suggests that NBCA provides predictable and effective occlusion.

  18. Transcatheter Arterial Embolization for Postpartum Hemorrhage with Disseminated Intravascular Coagulation: Outcome Assessment

    Energy Technology Data Exchange (ETDEWEB)

    An, Eun Jung; Kim, Young Hwan; Kwon, Bo Ra; Kim, See Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-12-15

    We evaluated the efficacy and predictors of clinical outcome after transcatheter arterial embolization (TAE) for treatment of postpartum hemorrhage with disseminated intravascular coagulation (DIC). Of 127 patients who underwent TAE for postpartum hemorrhage, 46 progressed to DIC (group 1), 81 showed normal range hematological parameters (group 2). We retrospectively evaluated etiology, embolization methods and the efficacy of TAE for intergroup comparison Pearson Chi-Square test and logistic regression model. Overall TAE failed to control bleeding in 9 patients in spite of technical success. Lower bleeding control rate was found in group 2 (82.6%) relative to group 1 (98.8%, p = 0.001). And embolization methods were not statistically different between two groups no statistically significant predictors associated with failed hemostasis except the amount of transfusion in group 1. Although bleeding control rate is lower in postpartum hemorrhage with DIC than without DIC, we believe that TAE with correction of DIC is an effective method for postpartum hemorrhage with DIC.

  19. Transcatheter Arterial Embolization for Postpartum Hemorrhage with Disseminated Intravascular Coagulation: Outcome Assessment

    International Nuclear Information System (INIS)

    An, Eun Jung; Kim, Young Hwan; Kwon, Bo Ra; Kim, See Hyung

    2011-01-01

    We evaluated the efficacy and predictors of clinical outcome after transcatheter arterial embolization (TAE) for treatment of postpartum hemorrhage with disseminated intravascular coagulation (DIC). Of 127 patients who underwent TAE for postpartum hemorrhage, 46 progressed to DIC (group 1), 81 showed normal range hematological parameters (group 2). We retrospectively evaluated etiology, embolization methods and the efficacy of TAE for intergroup comparison Pearson Chi-Square test and logistic regression model. Overall TAE failed to control bleeding in 9 patients in spite of technical success. Lower bleeding control rate was found in group 2 (82.6%) relative to group 1 (98.8%, p = 0.001). And embolization methods were not statistically different between two groups no statistically significant predictors associated with failed hemostasis except the amount of transfusion in group 1. Although bleeding control rate is lower in postpartum hemorrhage with DIC than without DIC, we believe that TAE with correction of DIC is an effective method for postpartum hemorrhage with DIC.

  20. Efficacy of Preoperative Transcatheter Arterial Embolization for Nasopharyngeal Angiofibroma: A Comparative Study.

    Science.gov (United States)

    Tan, Guosheng; Ma, Zhenjiang; Long, Weiqing; Liu, Liangshuai; Zhang, Bing; Chen, Wei; Yang, Jianyong; Li, Heping

    2017-06-01

    This study aimed to retrospectively evaluate the efficacy and safety of preoperative transcatheter arterial embolization (pTAE) for treating nasopharyngeal angiofibroma (NPAF). Seventy-four NPAF patients were hospitalized for elective surgical treatment with pTAE (pTAE group, n = 32) or surgical treatment alone (non-pTAE group, n = 42) between January 1990 and December 2013. The following outcome measures were retrospectively analyzed and compared: intraoperative bleeding volume, surgery time (ST), duration of postoperative hospital stay (PHS), and disease recurrence. Among Radkowski stage I patients, those in pTAE group had a slightly higher but not significant bleeding volume than patients in non-pTAE group (344 ± 407 vs. 248 ± 219 mL, P = 0.899); among stage II/III patients, however, patients in pTAE group showed a significantly lower bleeding volume than patients in non-pTAE group (stage II, 829 ± 519 vs. 1339 ± 767 mL, P = 0.035; stage III, 1267 ± 592 vs. 2125  ± 479 mL, P = 0.024). The two groups presented comparable OTs, PHSs, and rates of frontal recurrence (all P>0.05). pTAE significantly reduces intraoperative bleeding in NPAF patients with Radkowski stage II/III disease, but offers no additional benefits regarding ST, PHS, or recurrence.

  1. Efficacy of Preoperative Transcatheter Arterial Embolization for Nasopharyngeal Angiofibroma: A Comparative Study

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Guosheng; Ma, Zhenjiang [The First Affiliated Hospital of Sun Yat-sen University, Department of Interventional Radiology (China); Long, Weiqing [The First Affiliated Hospital of Sun Yat-sen University, Department of Clinical Laboratory (China); Liu, Liangshuai [The First Affiliated Hospital of Sun Yat-sen University, Department of Interventional Radiology (China); Zhang, Bing [The First Affiliated Hospital of Sun Yat-sen University, Department of Nuclear Medicine (China); Chen, Wei; Yang, Jianyong; Li, Heping, E-mail: jxgdhp@163.com [The First Affiliated Hospital of Sun Yat-sen University, Department of Interventional Radiology (China)

    2017-06-15

    ObjectiveThis study aimed to retrospectively evaluate the efficacy and safety of preoperative transcatheter arterial embolization (pTAE) for treating nasopharyngeal angiofibroma (NPAF).MethodsSeventy-four NPAF patients were hospitalized for elective surgical treatment with pTAE (pTAE group, n = 32) or surgical treatment alone (non-pTAE group, n = 42) between January 1990 and December 2013. The following outcome measures were retrospectively analyzed and compared: intraoperative bleeding volume, surgery time (ST), duration of postoperative hospital stay (PHS), and disease recurrence.ResultsAmong Radkowski stage I patients, those in pTAE group had a slightly higher but not significant bleeding volume than patients in non-pTAE group (344 ± 407 vs. 248 ± 219 mL, P = 0.899); among stage II/III patients, however, patients in pTAE group showed a significantly lower bleeding volume than patients in non-pTAE group (stage II, 829 ± 519 vs. 1339 ± 767 mL, P = 0.035; stage III, 1267 ± 592 vs. 2125  ± 479 mL, P = 0.024). The two groups presented comparable OTs, PHSs, and rates of frontal recurrence (all P>0.05).ConclusionspTAE significantly reduces intraoperative bleeding in NPAF patients with Radkowski stage II/III disease, but offers no additional benefits regarding ST, PHS, or recurrence.

  2. Therapeutic Effect of Transcatheter Arterial Embolization for Hypervascular Hepatocellular Carcinoma: Web-based Multicenter Analysis

    International Nuclear Information System (INIS)

    Baik, Jun Hyun; Song, Kyung Sup; Han, Joon Koo

    2011-01-01

    To evaluate the therapeutic effect of transcatheter arterial embolization (TAE) as a first treatment course for hypervascular hepatocellular carcinoma (HCC), using nationwide web-based multicenter data in Korea. Eight hundred eighty eight HCC patients who were registered in the internet homepage of primary liver cancer registry (www.plcr.or.kr) from August 2003 to August 2005 were enrolled in this study, and they were investigated till February 2007. The patients were divided into three groups according to the following treatments after first TAE; TAE only, TAE + SL (any surgical resection, transplantation or percutaneous ablation followed), TAE + RC (any radiation therapy or chemotherapy followed). The clinical and tumor characteristics, embolization factors and survival periods were analyzed. The 5-year survival rates of the groups of TAE only, TAE + SL and TAE + RC were 21.6%, 57.4%, and 13.1%, respectively. In all cases and in the TAE only group, more selective and complete embolization increased survival rates. There were tendencies that as smaller tumor and the tumor in earlier stage, more selective and complete embolizations were performed in the TAE only group, and independent prognostic factors of this group were Child-Pugh classification, tumor size and Modified 4th UICC stage. This study is the first nationwide multicenter analysis for TAE using an online registration system in Korea. Selective and complete TAE increases patient's survival, and decisive combined treatment after TAE such as surgical resection, transplantation or percutaneous ablation increases patient's survival.

  3. Empiric transcatheter arterial embolization for massive bleeding from duodenal ulcers: efficacy and complications.

    Science.gov (United States)

    Ichiro, Ikushima; Shushi, Higashi; Akihiko, Ishii; Yasuhiko, Iryo; Yasuyuki, Yamashita

    2011-07-01

    To evaluate the efficacy and safety of empiric transcatheter arterial embolization (TAE) for patients with massive bleeding from duodenal ulcers. During January 2000 and December 2009, 59 patients with duodenal ulcer bleeding in whom TAE was attempted after endoscopic therapy failed were retrospectively analyzed. The patients were divided into empiric TAE (n = 36) and identifiable TAE (n = 23) groups according to angiographic findings with or without identification of the bleeding sites. The technical and clinical success rate, recurrent bleeding rate, procedure-related complications, and clinical outcomes were evaluated. The technical and clinical success rates of TAE were 100% and 83%. The recurrent bleeding rate, clinical success, duodenal stenosis, and 30-day mortality after TAE were not significantly different between the empiric and identifiable TAE groups. A high rate of technical and clinical success was obtained with empiric TAE comparable to identifiable TAE in patients with massive bleeding from duodenal ulcers. There were no severe complications. Empiric TAE is an effective and safe method when a bleeding site cannot determined by angiography. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  4. Transcatheter Potts shunt creation in patients with severe pulmonary arterial hypertension: initial clinical experience.

    Science.gov (United States)

    Esch, Jesse J; Shah, Pinak B; Cockrill, Barbara A; Farber, Harrison W; Landzberg, Michael J; Mehra, Mandeep R; Mullen, Mary P; Opotowsky, Alexander R; Waxman, Aaron B; Lock, James E; Marshall, Audrey C

    2013-04-01

    Patients with severe pulmonary arterial hypertension (PAH) face significant morbidity and death as a consequence of progressive right heart failure. Surgical shunt placement between the left PA and descending aorta (Potts shunt) appears promising for PAH palliation in children; however, surgical mortality is likely to be unacceptably high in adults with PAH. We describe a technique for transcatheter Potts shunt (TPS) creation by fluoroscopically guided retrograde needle perforation of the descending aorta at the site of apposition to the left PA to create a tract for deployment of a covered stent between these vessels. This covered stent-anchored by the vessel walls and surrounding tissue-serves as the shunt. TPS creation was considered in 7 patients and performed in 4. The procedure was technically successful in 3 patients; 1 patient died during the procedure as a result of uncontrolled hemothorax. One acute survivor, critically ill at the time of TPS creation, later died of comorbidities. The 2 mid-term survivors (follow-up of 10 and 4 months) are well at home, with symptomatic improvement and no late complications. The 3 candidate patients in whom the procedure was not performed died within 1 month of consideration, underscoring the tenuous nature of this population. TPS creation is feasible and may offer symptomatic relief to select patients with refractory PAH. Further study of this innovative approach is warranted. Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  5. An experimental study on the influence of infusion speed on the early mechanism of embolic effect of arterially infused absolute Ethanol in the rat

    International Nuclear Information System (INIS)

    Han, Joon Koo; Kim, Woo Ho; Lee, Byung Hee; Park, Kil Sun; Park, Jae Hyung; Kim, Chu Wan; Han, Man Chung

    1990-01-01

    In order to clarify the early mechanism of action of the tissue necrosis induced by intraarterially infused absolute ethanol, abdominal aortography and histopathologic examination after absolute ethanol infusion into aorta at fast (0.4ml/sec) and slow speed (0.04ml/sec) were performed on 22 rats (2 controls, 7 in fast infusion group, 7 in slow infusion group, 3 in fast and 3 in slow infusion groups during aorta compression, respectively). Histopathologic features under the light and scanning electron microscope were correlated with the angiographic findings within 30 minutes after ethanol infusion. The results are as follows : 1. In fast infusion group, histopathologic examination of the kidney showed severe glomerular and tubular damage. Extensive damage on endothelial and medial layer was noted in arteries, and fresh thrombi originated from the damaged arterial wall were seen. 2. Angiographic findings in the fast infusion group were luminal irregularity and early obstruction of large arteries. And circulation time was prolonged. 3. In slow infusion group, histopathologic examination of the kidney showed focal area of severe glomerular and tubular damage on relatively normal background. Endothelial and muscular damage was noted in arteries, but the degree of the damage was less severe than that of the fast infusion group. 4. Angiographic findings in the slow infusion group were focal perfusion defect of the kidney, delayed circulation time, and mild luminal irregularity, but obstruction of the major arteries was not seen

  6. An experimental study on combined transcatheter hepatic arterial embolization and retrograde hepatic venous embolization

    International Nuclear Information System (INIS)

    Wang Maoqiang; Zhang Jinshan; Xing Zhanhai

    1997-01-01

    The experimental study is aimed at achieving the effect of hepatic tumor and tumor-bearing lobar or segmental resection by using combined transcatheter hepatic arterial embolization and retrograde hepatic venous embolization (THAE-RHVE) in experimental study. THAE-RHVE was carried out in 8 mongrel dogs. Hepatic arterial embolization was performed by injecting lipiodol followed by gelatin sponge particles, following complete occlusion of the hepatic vein with balloon catheter. Retrograde hepatic venous embolization (RHVE) was then performed by injecting a mixture of absolute ethanol and meglumini diatrizoatis (MD) via the inflated balloon catheter. Ethanol and MD were combined with a ratio of 1:1. RHVE alone was performed in 4 dogs as control. The animals were followed up for 1∼8 weeks with liver function test, CT, gross and microscopic examinations. There was no technical failure or procedural complications. Transient elevation of AST and ALT levels was seen immediately in both groups after the procedure. Follow-up CT after 3 weeks showed dense lipiodol accumulation in the embolized lobe or segment and the corresponding portal branches in the THAE-RHVE animals. At 1 week after THAE-RHVE, complete coagulation necrosis was seen at histologic examination in the embolized lobe. The hepatic vein and portal branches of the embolized area had thickened walls and were filled with thrombus. At 2 weeks, granulomatous tissue and inflammatory cell infiltration surrounding the necrotic area could be seen. At 4∼8 weeks, marked atrophy of the embolized lobe was found, and the necrotic area was progressively reducing in size and being replaced by fibrosis. In the control group, incomplete segmental coagulated necrosis was seen and the necrosis area wa smaller than that of THAE-REVE. Hepatic lobectomy or segmentectomy can be achieved with THAE-RHVE. This new method is safe and easy, and may be useful in the treatment of HCC

  7. Transcatheter arterial embolization for endoscopically unmanageable non-variceal upper gastrointestinal bleeding.

    Science.gov (United States)

    Lee, Han Hee; Park, Jae Myung; Chun, Ho Jong; Oh, Jung Suk; Ahn, Hyo Jun; Choi, Myung-Gyu

    2015-07-01

    Transcatheter arterial embolization (TAE) is a therapeutic option for endoscopically unmanageable upper gastrointestinal (GI) bleeding. We aimed to assess the efficacy and clinical outcomes of TAE for acute non-variceal upper GI bleeding and to identify predictors of recurrent bleeding within 30 days. Visceral angiography was performed in 66 patients (42 men, 24 women; mean age, 60.3 ± 12.7 years) who experienced acute non-variceal upper GI bleeding that failed to be controlled by endoscopy during a 7-year period. Clinical information was reviewed retrospectively. Outcomes included technical success rates, complications, and 30-day rebleeding and mortality rates. TAE was feasible in 59 patients. The technical success rate was 98%. Rebleeding within 30 days was observed in 47% after an initial TAE and was managed with re-embolization in 8, by endoscopic intervention in 5, by surgery in 2, and by conservative care in 12 patients. The 30-day overall mortality rate was 42.4%. In the case of initial endoscopic hemostasis failure (n = 34), 31 patients underwent angiographic embolization, which was successful in 30 patients (96.8%). Rebleeding occurred in 15 patients (50%), mainly because of malignancy. Two factors were independent predictors of rebleeding within 30 days by multivariate analysis: coagulopathy (odds ratio [OR] = 4.37; 95% confidence interval [CI]: 1.25-15.29; p = 0.021) and embolization in ≥2 territories (OR = 4.93; 95% CI: 1.43-17.04; p = 0.012). Catheterization-related complications included hepatic artery dissection and splenic embolization. TAE controlled acute non-variceal upper GI bleeding effectively. TAE may be considered when endoscopic therapy is unavailable or unsuccessful. Correction of coagulopathy before TAE is recommended.

  8. Intra-arterial infusion of prostaglandin E1 in normal subjects and patients with peripheral arterial disease

    DEFF Research Database (Denmark)

    Nielsen, P E; Nielsen, S L; Holstein, P

    1976-01-01

    Acute vasodilatation was produced by infusion of prostaglandin E1 (PGE1) in the femoral artery in 6 patients with occlusive arterial disease of the legs and in 3 normal subjects. The effect on blood flow and on blood pressure was measured at different segments of the leg with the strain gauge...

  9. Clinical assessment of first pass radionuclide ventriculography after dipyridamole infusion in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Kanaya, Tohru; Tono-oka, Ichiro; Satoh, Satoshi; Yamaguchi, Yoshiko; Hoshi, Hikaru; Ikeda, Kozue; Tsuiki, Kai; Yasui, Shoji; Komatani, Akio

    1986-01-01

    First pass radionuclide ventriculography (RNV) was performed after dipyridamole (D) infusion in 33 patients with coronary artery disease (CAD) and 15 normal volunteers. RNV findings after D infusion were compared with those of conventional exercise RNV and body surface ECG mapping (MAP). For patients with multiple vessel disease, left ventricular ejection fraction (LVEF) was significantly lower after D infusion than at rest. Wall motion abnormality (WMA) sites induced by D infusion were well coincident with those induced by exercise. Pressure rate product at exercise was significantly higher than that after D infusion, suggesting the different mechanism of the occurrence of WMA after D infusion and at exercise. The incidence of ischemic reaction tended to be higher after D infusion than at exercise in 25 patients with CAD. There was negative correlation between ST depression on MAP after D infusion and LVEF on RNV after D infusion. This RNV after D infusion can be used as a supplement tool to conventional exercise RNV in the evaluation of the degree of coronary artery lesions and preserved left ventricular function. (Namekawa, K.)

  10. Main Bile Duct Stricture Occurring After Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Miyayama, Shiro; Yamashiro, Masashi; Okuda, Miho; Yoshie, Yuichi; Nakashima, Yoshiko; Ikeno, Hiroshi; Orito, Nobuaki; Notsumata, Kazuo; Watanabe, Hiroyuki; Toya, Daisyu; Tanaka, Nobuyoshi; Matsui, Osamu

    2010-01-01

    The purpose of this study was to evaluate the clinical course of main bile duct stricture at the hepatic hilum after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Among 446 consecutive patients with HCC treated by TACE, main bile duct stricture developed in 18 (4.0%). All imaging and laboratory data, treatment course, and outcomes were retrospectively analyzed. All patients had 1 to 2 tumors measuring 10 to 100 mm in diameter (mean ± SD 24.5 ± 5.4 mm) near the hepatic hilum fed by the caudate arterial branch (A1) and/or medial segmental artery (A4) of the liver. During the TACE procedure that caused bile duct injury, A1 was embolized in 8, A4 was embolized in 5, and both were embolized in 5 patients. Nine patients (50.0%) had a history of TACE in either A1 or A4. Iodized oil accumulation in the bile duct wall was seen in all patients on computed tomography obtained 1 week later. Bile duct dilatation caused by main bile duct stricture developed in both lobes (n = 9), in the right lobe (n = 3), in the left lobe (n = 4), in segment (S) 2 (n = 1), and in S3 (n = 1). Serum levels of alkaline phosphatase and γ-glutamyltranspeptidase increased in 13 patients. Biloma requiring drainage developed in 2 patients; jaundice developed in 4 patients; and metallic stents were placed in 3 patients. Complications after additional TACE sessions, including biloma (n = 3) and/or jaundice (n = 5), occurred in 7 patients and were treated by additional intervention, including metallic stent placement in 2 patients. After initial TACE of A1 and/or A4, 8 patients (44.4%), including 5 with uncontrollable jaundice or cholangitis, died at 37.9 ± 34.9 months after TACE, and 10 (55.6%) have survived for 38.4 ± 37.9 months. Selective TACE of A1 and/or A4 carries a risk of main bile duct stricture at the hepatic hilum. Biloma and jaundice are serious complications associated with bile duct strictures.

  11. Preoperative Transcatheter Selective Arterial Chemoembolization in Treatment of Unresectable Hepatoblastoma in Infants and Children

    International Nuclear Information System (INIS)

    Li Jiaping; Chu Jianping; Yang Jianyong; Chen Wei; Wang Yu; Huang Yonghui

    2008-01-01

    The purpose of this study was to evaluate the clinical feasibility and efficacy of transcatheter selective arterial chemoembolization (TACE) for unresectable hepatoblastoma in infants and children. The study was performed with the approval of our institutional review board. Sixteen patients (13 boys, 3 girls) with unresectable hepatoblastoma were treated one to three times with preoperative TACE in an effort to improve the surgical and clinical outcome. Their ages ranged from 50 days to 60 months, with a mean age of 20.4 months. All cases were pathologically proved hepatoblastoma by fine-needle biopsy. After an intra-arterial catheter was selectively inserted into the main feeding artery of the tumor, cycles of cisplatin (40 to 50 mg/m 2 ) and adriamycin (20 to 30 mg/m 2 ) mixed with lipiodol were given, followed by gelatin foam particles or stainless-steel coils. Tumor response was evaluated according to tumor shrinkage, α-fetoprotein (AFP) levels, and pathological findings. TACE procedure was performed one to three times, depending on the patient's response. Surgical resection was carried out when the tumor volume appeared sufficiently reduced to allow safe resection by either lobectomy or extended lobectomy. A marked reduction in tumor size associated with decreased AFP level occurred after treatment. According to paired-samples test, tumor shrinkage ranged from 19.0% to 82.0%, with a mean value of 59.2%. AFP levels decreased 99.0% to 29.0% from initial levels, with a mean decrease of 60.0%. TACE allowed subsequent complete surgical resection in 13 cases and the other 3 cases underwent partial resection. One patient underwent successful orthotopic liver transplantation after receiving TACE therapy. Pathological examination showed that the mean percentage of necrotic area in the surgical specimens was 87%. Overall survival rate at 1, 3, and 5 years was 87.5%, 68.7%, and 50%, respectively. Correspondingly, event-free survival rate was 75%, 62.5%, and 43

  12. Computed tomographic and ultrasonographic evaluations of efficacy of transcatheter arterial embolization therapy for hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Horiguchi, Yuji; Ohsuki, Masao; Kitano, Tohru; Taguchi, Hiroko; Yamauchi, Masahiro; Itoh, Madoka

    1984-12-01

    Transcatheter arterial embolization (TAE) was performed in 50 patients with hepatocellular carcinoma, using gelatin sponge soaked with carcinostatics. The efficaciy of this therapy was evaluated by changes of serum AFP, computed tomogram (CT) and ultrasonogram(US), pathological findings, and survival rate. The most characteristic changes in CT image after TAE were decrease in attenuation value and gas-formation in the tumor. Early change after TAE was classified into 3 types, i. e. type 1; low density area with round and clear margin, type 2; low density area with irregular and obscure margin, and type 3; slightly low density area. Recurrence of tumor within 3 months was seen in only 16.7% out of 22 cases showing type 1, in contrast with 84.6% in the second type of 26. Serial CT during more than 6 months revealed that regrowing of the the tumor into necrotized lesion occured in 77.8% of type 2, in contrast with 20% of type 1. Survival rate of type 1 and type 2 was 80% and 66.7%, respectively. Therefore, it was considered that CT was valuable in detection of recurrence in the primary lesion, but nearly useful in evaluation of extracapsular extension as well as US. Serial US of most effective cases of 8 showed the decrease in echogenicity early after TAE, gradual elevation of the interior echo-level after about 3 months and change to strong echo with acoustic shadow more than 6 months later. On the other hand, the re-elevation of echo-level was not observed in recurrent cases. The effectiveness of TAE seemed to be dominated by the charactors of the tumor such as encapsulation, tumor size and invasion into the portal vein. (author).

  13. Comparison of survival rates among different treatment methods of transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Yong Woon; Lee, Jong Tae; Yoo, Hyung Sik; Lee, Do Yun; Jun, Pyoung Jun; Chang, So Yong [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-06-01

    To compare the survival rates of patients with hepatoma using different methods of transcatheter arterial chemoemblization(THAE). Four hundred and eighty three patients with hepatoma diagnosed by biopsy, serum alpha-fetoprotein, abdominal CT scan, abdominal ultrasonography or hepatic angiography were included, but not all had received surgical treatment. They were divided onto two groups according to Child's classification and into subgroups according to different methods of THAE. Five-tear survival rates among these groups were retrospectively compared. The patients were aged between 24 and 85(mean, 58) ; male to female ratio was 324 : 61 for those who received THAE (369 : 87 when only hepatic angiography was considered.). In the group with more than a single episode of chemoembolization, regardless of Child's classification, a better survival rate compared to the other groups with or without concommitant radiotherapy or without chemoembolization was noted. There was no difference in the survival rate of patients with multiple chemoembolization. moreover, no difference in this rate was observed no matter what chemotherapeutic agents, including Adriamycin, Cis-Diaminedichloroplatinum of I-131-Lipiodol, were used. Amortization by gelfoam in conjuction with Adriamycin resulted in no difference in survival rate regardless of frequency of chemoembolization. An improved survival rate was seen when multiple episodes of chemoembolization were applied, but no difference was seen when there was concomitant application of either gelfoam or radiotherapy. Two different chemotherapeutic agents, Adriamycin and Cis-Diaminedichloroplatinum, were used, but there was no difference between them in their effect on survival rates.

  14. Percutaneous microwave coagulation therapy combined with transcatheter arterial chmoembolization for hepatocellular carcinoma: preliminary results

    International Nuclear Information System (INIS)

    Won, Yoo Dong; Hahn, Seong Tai; Chung, Kyu Won; Park, Seog Hee

    2000-01-01

    To evaluate the efficacy of percutaneous microwave coagulation therapy (PMCT) combined with transcatheter arterial chemoemboization (TACE) for the treatment of hepatocellular carcinoma (HCC). Twenty-five nodular HCCs (long diameter of 1.2-10 (mean, 3.4) cm) in 19 patients (15 males and 4 females) were treated by PMCT 4-138 days after TACE. Under ultrasound guidance, the carcinoma were punctured with a 14-G guideneedle through which a microwave electrode (25.0 cm in length, 1.6 mm in diameter) was inserted. To coagulate the HCCs and surrounding hepatic parenchyma, microwave irradiation at 60W for 45-60 seconds was then applied. One to three sessions of PMCT were performed at intervals of 2-6 days, and one week to 29 months later, the therapeutic effect was evaluated by spiral CT, angiography, and serum alpha-fetoprotein. Eighteen of 25 HCCs (72.0%) were necrotized completely, but seven (28.0%) recurred. Ninety percent of HCCs smaller than 4 cm in long diameter showed complete remission, but all those larger than 4 cm recurred. Alpha-fetoprotein levels decreased markedly in five patients (26.3 %), while in 12 (63.2%), asparate aminotransferase (AST)/alanine aminotransferase (ALT) showed transient elevation. Minor complications occurred after PMCT (mild abdominal pain in 8 patients, fever in 7, pleural effusion in 3, portal vein thrombosis in 1, and hepatic abscess in 1), but in no case was this serious. PMCT combined with TACE provides effective and safe treatment for nodular HCCs with a long diameter of less than 4 cm. (author)

  15. Percutaneous microwave coagulation therapy combined with transcatheter arterial chmoembolization for hepatocellular carcinoma: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Won, Yoo Dong; Hahn, Seong Tai; Chung, Kyu Won; Park, Seog Hee [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2000-10-01

    To evaluate the efficacy of percutaneous microwave coagulation therapy (PMCT) combined with transcatheter arterial chemoemboization (TACE) for the treatment of hepatocellular carcinoma (HCC). Twenty-five nodular HCCs (long diameter of 1.2-10 (mean, 3.4) cm) in 19 patients (15 males and 4 females) were treated by PMCT 4-138 days after TACE. Under ultrasound guidance, the carcinoma were punctured with a 14-G guideneedle through which a microwave electrode (25.0 cm in length, 1.6 mm in diameter) was inserted. To coagulate the HCCs and surrounding hepatic parenchyma, microwave irradiation at 60W for 45-60 seconds was then applied. One to three sessions of PMCT were performed at intervals of 2-6 days, and one week to 29 months later, the therapeutic effect was evaluated by spiral CT, angiography, and serum alpha-fetoprotein. Eighteen of 25 HCCs (72.0%) were necrotized completely, but seven (28.0%) recurred. Ninety percent of HCCs smaller than 4 cm in long diameter showed complete remission, but all those larger than 4 cm recurred. Alpha-fetoprotein levels decreased markedly in five patients (26.3 %), while in 12 (63.2%), asparate aminotransferase (AST)/alanine aminotransferase (ALT) showed transient elevation. Minor complications occurred after PMCT (mild abdominal pain in 8 patients, fever in 7, pleural effusion in 3, portal vein thrombosis in 1, and hepatic abscess in 1), but in no case was this serious. PMCT combined with TACE provides effective and safe treatment for nodular HCCs with a long diameter of less than 4 cm. (author)

  16. Predisposing Factors of Liver Necrosis after Transcatheter Arterial Chemoembolization in Liver Metastases from Neuroendocrine Tumor

    Energy Technology Data Exchange (ETDEWEB)

    Joskin, Julien, E-mail: j.joskin@gmail.com; Baere, Thierry de, E-mail: Thierry.DEBAERE@igr.fr [Institut Gustave Roussy, Department of Interventional Radiology (France); Auperin, Anne, E-mail: Anne.AUPERIN@igr.fr [Institut Gustave Roussy, Department of Epidemiology (France); Tselikas, Lambros, E-mail: lambros.tselikas@gmail.com; Guiu, Boris, E-mail: boris.guiu@chu-dijon.fr; Farouil, Geoffroy, E-mail: g.farouil@gmail.com [Institut Gustave Roussy, Department of Interventional Radiology (France); Boige, Valérie, E-mail: boige@igr.fr; Malka, David, E-mail: david.malka@igr.fr [Institut Gustave Roussy, Department of Digestive Oncology (France); Leboulleux, Sophie, E-mail: sophie.leboulleux@igr.fr [Institut Gustave Roussy, Department of Nuclear Medicine and Endocrine Oncology (France); Ducreux, Michel, E-mail: ducreux@igr.fr [Institut Gustave Roussy, Department of Digestive Oncology (France); Baudin, Eric, E-mail: baudin@igr.fr [Institut Gustave Roussy, Department of Nuclear Medicine and Endocrine Oncology (France); Deschamps, Frédéric, E-mail: frederic.deschamps@igr.fr [Institut Gustave Roussy, Department of Interventional Radiology (France)

    2015-04-15

    PurposeTo investigate predictive factors for liver necrosis after transcatheter arterial chemoembolization (TACE) of neuroendocrine liver metastases.MethodsA total of 164 patients receiving 374 TACE were reviewed retrospectively to analyze predictive factors of liver necrosis. We analyzed patient age and sex; metastasis number and location; percentage of liver involvement; baseline liver function test; and pretreatment imaging abnormalities such as bile duct dilatation (BDD), portal vein narrowing (PVN), and portal vein thrombosis (PVT). We analyzed TACE technique such as Lipiodol or drug-eluting beads (DEB) as the drug’s vector; dose of chemotherapy; diameter of DEB; and number, frequency, and selectivity of TACE.ResultsLiver necrosis developed after 23 (6.1 %) of 374 TACE. In multivariate analysis, DEB > 300 μm in size induced more liver necrosis compared to Lipiodol (odds ratio [OR] 35.20; p < 0.0001) or with DEB < 300 μm in size (OR 19.95; p < 0.010). Pretreatment BDD (OR 119.64; p < 0.0001) and PVT (OR 9.83; p = 0.030) were predictive of liver necrosis. BDD or PVT responsible for liver necrosis were present before TACE in 59 % (13 of 22) and were induced by a previous TACE in 41 % (9 of 22) of cases.ConclusionDEB > 300 μm in size, BDD, and PVT are responsible for increased rate of liver necrosis after TACE. Careful analysis of BDD or PVT on pretreatment images as well as images taken between two courses can help avoid TACE complications.

  17. Transcatheter arterial chemoembolization of hepatocellular carcinoma with ethanol and iodized-oil emulsion

    International Nuclear Information System (INIS)

    Xiao Enhua; Hu Guodong; Li Jinqing

    2005-01-01

    Objective: To evaluate the effect of transcatheter arterial chemoembolization using ethanol and iodized-oil emulsion (TACE-EIOE) on prognosis of patients with hepatocellular carcinoma (HCC). Methods: Eighteen patients with histologically-proven HCC were underwent TACE-EIOE. The extent of apoptosis was analyzed by terminal deoxynucleotidy transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) staining. The expressions of Bcl-2, Bax, p53, Ki-67 and PCNA proteins were detected by immunohistochemical method. Changes of these markers, tumor necrosis, encapsulation, volume, cumulative survival were analyzed. Results: Complete tumor necrosis was 33.33% (6/18), severe tumor necrosis was 44.44% (8/18), moderate tumor necrosis was 5.56% (1/18), lesser tumor necrosis was 16.67% (3/18). Apoptosis rate was (22.79 ±3.34)%. Complete encapsulation was 88.89% (16/18). Evident volume-lessening was 66.67% (12/18), partial volume-lessening was 22.22% (4/18), and stable volume was 11.11% (2/18). Ki-67, PCNA, p53, Bcl-2, and Bax were (30.93±18.10)%, (41.16±11.83)%, (53.41±18.13)%, (6.32±2.10)%, and (58.73±17.32)%, respectively. The cumulative 1-, 2-, and 3-year survival rates were 83.33%, 72.22%, and 66.67% for patients, respectively. Conclusions: The preoperative TACE-EIOE is safe, it might benefit patients with HCC. (authors)

  18. Intra-arterial and intraportal infusion liver scintigraphy using 99mTc-labeled colloid

    International Nuclear Information System (INIS)

    Inoue, Yusuke; Ohtake, Tohru; Momose, Toshimitsu; Watanabe, Toshiaki; Kosaka, Noboru; Nishikawa, Jun-ichi; Sasaki, Yasuhito; Sawada, Toshio; Muto, Tetsuichiro

    1991-01-01

    Intra-arterial infusion liver scintigraphy was performed in 11 patients with primary or metastatic liver tumor. and intraportal infusion liver scintigraphy was performed in 6 patients for prophylaxis of liver metastasis from colorectal cancer. 99m Tc-Sn colloid or 99m Tc-phytate was administered through the catheter of which tip was placed in the portal vein or the hepatic artery, and then liver image was obtained. When 99m Tc-phytate was infused intra-arterially, significant amount of the infused tracer passed through the liver and we could not get sufficient information to assess the distribution of drug administered through the catheter. On the other hand, intraportal infusion liver scintigraphy using 99m Tc-Sn colloid or 99m Tc-phytate and intra-arterial infusion liver scintigraphy using 99m Tc-Sn colloid revealed heterogenity of liver uptake, tracer uptake in spleen, low uptake area corresponding to the liver tumor and high uptake area around it. The findings will be clinically useful, and these methods are thought to be helpful to confirm the satisfactory drug distribution. (author)

  19. Hepatocellular carcinoma after transcatheter arterial chemoembolization: difficulties on imaging follow-up

    International Nuclear Information System (INIS)

    Yu, Jeong Sik

    2005-01-01

    Due to the narrow surgical indications for hepatocellular carcinoma (HCC) in the cirrhotic liver with decreased liver function, transcatheter arterial chemoembolization (TACE) has been generally performed in the worldwide institutions for the curative or palliative treatment of this tumor. In the majority of the cases, however, the tumors are not completely necrotized, and the recurrence rate after TACE is still high even for the patients who have received curative TACE for grossly uncomplicated localized lesions. Thus, on the follow-up imaging studies after TACE, accurate diagnosis of a residual or locally recurrent tumor is crucial and this can facilitate successful management at an early stage of the disease so as to avoid more complicated or advanced disease that has an unfavorable prognosis. Multiphase dynamic CT, including the pre-contrast phase, the arterial phase and the more delayed phase imaging, is popularly used for evaluating the therapeutic effect of TACE because the degree of uptake and the distribution of the iodized oil within the tumor and the surrounding hepatic parenchyma can provide useful information on the degree of tumor necrosis, and so a strategy can be planned for the subsequent therapeutic approach. The article by Jang et al. in this issue of the Korean Journal of Radiology is one of the studies that have assessed the diagnostic ability of multiphase dynamic CT to depict a viable tumor in HCC treated with TACE. In that study, a review of the previous serial CT images provided more accurate information for the determination of the viability of the lesion than did a review of the last CT alone in several cases that were roughly verified by subsequent pathological review of the resected specimens. The overall false positive interpretation rate for the totally necrotic tumors was just 3%; however, false negative interpretation for viable tumors was 22%, which was still too high to get reliable results with using the serial follow-up CT as

  20. Detection of the origin of the cystic artery during transcatheter arterial embolization of hepatocellular carcinomas. Comparison of cone beam CT and digital subtraction angiography

    International Nuclear Information System (INIS)

    Hashizume, Takashi; Honda, Minoru; Seino, Noritaka; Gokan, Takehiko; Hashimoto, Toshi

    2009-01-01

    In this study, we retrospectively compared the usefulness of cone beam CT (CBCT) with that of digital subtraction angiography (DSA) in the identification of the origin of the cystic artery during arterial embolization for hepatocellular carcinoma. Subjects were sixty-four patients who underwent transcatheter arterial embolization (TAE) for hepatocellular carcinoma, in whom both CBCT and DSA were performed. Two radiologists independently examined CBCT and DSA images, and attempted to identify the origin of the cystic artery in each image. For DSA, en face views were reviewed on the monitor. For CBCT, 5 mm thick horizontal sections were generated using Workstation software, and the MPR (multi-planner reconstruction) method was used for coronary sections. These were then investigated with OsiriX. Of the sixty-four patients, the cystic arterial origin could be identified using DSA in 21 (32.8%) and CBCT in 62 (96.8%). The cystic artery was shown to originate in the proper, right, middle, and left hepatic artery in one, 58, two, and one patient, respectively. These results show that CBCT was more useful than DSA for identifying cystic arterial origin. Therefore CBCT should be positively applied during TAE. (author)

  1. The study of correlation between HBV genotype and the response to transcatheter arterial chemoembolization therapy in hepatocellular carcinoma patients

    International Nuclear Information System (INIS)

    Huang Keyao; Yang Weizhu; Jiang Na; Zheng Qubing

    2004-01-01

    Objective: To evaluate the influence of hepatitis B virus(HBV) genotype on response to transcatheter arterial embolization therapy in patients with HBV-related HCC. Methods: Transcatheter arterial chemoem-bolization therapy was conducted in patients with HBV-related HCC and response to embolization therapy were observed according to the tumor necrosis rate, the HCC recurrence rate, the cumulative incidence of survival rate and the change of AFP. The HBV genotype was determined by sequencing directly the polymerase chain reaction products of the HBV S gene. The response of HCC to embolization therapy was compared between patients who were infected with different genotypic HBV. Results: The tumor necrosis rate of genotype C patients was similar to that of genotype B patients (P=0.099). The HCC recurrence rate of genotype B was lower than that of genotype C patients (P=0.036). The cumulative incidence of survival rates of 2 and 3 years were significantly higher in the genotype B patients (P=0.036 and P=0.013). There was no difference between the two genotypes, patients in the change of AFP (P>0.05). Conclusions: HBV genotype B patients seem to have a better response to embolization therapy as compared to genotype C patients. Determination of HBV genotype may be useful in predicting the outcomes of TACE therapy in HBV-related HCC. (authors)

  2. Effect of preoperative S-1 combined with regional transcatheter arterial chemoembolization on malignant degree of locally advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Ru-Juan Xu

    2016-07-01

    Full Text Available Objective: To study the effect of preoperative S-1 combined with regional transcatheter arterial chemoembolization on malignant degree of locally advanced gastric cancer. Methods: A total of 134 patients who were diagnosed with advanced gastric cancer in our hospital from May 2012 to December 2014 were selected for study, received surgical resection after chemotherapy, and were divided into intravenous chemotherapy group and combined treatment group according to different chemotherapy regimens. After chemotherapy and before operation, serum tumor marker levels were detected; after operation, recurrence and metastasis-related molecule levels in tumor tissue were detected. Results: After chemotherapy and before operation, serum CEA, CA199, CA72-4, TSGF, ESM-1 and DKK-1 levels of combined treatment group were significantly lower than those of intravenous chemotherapy group; TET1, TET2, LATS1 and RUNX3 levels in tumor tissue of combined treatment group were higher than those of intravenous chemotherapy group while Sipa1, GOLPH3, AEP, MT2- MMP, OPN, Galectin-1, Galectin-3 and Galectin-9 levels were lower than those of intravenous chemotherapy group. Conclusions: Compared with systemic intravenous chemotherapy, preoperative S-1 combined with regional transcatheter arterial chemoembolization can more effectively kill gastric cancer cells and prevent tumor recurrence and metastasis at molecular level.

  3. Preoperative chemoradiotherapy using superselective intraarterial infusion via superficial temporal artery for stage III, IV oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tohnai, Iwai; Shigetomi, Toshio [Nagoya Univ. (Japan). Graduate School of Medicine; Hayashi, Yasushi [Nagoya Second Red Cross Hospital (Japan)] (and others)

    2002-03-01

    Thirty-eight patients with stage III, IV oral cancer were treated by preoperative chemoradiotherapy using superselective intraarterial infusion via the superficial temporal artery. Radiotherapy (total dose: 40 Gy) and chemotherapy using CBDCA (total dose: 460 mg/m{sup 2}) were performed daily, followed by surgery. Catheter-insertion of 34 patients was done successfully. Four catheter insertions were not done successfully because of the anomaly of the artery such as common trunk of the lingual artery and the facial artery. The clinical effects were CR in 9 patients (26.5%) and PR in 25 (73.5%), and histopathological effects after surgery were grade III, IV in 10 (29.4%), grade IIb in 23 (67.6%), and grade IIa in 2 (5.8%). The 5-year cumulative survival rate was 67.8%. This superselective intra arterial infusion method could be the technique of choice for the treatment of oral cancer. (author)

  4. Preoperative chemoradiotherapy using superselective intraarterial infusion via superficial temporal artery for stage III, IV oral cancer

    International Nuclear Information System (INIS)

    Tohnai, Iwai; Shigetomi, Toshio

    2002-01-01

    Thirty-eight patients with stage III, IV oral cancer were treated by preoperative chemoradiotherapy using superselective intraarterial infusion via the superficial temporal artery. Radiotherapy (total dose: 40 Gy) and chemotherapy using CBDCA (total dose: 460 mg/m 2 ) were performed daily, followed by surgery. Catheter-insertion of 34 patients was done successfully. Four catheter insertions were not done successfully because of the anomaly of the artery such as common trunk of the lingual artery and the facial artery. The clinical effects were CR in 9 patients (26.5%) and PR in 25 (73.5%), and histopathological effects after surgery were grade III, IV in 10 (29.4%), grade IIb in 23 (67.6%), and grade IIa in 2 (5.8%). The 5-year cumulative survival rate was 67.8%. This superselective intra arterial infusion method could be the technique of choice for the treatment of oral cancer. (author)

  5. Superselective uterine arterial infusion and embolization in the treatment of ectopic pregnancies of 56 cases

    International Nuclear Information System (INIS)

    Han Chaolin; Li Changfu; Zhang Yanhua; Liu Feng; Guan Yafang; Liu Zhen; Wang Weibo; Niu Haijuan

    2008-01-01

    Objective: To probe a simple, safe, and minimally invasive method to treat ectopic pregnancy with preservation of the organs. Methods: Superselective catheterization of uterine artery through cannulation of right femoral artery was achieved in 56 patients with ectopic pregnancy. Location of the lesions involved, feeding arteries, and active bleeding were observed on angiography. 150 mg of methylamine neopterin diluted in 100 ml of saline water was infused slowly into the target artery. Small gelatin spongy particles with size of 0.5 mm in diameter were used to embolize the uterine artery until its branches were totally obliterated. Follow-up was undertaken to observe the results of the treatment. Results: Superselective uterine arterial infusion and embolization were successfully performed in all 56 patients without any related complications. Active bleeding in the peritoneum in 33 eases ceased soon after embolization. The embryos in 13 patients were confirmed to have died by ultrasound two days after the procedure. Beta-HCG value dropped to below 5 U/L within two to twelve days. Hemorrhage in the peritoneum dissolved after seven days in all cases. Mixed mass disappeared after one month. Histerosalpingography was performed three months after the procedure in 19 patients and patent fallopians were demonstrated in 11 patients. Conclusions: Superselective uterine arterial infusion and embolization is a minimally invasive procedure, which can be used to effectively treat ectopic pregnancy by disabling the ectopic embryo and embolizing leaking arteries with the advantages of preserving the fallopian tubes. (authors)

  6. Clinical study on external carotid artery infusion (trans-femoral) treatment of recurrent nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Zhou Zejian; Li Chong; Luo Pengfei; Shao Peijian; Zhang Liangming; Li Weike; Li Yong; Xu Rongde; Zhuang Wenxing; Zhang Hua

    2002-01-01

    Objective: To evaluate the effect and safety of external carotid artery infusion treatment of recurrent nasopharyngeal carcinoma (NPC). Methods: 20 cases of recurrent NPC (13 male and 7 female, age 36-65 years, mean 50 years) diagnosed by clinical examination (including nasopharyngoscope), serology (VCA-IgA) and imaging (CT, MR) and treated by external carotid artery infusion (trans-femoral) with adriamycin (or epi-adriamycin), cisplatin (or carboplatin), Pingyangmycin and 5-Fluorouracil. Results: Of all the patients, 8 cases (40%) had a complete response (CR), 7 cases (35%) had a partial response (PR). The overall response rate (CR + PR) was 75%. Cumulative survival rates at 1, 3 years were 90% (18/20), 50%(10/20) respectively. No severe side-effects and complications found. Conclusion: External carotid artery infusion (trans-femoral) should be effective and safe in the treatment of recurrent NPC

  7. Effect of intra-hepatic arterial infusion chemotherapy for patients with liver metastasis from breast cancer

    International Nuclear Information System (INIS)

    Liu Dezhong; Li Huai; Zeng Huiying; Yang Ling

    2001-01-01

    Objective: To evaluate the efficacy of intra-hepatic arterial infusion chemotherapy for patients with liver metastasis from breast cancer. Methods: 1993-1998 years, Thirty four patients with liver metastasis from breast cancer had received epi-adriamycin, cisplatin, mitomycin and 5-fluorouracil by intrahepatic arterial infusion chemotherapy. Twelve patients had received embolization. Results: Six patients (17.65%) had a complete response, 12 patients (35.29%) had a partial response. The overall response rate was 52.94%. Cumulative survival rates at 1, 2, 3 and 4 years were 56.90%, 25.00%, 5.00% and 5.00% respectively (Kaplan-Meier method). The median overall survival time was 11.5 months. Conclusion: Intra-hepatic arterial infusion chemotherapy is safe and effective for liver metastasis from breast cancer and should be the first choice of treatment for these patients

  8. Switching the Loaded Agent from Epirubicin to Cisplatin: Salvage Transcatheter Arterial Chemoembolization with Drug-eluting Microspheres for Unresectable Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Seki, Akihiko; Hori, Shinich

    2012-01-01

    Purpose: There is no consensus on switching anticancer agents loaded onto drug carriers in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). This study aimed to evaluate the safety and clinical outcomes of TACE with cisplatin-loaded microspheres (CLM-TACE) in HCC patients refractory to TACE with epirubicin-loaded microspheres (ELM-TACE). Methods: Between February 2008 and June 2010, 85 patients with unresectable HCC refractory to ELM-TACE were enrolled to undergo CLM-TACE. The number of ELM-TACE sessions until judgment of resistance ranged from 1 to 4 (median, 2.1). CLM-TACE was performed using 50–100-μm superabsorbent polymer microspheres loaded with 1 mg cisplatin/1 mg microspheres together with hepatic arterial infusion of 25 mg cisplatin and 500 mg 5-fluorouracil per patient. Tumor responses were evaluated by computed tomography according to the European Association for the Study of the Liver criteria. Results: The median number of CLM-TACE treatment sessions was 1.8 (range, 1–5), and the mean total dose of cisplatin per session was 42.8 mg (range, 30.0–59.0). After 6 months, 3 (3.5%) patients achieved complete response, 31 (36.5%) had partial response, 15 (17.6%) had stable disease, and 36 (42.4%) had progressive disease. The median overall survival and time to treatment failure after initial CLM-TACE were 13.3 and 7.2 months, respectively. Overall, 9.4% of patients experienced grade 3/4 adverse events. Conclusions: witching the loaded agent from epirubicin to cisplatin is a safe, well-tolerated, and efficacious treatment strategy for salvage TACE with drug-eluting microspheres in HCC patients refractory to ELM-TACE.

  9. Intra-arterial urokinase infusion in the very early stage of cerebral artery occlusion and stenosis at their main trunks

    Energy Technology Data Exchange (ETDEWEB)

    Shizume, Kengo

    1988-02-01

    Eight patients, aged 43 approx. 78 years, with occlusion or stenosis of intracranial cerebral arteries at their main trunks were treated with intraarterial urokinase infusion within 5 hours after onset. Intracranial hemorrhage was excluded and low density area were absent on the first CT examination. Three of eight patients were diagnosed as embolism because of the sudden onset and coexisted atrial fibrillation. Middle cerebral artery (MCA) occlusion was disclosed in 5 cases. MCA stenosis, internal carotid artery (ICA) occlusion and ICA stenosis were revealed in each one case by angiography. 24 approx. 72 x 10/sup 4/ units of urokinase was infused manually into the common or internal carotid artery through the catheter for angiography within 10 approx. 50 minutes. Anticoagulants were not used exept in one case. Four patients were immediately improved after urokinase infusion and discharged without any significant sequelae. Patients with mild or moderate disability due to thrombosis recovered and those with severe symptoms due to embolism scarcely improved. The follow-up CT scans revealed hemorragic infarction in only one case (embolism of MCA), although symptoms did not deteriorate. After infusion of 48 x 10/sup 4/ units of urokinase for 50 minutes, fibrinogen and ..cap alpha../sub 2/-antiplasmin (..cap alpha../sub 2/ AP) decreased to 34 % and 21 % of the original values, respectively. Although the decrease of fibrinogen level is a disadvantage in this therapy, the decrease in the level of ..cap alpha../sub 2/ AP near the clot is probably indispensable for the fibrinolytic effect. If the endothelial damage of ischemic arteries still remain mild and reversible, hemorrhagic complication after reperfusion may rarely take place. It is suggested that intraarterial urokinase infusion is a relatively safe and effective therapy of cerebral artery occlusion and stenosis in strictly selected cases.

  10. Intra-arterial cis-diamminedichloroplatinum infusion treatment for widespread hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Park, Sung Il; Yang, Hee Chul; Lee, Do Yon; Shim, Yong Woon; Kim, Sang Heum; Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik

    1997-01-01

    The purpose of this study is to evaluate the therapeutic efficacy of intra-arterial infusion of Cis-diamminedichloroplatinum (C-DDP) for the treatment of hepatocellular carcinomas with widespread involvement. We retrospectively analyzed 22 patients who between July 1994 and June 1996 had undergone intra-arterial c-DDP infusion therapy for the treatment of hepatocellular carcinomas with widespread involvement. The hepatomas involved both lobes in ten, portal venous obstructions in fourteen, arterio-portal shunts in nine, and arterio-venous shunts in two. Proper hepatic artery was selected for infusion of 100 mg/BSA of C-DDP. The same procedure was repeated every 3 to 4 weeks, and the total number of infusions was 65. On the basis of WHO criteria, response was classified as complete remission, partial remission, stable, or progression of the disease. Six-month and one-year survival rates were estimated, and adverse reactions were evaluated. Although the response rate is not high, intra-arterial C-DDP infusion therapy can be used as an alternative treatment for hepatocellular carcinomas with widespread involvement; adverse reactions are tolerable. (author). 16 refs., 3 figs

  11. Chemoradiotherapy using retrograde superselective intra-arterial infusion for advanced oral cancer

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Iwai, Toshinori; Mitsunaga, Sachiyo

    2011-01-01

    Concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion demonstrates good local control and overall survival rates due to the advantage of simultaneous infusion of anticancer agent with the synergistic effects of chemotherapy and radiotherapy. This study evaluated the therapeutic results, overall survival and local control rates in patients with advanced oral cancer treated with definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. A total of 688 patients with carcinoma of the head and neck were referred to our institution between January 2001 and December 2006. Among them, 175 patients with carcinoma of the oral cavity underwent definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. Treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m 2 , cisplatin, total 125-150 mg/m 2 ) and daily concurrent radiotherapy (total 50-60 Gy) for 5-6 weeks. Four weeks after the completion of all treatments, patients underwent biopsy of the primary lesion and radiological examinations. Complete response (CR) of the primary site was achieved in 160 (91.4%) of the 175 patients. Residual disease at the primary site was seen in 15 patients (8.6%), and 14 patients (8.0%) showed local recurrence during follow-up. Five-year survival and local control rates were 71.6% and 82.2%, respectively. (author)

  12. Palliation of inoperable head and neck cancer: combined intra-arterial infusion chemotherapy and irradiation

    International Nuclear Information System (INIS)

    Armstrong, A.L.; Meeker, W.R.

    1978-01-01

    Palliation of unresectable head and neck cancer remains a difficult problem. Because of excellent results reported by others with infusion of vinblastine, methotrexate, and 5-fluorouracil into the external carotid artery followed by irradiation before curative surgery, we applied this technic to 22 patients with advanced head and neck cancer. Fifteen patients from this group who had chemotherapy infusion followed by radiation therapy are compared with 21 patients who received radiation therapy alone. Both groups were similar in distribution of primary site, histology, and TNM stage. Of 15 patients, 14 (93%) had partial or complete tumor regression after both arterial chemotherapy infusion and irradiation, while 14 of 17 patients (82%) receiving primary irradiation had partial or complete response. Drug toxicity and complications related to infusion occurred in all patients. Most patients in both groups had short survivals (mean of 14.1 months in infusion chemotherapy and radiation vs 9.1 months in primary irradiation). One patient remains alive in the infusion group and two in the control group; however, all have recurrent disease. Results indicate a slight increase in survival time with the addition of infusion chemotherapy to irradiation in palliative treatment of head and neck cancer

  13. [Clinical features and risk factors of biloma formation after transcatheter arterial chemoembolization].

    Science.gov (United States)

    Zhaolin, Zeng; Xuelian, Liu; Wensou, Huang; Mingyue, Cai; Haofan, Wang; Ming'an, Li; Hong, Shan; Zhu, Kangshun

    2015-04-07

    To explore the risk factors, treatment and outcomes of biloma after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). A total of 481 patients with a diagnosis of HCC underwent TACE at our hospital from January 2011 to December 2013. Biloma was tracked by the follow-ups of computed tomography or magnetic resonance imaging (CT/ MRI) . Retrospective analyses were conducted for their clinical features, treatments and prognosis. The statistically significant factors for univariate analysis were introduced into Logistic regression models for multivariate analysis to obtain the risk factors of biloma post-TACE. There were 43 cases of complicated biloma after TACE. And 38 patients (88.4% ) developed biloma at 0.5-3 months post-TACE while another 5 (9.7%) did so at 3-5 months. The multivariate analysis showed that bile duct dilation, a history of hepatectomy prior to TACE, use of polyvinyl alcohol (PVA) particles and nonsuperselective embolization were the risk factors of biloma formation after TACE. Among 9 symptomatics, there were jaundice (n =2) and fever (n =7). The diameter of bilomas was (8.07 ± 3.53) cm for 9 symptomatics and (2.81 ± 1.26) cm for 35 asymptomatics. And the difference was statistically significant (P <0. 01). Nine symptomatic patients underwent percutaneous drainage with tube and biloma diminished (n = 7) and even vanished (n = 2). Only conservative treatment was offered for 35 asymptomatics. During the follow-ups, it showed no change (n = 24) , diminishing (n = 8) and disappearance (n = 2). One case died from a greatly enlarged biloma due to hepatic failure and septic shock via a rupture into abdominal cavity and choleperitonitis. The risk factors of biloma formation after TACE for HCC are bile duct dilation, a history of hepatectomy before TACE, use of PVA particles and nonsuperselective embolization. For symptomatics, drainage must be performed timely and the prognosis is fair. For asymptomatics, regular imaging

  14. Transcatheter arterial chemoembolization combined with radiotherapy for the treatment of advanced cervical cancer

    International Nuclear Information System (INIS)

    Zhu Jun; Luo Jianjun; Zhang Wen; Huang Yong; Li Dengke; Cao Yueyong

    2010-01-01

    Objective: To discuss the clinical value of interventional transcatheter arterial chemoembolization (TACE) combined with subsequent pelvic radiotherapy in treating patients with advanced cervical cancer. Methods: According to the therapeutic scheme, 195 patients with phase IIb or beyond advanced cervical cancer were divided into two groups: (1) study group (n = 99), treated with TACE combined with subsequent pelvic radiotherapy (i.e. combination group); (2) control group(n = 96), treated with radiotherapy alone (i. e. radiotherapy alone group). The short-term and long-term clinical results as well as the occurrence of complications were compared between two groups. Results: Different degrees of the tumor shrinkage were found in patients of both groups after treatment. The short-term remission rate of the study group was significantly higher than that of the control group, and the difference between two groups was statistically significant (P = 0.012). After the procedure, the anaemia in patients of study group was markedly corrected. The difference in hemoglobin between preoperative levels and postoperative ones was significant (T-test, P < 0.01). Long-term follow-up for 3 years the survival rate of the study group was higher than that of the control group (P = 0.032). Both the recurrence rate and metastatic rate at one and three years after the therapy in the study group were distinctly lower than that in the control group (P < 0.05). No significant difference in one-year, five-year survival rate and in five-year recurrent rate existed between two groups. The main short-term complications included digestive untoward reaction, bone marrow depression, hepatic and renal toxicity, etc., which could be well relieved after active symptomatic medication. The long-term complications included radiodermatitis, radiocystitis and / or radioproctitis. The incidence of radiocystitis and radioproctitis in the study group was significantly lower than that in the control group (P

  15. Pilot Evaluation of Angiogenesis Signaling Factor Response after Transcatheter Arterial Embolization for Hepatocellular Carcinoma.

    Science.gov (United States)

    Ronald, James; Nixon, Andrew B; Marin, Daniele; Gupta, Rajan T; Janas, Gemini; Chen, Willa; Suhocki, Paul V; Pabon-Ramos, Waleska; Sopko, David R; Starr, Mark D; Brady, John C; Hurwitz, Herbert I; Kim, Charles Y

    2017-10-01

    Purpose To identify changes in a broad panel of circulating angiogenesis factors after bland transcatheter arterial embolization (TAE), a purely ischemic treatment for hepatocellular carcinoma (HCC). Materials and Methods This prospective HIPAA-compliant study was approved by the institutional review board. Informed written consent was obtained from all participants prior to entry into the study. Twenty-five patients (21 men; mean age, 61 years; range, 30-81 years) with Liver Imaging Reporting and Data System category 5 or biopsy-proven HCC and who were undergoing TAE were enrolled from October 15, 2014, through December 2, 2015. Nineteen plasma angiogenesis factors (angiopoietin 2; hepatocyte growth factor; platelet-derived growth factor AA and BB; placental growth factor; vascular endothelial growth factor A and D; vascular endothelial growth factor receptor 1, 2, and 3; osteopontin; transforming growth factor β1 and β2; thrombospondin 2; intercellular adhesion molecule 1; interleukin 6 [IL-6]; stromal cell-derived factor 1; tissue inhibitor of metalloproteinases 1; and vascular cell adhesion molecule 1 [VCAM-1]) were measured by using enzyme-linked immunosorbent assays at 1 day, 2 weeks, and 5 weeks after TAE and were compared with baseline levels by using paired Wilcoxon tests. Tumor response was assessed according to modified Response Evaluation Criteria in Solid Tumors (mRECIST). Angiogenesis factor levels were compared between responders and nonresponders by mRECIST criteria by using unpaired Wilcoxon tests. Results All procedures were technically successful with no complications. Fourteen angiogenesis factors showed statistically significant changes following TAE, but most changes were transient. IL-6 was upregulated only 1 day after the procedure, but showed the largest increases of any factor. Osteopontin and VCAM-1 demonstrated sustained upregulation at all time points following TAE. At 3-month follow-up imaging, 11 patients had responses to TAE

  16. Inferior phrenic artery embolization in the treatment of hepatic neoplasms

    International Nuclear Information System (INIS)

    Duprat, G.; Charnsangavej, C.; Wallace, S.; Carrasco, C.H.

    1988-01-01

    Twenty-nine inferior phrenic artery embolizations were performed in 20 patients with primary or metastatic hepatic neoplasms. All patients had interruption of their hepatic arteries by previous infusion of chemotherapy, hepatic arterial embolization or surgical ligation. In one patient, bilateral pleural effusions developed following embolization of the inferior phrenic artery. No other severe complications occurred. Inferior phrenic artery embolization is a safe procedure and permits the continuation of transcatheter treatment of hepatic neoplasms. (orig.)

  17. Inferior phrenic artery embolization in the treatment of hepatic neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Duprat, G.; Charnsangavej, C.; Wallace, S.; Carrasco, C.H.

    Twenty-nine inferior phrenic artery embolizations were performed in 20 patients with primary or metastatic hepatic neoplasms. All patients had interruption of their hepatic arteries by previous infusion of chemotherapy, hepatic arterial embolization or surgical ligation. In one patient, bilateral pleural effusions developed following embolization of the inferior phrenic artery. No other severe complications occurred. Inferior phrenic artery embolization is a safe procedure and permits the continuation of transcatheter treatment of hepatic neoplasms.

  18. Blunt renal trauma: comparison of contrast-enhanced CT and angiographic findings and the usefulness of transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Kitase, M.; Mizutani, M.; Tomita, H.; Kono, T.; Sugie, C.; Shibamoto, Y.

    2007-01-01

    Full text: Background: The purpose of this study was to evaluate the role of contrast-enhanced CT and the usefulness of super selective embolization therapy in the management of arterial damage in patients with severe blunt renal trauma. Patients and Methods: Nine cases of severe renal trauma were evaluated. In all cases, we compared contrast enhanced CT findings with angiographic findings, and performed transcatheter arterial embolization (TAE) in six of them with microcoils and gelatin sponge particles. Morphological changes in the kidney and site of infarction after TAE were evaluated on follow-up CT Chronological changes in blood biochemistry findings after injury, degree of anemia and renal function were investigated. Adverse effects or complications such as duration of hematuria, fever, abdominal pain, renovascular hypertension and abscess formation were also evaluated. Results: The CT finding of extravasation was a reliable sign of active bleeding and useful for determining the indication of TAE. In all cases, bleeding was effectively controlled with super selective embolization. There was minimal procedure-related loss of renal tissue. None of the patients developed abscess, hypertension or other complications. Conclusions: In blunt renal injury, contrast-enhanced CT was useful for diagnosing arterial hemorrhage. Arterial bleeding may produce massive hematoma and TAE was a useful treatment for such cases. By using selective TAE for a bleeding artery, it was possible to minimize renal parenchymal damage, with complications of TAE rarely seen. (author)

  19. Study on blood supply of lung metastasis with trans-pulmonary arterial lipiodol infusion

    International Nuclear Information System (INIS)

    Zhou Jianqin; Dong Weihua; Dong Weihua; Ouyang Chang; Chang Heng; Xiao Xiangsheng

    2008-01-01

    Objective: To evaluate the blood supply of pulmonary metastases using small volume of lipiodol through pulmonary arterial infusion. Methods: 10 cases of lung metastasis were enroled including the primary tumors of liver cancer (n=5), renal carcinoma (n=3), chordoma (n=1) and malignant neurofibroma (n=1). Plain CT scan was performed to exclude calcification or ossification within metastasis and then pulmonary arterial DSA was undertaken to evaluate tumor vessels or staining. After pulmonary arteriovenous fistula or other anomalous circulation was excluded by lobar arterial DSA, small volume of lipiodol was infused under fluoroscopy (0.5-1.5 ml for each lobar artery, total volume less than 3.0 ml). CT scan was immediately performed. Blood supply of the pulmonary metastases was assessed according to the accumulation of lipiodol on CT scans. Results: No cases but one experienced cough, expectoration, suffocating or dyspnea. No complication of cerebral or visceral embolism occurred. Totally 27 nodules were studied including 6 nodules with cloudy lipiodol accumulation and 6 nodules with tiny granules of lipiodol accumulation. No enlarged tumor vessel or tumor stain was observed within all 27 nodules on pulmonary arterial DSA. Conclusions: Pulmonary artery supplys only parts of pulmonary metastases, especially those sited at the peripheral region of the lung. Infusion of small volume of lipiodol through pulmonary artery is safe, and the increased density of lung field could return normal after several days. (authors)

  20. Giant liver hemangioma resected by trisectorectomy after efficient volume reduction by transcatheter arterial embolization: a case report

    Directory of Open Access Journals (Sweden)

    Akamatsu Nobuhisa

    2010-08-01

    Full Text Available Abstract Introduction Liver hemangiomas are the most common benign liver tumors, usually small in size and requiring no treatment. Giant hemangiomas complicated with consumptive coagulopathy (Kasabach-Merritt syndrome or causing severe incapacitating symptoms, however, are generally considered an absolute indication for surgical resection. Here, we present the case of a giant hemangioma, which was, to the best of our knowledge, one of the largest ever reported. Case presentation A 38-year-old Asian man was referred to our hospital with complaints of severe abdominal distension and pancytopenia. Examinations at the first visit revealed a right liver hemangioma occupying the abdominal cavity, protruding into the right diaphragm up to the right thoracic cavity and extending down to the pelvic cavity, with a maximum diameter of 43 cm, complicated with "asymptomatic" Kasabach-Merritt syndrome. Based on the tumor size and the anatomic relationship between the tumor and hepatic vena cava, primary resection seemed difficult and dangerous, leading us to first perform transcatheter arterial embolization to reduce the tumor volume and to ensure the safety of future resection. The tumor volume was significantly decreased by two successive transcatheter arterial embolizations, and a conventional right trisectorectomy was then performed without difficulty to resect the tumor. Conclusions To date, there have been several reports of aggressive surgical treatments, including extra-corporeal hepatic resection and liver transplantation, for huge hemangiomas like the present case, but because of its benign nature, every effort should be made to avoid life-threatening surgical stress for patients. Our experience demonstrates that a pre-operative arterial embolization may effectively enable the resection of large hemangiomas.

  1. Tracer measured substrate turnover requires arterial sampling downstream of infusion site

    International Nuclear Information System (INIS)

    Stanley, W.C.; Neese, R.A.; Gertz, E.W.; Wisneski, J.A.; Morris, D.L.; Brooks, G.A.

    1986-01-01

    Measurement of metabolite turnover (Rt) with radioactive tracers is done by either infusing tracer venously and sampling specific activity (SA) arterially (V-A modes), or by infusing into the aorta and sampling venous blood (A-V mode). Using the Fick principle, the necessity for using the V-A mode can be demonstrated. If tracer is infused into the left ventricle, in a steady state the Rt is the product of arterial trace concentration, the cardiac output, and the tracer extraction ratio for the whole body. This is expressed as: Rt = Ca x Qx ((*Ca - *Cv)/*Ca) (Eq1) where C=trace concentration (μmol/ml), *C=tracer conc. (dpm/ml), a=arterial, v-=mixed venous, and Q=cardiac output (ml/min). Rearranging the equation: Rt = Qx(*Ca - *Cv)/SAa = F/SAa (Eq2) where SAa is *Ca/Ca, and Qx (*Ca-*Cv) equals the infusion rate (F). The authors compared Eqs1 and 2 (Rt = F/SAa) in 3 anesthetized dogs in which [1- 14 C] lactate was infused into the left ventricle, and blood was sampled arterially downstream from the infusion site and in the pulmonary artery. Eqs 1 and 2 gave similar results for Rt (45.9 vs. 43.9 μmol/kg min), while substituting SAv for SAa (A-V mode) into Eq 2 gave a higher Rt (53.6). When SAv (A-V mode) is used, the specific activity seen by the tissues (SAa) is not considered in the calculation of Rt. Therefore, only the V-A mode meets the requirements for tracer measured metabolite turnover

  2. Intraarterial digital subtraction angiography in bronchogenic carcinoma treated with bronchial artery infusion

    International Nuclear Information System (INIS)

    Gao-Jun Teng; Xi-Lei Chai; Guang-Ru Gao; Cheng-Fong Chu; Xian-Guang Zhou; Zhu-Yi Zhang; Ru-Li Xiang

    1991-01-01

    Intra-arterial digital subtraction angiography (IADSA) has been used with advantage for control of the results of bronchial artery infusion of drugs for primarily unresectable bronchogenic carcinoma. The IADSA has been performed as road mapping prior to therapy. Drug treatment has been performed with 4 different regimes, depending on tumour type. Debulking and in some cases complete healing are the results, which are superior to other reported treatments. (author). 7 refs.; 4 figs.; 3 tabs

  3. Guide to intra-arterial infusion chemotherapy for pancreatic cancers (draft text)

    International Nuclear Information System (INIS)

    2012-01-01

    Pancreatic cancer is one of most malignant solid tumors. Trans-arterial infusion chemotherapy has been used for the inoperable pancreatic cancers. The local drug concentration in intra-arterial infusion chemotherapy is much higher than that in intravenous chemotherapy. Thus, a better therapeutic effect can be surely achieved, the disease-related symptoms can be well improved, the patient's survival time can be markedly prolonged, and the liver metastases can be effectively reduced. This paper aims to suggest a more detailed and standardized therapeutic scheme to perform intra-arterial infusion chemotherapy for inoperable pancreatic cancers, focusing on the relevant concept, contraindications, indications, preoperative preparation, methods of operation, postoperative treatment, the prevention and treatment of complications, etc. The scheme will help domestic interventional physicians to make reasonable decisions in their clinical practice. Of course, the scheme proposed here is not a mandatory standard, and it can not resolve all the problems which might be encountered in employing intra-arterial infusion chemotherapy for patients with inoperable pancreatic cancer. Therefore, the interventional physicians should fully understand the most useful medical evidence of a given patient and sincerely take the patient's own will into consideration before an individualized and reasonable therapeutic plan is able to be worked out. (authors)

  4. CT detection of daughter nodules in hepatocellular carcinoma after lipiodol infusion via the hepatic artery

    Energy Technology Data Exchange (ETDEWEB)

    Ohishi, Hajime; Ohgami, Syoichi; Katsuragi, Masami

    1985-02-01

    The detectability of daughter nodules in 80 hepatocellular carcinomas was compared between CT assisted by Lipiodol Ultra Fluid (Lipiodol) infused via the hepatic artery and IHA (Infusion hepatic angiography). Lipiodol infused via the hepatic artery was selectively accumulated in the tumor vessels and the tumors and small daughter nodules appeared as markedly high density areas by CT. 18 cases in which the daughter nodules were detected were identified only by CT. Furthermore, in 38 cases CT demonstrated superior detectability of the daughthr nodules than IHA. In 15 cases the daughter nodules were newly detected in areas other than the invaded area where the primary tumor existed. This method is very effective in the diagnosis of daughter nodules of hepatocellular carcinoma. (author).

  5. PACAP-38 infusion causes sustained vasodilation of the middle meningeal artery in the rat

    DEFF Research Database (Denmark)

    Bhatt, Deepak K; Gupta, Saurabh; Olesen, Jes

    2014-01-01

    BACKGROUND: In healthy human volunteers and in migraineurs, pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) infusion caused sustained vasodilation of the middle meningeal artery (MMA) and an immediate as well as a delayed headache. All the study subjects experienced facial flushing....... Mast cells (MCs) might have a role in the long-lasting effect of PACAP-38 infusion. We hypothesized that in mast cell-depleted (MCD) rats the vascular responses to PACAP-38 would be lesser than in control rats because of a lack of vasodilatory products released during MC degranulation. METHODS: MCs...... were depleted by chronic treatment with compound 48/80. The effect of 20 minutes' intravenous (i.v.) infusion of calcitonin gene-related peptide (CGRP), PACAP-38, PACAP(6-38) (PAC-1 receptor antagonist) and PACAP-27 on the diameter of the MMA and on mean arterial blood pressure (MABP) in control...

  6. Evaluation of transcatheter arterial chemoembolization combined with radiofrequency capacitive heating on clinical therapeutic effect of metastatic carcinoma

    International Nuclear Information System (INIS)

    Chen Qianli; Ye Qiang; Gu Weizhong; Zhang Jiazhong; Tong Qiangang; Xi Shunfa

    2006-01-01

    Objective: To evaluate clinical therapeutic efficacy and adverse efficacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency capacitive heating (RCH) for metastatic hepatic carcinoma (MHC). Methods: Thirty-nine cases of MHC were enrolled in this study and divided into two groups: study group (n=19) and control group (n=20). Before therapy, the Karnofsky's score of the patients was all beyond 60. Results: The carcinoma growth rate of the study group was -(0.38±0.22), while that of the control group was -(0.13±0.25), showing significant statistical difference (P 0.05). Conclusion: The therapeutic effect of MHC can be further improved by the treatment of TACE combined with radiofrequency capacitive heating without increase of adverse side effects. (authors)

  7. Transcatheter renal denervation for the treatment of resistant arterial hypertension: the Swiss expert consensus.

    Science.gov (United States)

    Wuerzner, Gregoire; Muller, Olivier; Erne, Paul; Cook, Stéphane; Sudano, Isabella; Lüscher, Thomas F; Noll, Georg; Kaufmann, Urs; Rickli, Hans; Waeber, Bernard; Kaiser, Christophe; Sticherling, Christian; Pechère-Bertschi, Antoinette; Baumgartner, Iris; Jacob, Augustinus L; Burnier, Michel; Qanadli, Salah D

    2014-03-20

    Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practice. The eligibility of patients for transcatheter renal denervation needs (1.) confirmation of truly resistant hypertension, (2.) exclusion of secondary forms of hypertension, (3.) a multidisciplinary decision confirming the eligibility, (4.) facilities that guarantee procedural safety and (5.) a long-term follow-up of the patients, if possible in cooperation with a hypertension specialist. These steps are essential until long-term data on safety and efficacy are available.

  8. Evaluation of the malignant degree of primary hepatocellular carcinoma after endostar combined with transcatheter arterial chemoembolization ( TACE treatment

    Directory of Open Access Journals (Sweden)

    Yong Zeng

    2018-01-01

    Full Text Available Objective: To analyze the malignant degree of primary hepatocellular carcinoma after endostar combined with transcatheter arterial chemoembolization (TACE treatment. Methods: A total of 68 cases of patients with primary hepatocellular carcinoma treated in our hospital from September 2011 to December 2014 were enrolled for study and divided into observation group 34 cases and control group 34 cases according to different treatment methods. Control group received transcatheter arterial chemoembolization (TACE treatment, observation group received endostar combined with TACE treatment, and then differences in serum amino acid levels, micro RNA levels, levels of GP73, GPC3, GS, etc as well as levels of ChE, TBA and AFP were compared between two groups after treatment. Results: Serum aspartic acid, leucine and arginine levels of observation group after treatment were higher than those of control group, and αα-aminoadipic acid, methionine, β-alanine and 3-methylhistidine levels were lower than those of control group; relative values of serum miR-106b, miR-222 and miR-21 expression of observation group after treatment were lower than those of control group, and relative values of miR-199a and miR-122 expression were higher than those of control group; GP73, IL-17, IL-6, GPC3, GS and HSP70 levels of observation group after treatment were lower than those of control group, and endostatin level was higher than that of control group; ChE level of observation group after treatment was higher than that of control group, and TBA and AFP levels were lower than those of control group. Conclusion: Endostar combined with TACE treatment for patients with primary hepatocellular carcinoma can effectively inhibit tumor proliferation, invasion and other malignant processes and improve liver function, and it has positive clinical significance.

  9. Transcatheter arterial embolisation in upper gastrointestinal bleeding in a sample of 29 patients in a gastrointestinal referral center in Germany.

    Science.gov (United States)

    Heining-Kruz, S; Finkenzeller, T; Schreyer, A; Dietl, K H; Kullmann, F; Paetzel, C; Schedel, J

    2015-09-01

    This is a retrospective analysis of interventional embolisation performed with catheter angiography in 29 patients with upper gastrointestinal bleeding in the setting of a secondary care hospital. From April 2007 to February 2013, 29 patients with upper gastrointestinal bleeding underwent endovascular diagnostics and treatment. The diagnosis was established by endoscopy, computed tomography or clinically based on a significant decrease in hemoglobin. Transcatheter arterial embolisation was performed with coils, liquid embolic agents, and particles. The technical and clinical outcomes were assessed by postinterventional endoscopy, hemoglobin concentrations, number of necessary transfusions, or surgical interventions, as well as by post-interventional mortality within 28 days after the procedure. Selective angiographic embolisation in upper gastrointestinal bleeding was primarily successful technically and clinically in 22 of 29 patients. In 4/29 cases an angiographic reintervention was performed, which was successful in 3 cases. In 3 cases of primarily technically unsuccessful procedures reintervention was not attempted. No catheterisation-related complications were recorded. Peri-interventional mortality was 31%, but only 2 of these patients died due to uncontrolled massive bleeding, whereas the lethal outcome in the other 7 patients was due to their underlying diseases. Transcatheter arterial embolisation is an effective and rapid method in the management of upper gastrointestinal bleeding. Radiological endovascular interventions may considerably contribute to reduced mortality in GI bleeding by avoiding a potential surgical procedure following unsuccessful endoscopic treatment. The study underlines the importance of the combination of interventional endoscopy with interventional radiology in secondary care hospitals for patient outcome in complex and complicated upper gastrointestinal bleeding situations. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Clinical observation of transcatheter arterial chemoembolization combined with sorafenib on intermediate-advanced hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Wei Zhaoguang; Lu Ligong; Shao Peijian; Hu Baoshan; Li Yong; Zhang Lei; He Xu; Yu Xianyi; Luo Xiaoning

    2012-01-01

    Objective: To evaluate the treatment effect and security of transcatheter arterial chemoembolization (TACE) combined with sorafenib for intermediate-advanced hepatocellular carcinoma. Methods: From July 2008 to November 2010,the treatment effects of two groups of patients with advanced hepatocellular carcinoma were retrospectively analyzed and compared, including 44 patients treated by sorafenib combined with TACE (test group) and the other 44 patients treated only with TACE (control group). To assess the treatment effect based on mRECIST, the time for patients' tumor progression (TTP), overall survival (OS) time and adverse events were recorded. Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis in SPSS 18.0. Results: Till January 2011, 24 patients (54.5%) survived and 20 patients (include patients lost to visit) died (45.5%) among the test group, 13 patients survived (29.5 %) and 31 patients (include patients lost to visit) died (70.5 %) among the control group. No complete remission condition was observed in all patients. Among the test group, 1 patient got partial remission, 24 ones remain stable and 19 patients got progression. While among the control group, conditions remained stable in 21 patients and progressed in rest 23 ones. The disease control rate (DCR) in the test group and control group were 56.8% (25/44) and 47.7% (21/44) respectively, with no statistical significance (χ 2 =0.729, P=0.393). The median overall survival time (mOS) of test group and control group were 21.0 (95% CI: 14.9-27.1)months and 10.0 (95% CI: 6.4-13.6) months respectively, and the difference reached statistical significance (χ 2 =7.436, P=0.006). The median time to tumor progression (mTTP) of test group and control group was 11.0 (95% CI: 8.7-13.3) and 6.0 (95% CI: 3.9-8.1) months respectively, and the difference had statistical significance (χ 2 =10.437, P=0.001). The adverse events of test group mainly included hand-foot skin reaction, loss of

  11. Combined intra-arterial infusion and radiotherapy for the head and neck tumors, 1

    International Nuclear Information System (INIS)

    Hattori, Takao

    1989-01-01

    A superselective insertion of a long-term retaining infusion catheter via superficial temporal artery was attempted in 77 patients with head and neck cancer treated between February 1984 and April 1988. It was successfully accomplished in 73 patients (95%). In 67 patients receiving the combination of radiotherapy, average durations of the catheter inserted into the maxillary, lingual, and facial arteries were 27, 31, and 29 days, respectively. Continuous arterial infusion chemotherapy was attained through the catheter. Possible complications of catheter insertion were as follows: local infection (5), blood clots inside the catheter (4), change in the tip of the catheter (3), spontaneous removal of the catheter (3), catheter injury (2), bleeding in the inserted area (one), and intimal injury (one). No other severe complications were observed. The superselective insertion of the catheter seemed to be superior to conventional method in view of its safety and accuracy. (Namekawa, K)

  12. Acute Superior Mesenteric Venous Thrombosis: Transcatheter Thrombolysis and Aspiration Thrombectomy Therapy by Combined Route of Superior Mesenteric Vein and Artery in Eight Patients

    International Nuclear Information System (INIS)

    Yang, Shuofei; Liu, Baochen; Ding, Weiwei; He, Changsheng; Wu, Xingjiang; Li, Jieshou

    2015-01-01

    PurposeTo assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT).MethodsThis retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described.ResultsTechnical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5–7 (6.13 ± 0.83) and 7–15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10–27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10–13 (12.13 ± 0.99) months.ConclusionsCatheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome

  13. Acute Superior Mesenteric Venous Thrombosis: Transcatheter Thrombolysis and Aspiration Thrombectomy Therapy by Combined Route of Superior Mesenteric Vein and Artery in Eight Patients

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Shuofei, E-mail: yangshuofei@gmail.com; Liu, Baochen, E-mail: 306446264@qq.com; Ding, Weiwei, E-mail: dingwei-nju@hotmail.com; He, Changsheng, E-mail: hechsh@163.com; Wu, Xingjiang, E-mail: wuxingjiang@sohu.com; Li, Jieshou, E-mail: lijieshou2013@sohu.com [Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University (China)

    2015-02-15

    PurposeTo assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT).MethodsThis retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described.ResultsTechnical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5–7 (6.13 ± 0.83) and 7–15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10–27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10–13 (12.13 ± 0.99) months.ConclusionsCatheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome.

  14. The safety and efficacy of hemostasis with Clo-Sur P.A.D. after transcatheter arterial chemoembolization

    International Nuclear Information System (INIS)

    Jung, Seung Chai; Jae, Hwan Jun; Kim, Sang Youn; Lee, Whal; Chung, Jin Wook; Park, Jae Hyung

    2007-01-01

    We wanted to evaluate the safety and efficacy of a new hemostatic device, Clo-Sur P.A.D., at an arterial access site after performing femoral arterial catheterization to achieve transcatheter arterial chemoembolization (TACE). From August 2002 to March 2005, 113 patients who underwent TACE and agreed on using the Clo-Sur P.A.D. were enrolled in this study. We evaluated the mean time interval from compression to the first movement and also to the first walk. We also evaluated such complications as rebleeding, pseudoaneurysm, vascular occlusion, hematoma, infection and pain. For 92 patients who had previous experiences with manual compression, we evaluated their preference of hemostatic method by asking them. Successful hemostasis was achieved with the Clo-Sur P.A.D. in 105 subjects (92%). The mean time interval from compression to the first movement was 201 minutes, and that to the first walk was 267 minutes. There was no statistical difference between the complicated and the uncomplicated groups for the mean time, prothrombin time, Child-Pugh class and platelet count (ρ > 0.05). Rebleeding occurred in 3 patients (2.7%) and mild hematoma around puncture site was noted in 5 patients (5.4%). Eighty-seven patients (95%) preferred Clo-Sur P.A.D. to the manual compression method. The Clo-Sur P.A.D. is a safe and effective hemostatic device and it provides early ambulation after TACE

  15. First pass effect by infusing 99mTc-human serum albumin into the hepatic artery

    International Nuclear Information System (INIS)

    Ozawa, Takashi; Kimura, Kousaburou; Koyanagi, Yasuhisa

    1988-01-01

    The fundamental principles of intra-arterial infusion chemotherapy are thought to be increased local drug concentration and the ''first-pass'' effect. The concentration in the rest of the body can only be decreased if there is local elimination of the infused drug before reaching the systemic circulation. This is referred to as the ''first-pass'' effect. In the evaluation of ''first-pass'' effect, the uptake of liver after infusing 99m Tc-human serum albumin ( 99m Tc-HSA) in the hepatic artery by injecting the subcutaneously implanted silicon reservoir was compared with that obtained after intravenous administration of 99m Tc-HSA. In order to remove the factor of portal infusion, each count of liver up take had been continued for only 24 seconds after starting the liver uptake. The results are as follows : for 24 cases excepting 6 cases with catheter obstruction, the mean i.a./i.v. ratio was 7.92 ± 3.34 (range 3.25 to 17.25). Although the elimination rate of drugs in the liver varies with each drug, the infusion of intraarterial chemotherapy should be about 8 times more concentrative than intravenous administration on the ''first-pass'' effect. (author)

  16. Effects of intra-arterial infusion therapy or systemic chemotherapy with docetaxel for VX2 tumor in rabbit hind limb

    International Nuclear Information System (INIS)

    Qian Yuanxin; Wu Xiaomei; He Miao; Liu Tao; Deng Duo

    2010-01-01

    Objective: To discuss the efficacy and safety of intra-arterial infusion therapy with docetaxel. Methods: Animal model of VX2 tumor in rabbit hind limb was set up. Intra-arterial infusion therapy or systemic chemotherapy with docetaxel was performed. Concentrations of docetaxel in VX2 tumor, wall of stomach, liver, kidney and plasma of rabbits with VX2 tumors in hind limbs were determined. Difference of drug concentrations between intra-arterial infusion therapy and systemic chemotherapy was compared using Student t-test. Results: Concentrations of docetaxel in VX2 tumor and wall of stomach of rabbits with intra-arterial infusion therapy were significantly higher than those with systemic chemotherapy (p<0.05). The drug concentration in VX2 tumor of rabbits with intra-arterial infusion was 14 times higher than that with systemic chemotherapy. Concentration of docetaxel in plasma of rabbits with intra-arterial infusion therapy was not significantly lower than that with systemic chemotherapy (P<0.05). Conclusion: Intra-arterial infusion therapy with docetaxel for tumor is effective. However, there is increased risk of toxicity and the dose should adjusted accordingly. (authors)

  17. Superselective intra-arterial infusion via the superficial temporal artery and occipital artery for gingival carcinoma of the mandible. Simultaneous catheter placement to the maxillary artery and facial artery

    International Nuclear Information System (INIS)

    Iwai, Toshinori; Mitsudo, Kenji; Fukui, Takafumi

    2009-01-01

    Superselective intra-arterial infusion via the superficial temporal artery (STA) has become useful for oral cancer. Approaching via the occipital artery (OA) enables superselective intra-arterial infusion when catheter placement via the STA is impossible. Therefore, simultaneous catheter placement via the STA and OA is possible. We report a surgical method of simultaneous catheter placement via the STA and OA to achieve retrograde superselective intra-arterial infusion for gingival carcinoma of the mandible. Preoperatively, three-dimensional computed tomography angiography was performed to identify the route of the external carotid artery and branches such as the STA, OA, maxillary artery, and facial artery (FA). Thirteen patients with mandibular gingival cancer underwent catheter placement via the STA and OA under local anesthesia. Catheter placement via the STA and OA was superselectively successful in all the patients. The mean operating time was 150.8 min. Catheter placed to the FA via the OA was dislocated during the treatment in one patient, and so the catheter was replaced. This method is useful to enable superselective intra-arterial chemotherapy to the whole gingival carcinoma of the mandible from the start of treatment compared with approaching via the STA. (author)

  18. Transcatheter Embolization for Giant Splenic Artery Aneurisms: Still an Open Question

    Directory of Open Access Journals (Sweden)

    Marianna Mastroroberto

    2012-01-01

    patients with portal hypertension. It is indicated when the SAA diameter reaches 20 mm. Although endovascular techniques are effective and safe for the treatment of medium-sized SAAs, little is known about their applicability to large-sized SAAs. Herein, we report a case of giant SAA, which was treated with transcatheter coil embolization. The case was not considered suitable for surgery because of the presence of severe portal hypertension. The procedure was complicated by bacterial infection of the coils within the aneurismatic sac, leading to the development of hepatic failure. A liver transplant was then successfully performed despite the presence of a nonresponsive infection.

  19. Intravascular streaming and variable delivery to brain following carotid artery infusions in the Sprague-Dawley rat

    International Nuclear Information System (INIS)

    Saris, S.C.; Wright, D.C.; Oldfield, E.H.; Blasberg, R.G.

    1988-01-01

    Intracarotid artery infusions in animals are commonly performed in studies of the blood-brain barrier and in chemotherapy trials. Implicit in the analysis of these experiments is that the infusate will be distributed to the territory of the internal carotid artery in a manner that is proportional to blood flow. Fifteen Sprague-Dawley rats were studied to determine if poor infusate mixing with blood due to intravascular streaming occurred during intracarotid artery drug infusions and if it could be eliminated with fast retrograde infusion. In three experimental groups, a radiolabeled flow tracer-- 14 C-iodoantipyrine (IAP)--was infused retrograde through the external carotid artery into the common carotid artery at slow, medium, and fast rates (0.45, 1.5, and 5.0 ml/min). In a control group, IAP was injected intravenously (i.v.). Local isotope concentrations in the brain were determined by quantitative autoradiography, and the variability of isotope delivery was assessed in the frontoparietal cortex, temporal cortex, and caudate putamen of all animals. Streaming phenomena were manifest in all selected anatomic areas after the slow and medium rates of intraarterial infusion. After fast intracarotid infusion or i.v. injection, there was uniform distribution of isotope in the same brain regions

  20. A clinical evaluation of the intraluminal bronchial artery infusion with reptilase or plus additional target artery embolization in treatment of severe hemoptysis in patients with pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Lu Puxuan; Cai Xiongmao; Cao Mairui; Yu Weiye; Yang Gendong; Chen Xinchun; Sun Yanzhi; Liu Jinqing; Gong Xiaolong; Fu Xiangdong; Deng Yongcong; Liu Zhi; Zheng Guangping

    2003-01-01

    Objective: To investigate the effect of bronchial artery infusion with Reptilase or plus additional target artery embolization in treatment of massive hemoptysis in patients with pulmonary tuberculosis. Methods: Among 34 patients with massive hemoptysis (≥600 ml/24 hours) resultant from pulmonary tuberculosis, 21 cases (group 1) received by bronchial artery infusion with Reptilase (1-3KU) plus target artery embolization with gelfoam sponge. In the rest 13 cases (group 2) a simple bronchial artery infusion with Reptilase (1-3KU) was performed because the bleeding target arteries were inaccessible. Results: In total 32 cases out of 34 (94.1%) the hemoptysis ceased after the intervention, while 1 case in each group respectively needed further surgery. Among the cured 34 cases, single treatment was done in 32 cases, twice interventions were performed in 1 case and triple intraluminal therapies were done in 1 case. There is no significant difference between the efficiency of the treatment applied in group 1 and group 2 (P>0.05). Conclusion: Bronchial artery infusion with Reptilase or plus additional target artery embolization is effective and safe method in the management of massive hemoptysis in patients with pulmonary tuberculosis. When the target the bleed artery is inaccessible, local intraluminal infusion with Reptilase (1-3KU) is an acceptable option

  1. Quantitative Real-Time Fluoroscopy Analysis on Measurement of the Hepatic Arterial Flow During Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma: Comparison with Quantitative Digital Subtraction Angiography Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yi-Yang; Lee, Rheun-Chuan, E-mail: rclee@vghtpe.gov.tw; Guo, Wan-Yuo, E-mail: wyguo@vghtpe.gov.tw; Chu, Wei-Fa [Taipei Veterans General Hospital, Department of Radiology (China); Wu, Frank Chun-Hsien [Siemens Healthcare Ltd. (China); Gehrisch, Sonja [Siemens Healthcare GmbH (Germany)

    2016-11-15

    PurposeTo quantify the arterial flow change during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) using digital subtraction angiography, quantitative color-coding analysis (d-QCA), and real-time subtraction fluoroscopy QCA (f-QCA).Materials and MethodsThis prospective study enrolled 20 consecutive patients with HCC who had undergone TACE via a subsegmental approach between February 2014 and April 2015. The TACE endpoint was a sluggish antegrade tumor-feeding arterial flow. d-QCA and f-QCA were used for determining the relative maximal density time (rT{sub max}) of the selected arteries. The rT{sub max} of the selected arteries was analyzed in d-QCA and f-QCA before and after TACE, and its correlation in both analyses was evaluated.ResultsThe pre- and post-TACE rT{sub max} of the embolized segmental artery in d-QCA and f-QCA were 1.59 ± 0.81 and 2.97 ± 1.80 s (P < 0.001) and 1.44 ± 0.52 and 2.28 ± 1.02 s (P < 0.01), respectively. The rT{sub max} of the proximal hepatic artery did not significantly change during TACE in d-QCA and f-QCA. The Spearman correlation coefficients of the pre- and post-TACE rT{sub max} of the embolized segmental artery between d-QCA and f-QCA were 0.46 (P < 0.05) and 0.80 (P < 0.001). Radiation doses in one series of d-QCA and f-QCA were 140.7 ± 51.5 milligray (mGy) and 2.5 ± 0.7 mGy, respectively.Conclusionsf-QCA can quantify arterial flow changes with a higher temporal resolution and lower radiation dose. Flow quantification of the embolized segmental artery using f-QCA and d-QCA is highly correlated.

  2. Quantitative Real-Time Fluoroscopy Analysis on Measurement of the Hepatic Arterial Flow During Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma: Comparison with Quantitative Digital Subtraction Angiography Analysis

    International Nuclear Information System (INIS)

    Lin, Yi-Yang; Lee, Rheun-Chuan; Guo, Wan-Yuo; Chu, Wei-Fa; Wu, Frank Chun-Hsien; Gehrisch, Sonja

    2016-01-01

    PurposeTo quantify the arterial flow change during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) using digital subtraction angiography, quantitative color-coding analysis (d-QCA), and real-time subtraction fluoroscopy QCA (f-QCA).Materials and MethodsThis prospective study enrolled 20 consecutive patients with HCC who had undergone TACE via a subsegmental approach between February 2014 and April 2015. The TACE endpoint was a sluggish antegrade tumor-feeding arterial flow. d-QCA and f-QCA were used for determining the relative maximal density time (rT_m_a_x) of the selected arteries. The rT_m_a_x of the selected arteries was analyzed in d-QCA and f-QCA before and after TACE, and its correlation in both analyses was evaluated.ResultsThe pre- and post-TACE rT_m_a_x of the embolized segmental artery in d-QCA and f-QCA were 1.59 ± 0.81 and 2.97 ± 1.80 s (P < 0.001) and 1.44 ± 0.52 and 2.28 ± 1.02 s (P < 0.01), respectively. The rT_m_a_x of the proximal hepatic artery did not significantly change during TACE in d-QCA and f-QCA. The Spearman correlation coefficients of the pre- and post-TACE rT_m_a_x of the embolized segmental artery between d-QCA and f-QCA were 0.46 (P < 0.05) and 0.80 (P < 0.001). Radiation doses in one series of d-QCA and f-QCA were 140.7 ± 51.5 milligray (mGy) and 2.5 ± 0.7 mGy, respectively.Conclusionsf-QCA can quantify arterial flow changes with a higher temporal resolution and lower radiation dose. Flow quantification of the embolized segmental artery using f-QCA and d-QCA is highly correlated.

  3. Percutaneous hepatic arterial catheterization for infusion chemotherapy in treatment of primary hepatoma

    International Nuclear Information System (INIS)

    Juhn, Jae Ryang; Chang, Jae Yong; Cha, Seong Sook; Han, Sang Suk; Bae, Cheol; Kim, Sung Rok; Chae, Yoo Soon

    1984-01-01

    Chemotherapy offers palliative treatment to patient with advanced nonresectable hepatoma. The usefulness of systemic chemotherapy is limited because of serious side reaction and low concentration of drug at tumor. But this problem may be overcome by intraarterial infusion. Nonsurgical percutaneous hepatic arterial catheterization was done in 21 patients with primary hepatoma, and infusion chemotherapy was done in 19 patients who were successful in catheterization. The results were as follows: 1. Selective catheterization of hepatic artery proper, common hepatic artery, and celiac artery were successful in 4, 9 and 4 patients respectively. The success rate of selective catheterization is 80.9% including celiac artery among 21 patients with hepatoma. 2. Simple catheterization method was applied in 14 patients, and catheter exchange and Loop methods were applied in 2 and 1 patient respectively. 3. Complication related to catheterization, such as infection and bleeding on punctured site, intimal injury and dislodgement of catheter were not serious. 4. Drugs were well tolerated without serious toxicity or complication. 5. 3 patients showed objective response and median survival time of treated patients is 2.5 months.

  4. Complications Following Balloon-Occluded Arterial Infusion Chemotherapy for Pelvic Malignancies

    International Nuclear Information System (INIS)

    Sugimoto, Koji; Hirota, Shozo; Imanaka, Kazufumi; Kawabe, Tetsuya; Nakayama, Yoshiharu; Takeuchi, Yasuhito

    1999-01-01

    Purpose: To evaluate the incidence and causes of complications associated with balloon-occluded arterial infusion chemotherapy (BOAI) for pelvic malignancies. Methods: In 34 courses of BOAI in 22 patients with pelvic malignancies, we analyzed the incidence of complications as well as the effect of the dose of the anticancer drugs, the infusion site, and the number of BOAI administrations on these complications. Complications were divided into two categories: cystitis-like symptoms and neurological complications such as pain, numbness, and paresthesia of the lower extremities and the hip. Results: Eleven patients (50%) suffered from complications, seven (31.8%) from neurological complications and four (18.2%) from cystitis-like symptoms. The complications appeared in 14 courses (42.4%) of BOAI, neurological complications in 10 (30.3%) and cystitis-like symptoms in four (12.1%). A high dose of anti-cancer drugs and infusion from the anterior division tended to induce neurological complications more frequently; however, the cystitis-like symptoms were not related to any factors. Conclusion: Our results indicate that a smaller dose of anti-cancer drugs should be infused from the bilateral internal iliac arteries for safer pelvic BOAI

  5. Hepatic perfusion during hepatic artery infusion chemotherapy: Evaluation with perfusion CT and perfusion scintigraphy

    International Nuclear Information System (INIS)

    Miller, D.L.; Carrasquillo, J.A.; Lutz, R.J.; Chang, A.E.

    1989-01-01

    The standard method for the evaluation of hepatic perfusion during hepatic artery infusion (HAI) chemotherapy is planar hepatic artery perfusion scintigraphy (HAPS). Planar HAPS was performed with 2 mCi of [99mTc] macroaggregated albumin infused at 1 ml/min and compared with single photon emission CT (SPECT) HAPS and with a new study, CT performed during the slow injection of contrast material through the HAI catheter (HAI-CT). Thirteen patients underwent 16 HAI-CT studies, 14 planar HAPS studies, and 9 SPECT HAPS studies. In 13 of 14 studies (93%) HAI-CT and planar HAPS were in complete agreement as to the perfusion pattern of intrahepatic metastases and normal liver. In nine studies where all modalities were performed, the findings identified by HAI-CT and planar HAPS agreed in all cases, whereas the results of two SPECT scans disagreed with the other studies. With respect to perfusion of individual metastases, 14 of 14 HAI-CT studies, 12 of 13 planar HAPS studies, and 9 of 9 SPECT HAPS studies correctly demonstrated the perfusion status of individual lesions as indicated by the pattern of changes in tumor size determined on CT obtained before and after the perfusion studies. Hepatic artery infusion CT was superior for delineation of individual metastases, particularly small lesions, and for the evaluation of nonperfused portions of the liver. Planar HAPS detected extrahepatic perfusion in four patients, and this was not detected by HAI-CT. We conclude that HAI-CT and scintigraphy are complementary techniques. Hepatic artery infusion CT has advantages for the evaluation of intrahepatic perfusion, and planar HAPS is superior to HAI-CT for the detection of extrahepatic perfusion

  6. Change in Imaging Findings on Angiography-Assisted CT During Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimatsu, Rika [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan); Yamagami, Takuji, E-mail: yamagami@kochi-u.ac.jp [Kochi University, Department of Radiology (Japan); Ishikawa, Masaki; Kajiwara, Kenji [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan); Aikata, Hiroshi; Chayama, Kazuaki [Hiroshima University, Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences (Japan); Awai, Kazuo [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan)

    2016-06-15

    PurposeTo evaluate changes in imaging findings on CT during hepatic arteriography (CTHA) and CT during arterial portography (CTAP) by balloon occlusion of the treated artery and their relationship with iodized oil accumulation in the tumor during balloon-occluded transcatheter arterial chemoembolization (B-TACE).MethodsBoth B-TACE and angiography-assisted CT were performed for 27 hepatocellular carcinomas. Tumor enhancement on selective CTHA with/without balloon occlusion and iodized oil accumulation after B-TACE were evaluated. Tumorous portal perfusion defect size on CTAP was compared with/without balloon occlusion. Factors influencing discrepancies between selective CTHA with/without balloon occlusion and the degree of iodized oil accumulation were investigated.ResultsAmong 27 tumors, tumor enhancement on selective CTHA changed after balloon occlusion in 14 (decreased, 11; increased, 3). In 18 tumors, there was a discrepancy between tumor enhancement on selective CTHA with balloon occlusion and the degree of accumulated iodized oil, which was higher than the tumor enhancement grade in all 18. The tumorous portal perfusion defect on CTAP significantly decreased after balloon occlusion in 18 of 20 tumors (mean decrease from 21.9 to 19.1 mm in diameter; p = 0.0001). No significant factors influenced discrepancies between selective CTHA with/without balloon occlusion. Central area tumor location, poor tumor enhancement on selective CTHA with balloon occlusion, and no decrease in the tumorous portal perfusion defect area on CTAP after balloon occlusion significantly influenced poor iodized oil accumulation in the tumor.ConclusionsTumor enhancement on selective CTHA frequently changed after balloon occlusion, which did not correspond to accumulated iodized oil in most cases.

  7. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results

    International Nuclear Information System (INIS)

    Bhalgat, Parag S; Pinto, Robin; Dalvi, Bharat V

    2012-01-01

    To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT. This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT. Of 76 patients, nine were found to have PDA with Eisenmenger's syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2. The follow up was available in 56 (86%) with a mean follow up period of 65 ± 34 months. All the patients had complete closure of the PDA at 6 months follow up. Mild obstruction of left pulmonary artery (n=3) and aortic isthmus flow (n=6) was noted at the time of discharge. During the follow up, partial or complete resolution of PHT was observed in all the patients in whom Doppler-derived right ventricular systolic pressure was recorded (available in 40 of 56 patients). TCC of large PDA with severe PHT and significant left to right shunt was found to be effective and safe in the short and intermediate term

  8. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results.

    Science.gov (United States)

    Bhalgat, Parag S; Pinto, Robin; Dalvi, Bharat V

    2012-07-01

    To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT. This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT. Of 76 patients, nine were found to have PDA with Eisenmenger's syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2. The follow up was available in 56 (86%) with a mean follow up period of 65 ± 34 months. All the patients had complete closure of the PDA at 6 months follow up. Mild obstruction of left pulmonary artery (n=3) and aortic isthmus flow (n=6) was noted at the time of discharge. During the follow up, partial or complete resolution of PHT was observed in all the patients in whom Doppler-derived right ventricular systolic pressure was recorded (available in 40 of 56 patients). TCC of large PDA with severe PHT and significant left to right shunt was found to be effective and safe in the short and intermediate term.

  9. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results

    Energy Technology Data Exchange (ETDEWEB)

    Bhalgat, Parag S [Department of Cardiology, King Edward VII Memorial Hospital, Mumbai, Maharashtra (India); Pinto, Robin; Dalvi, Bharat V, E-mail: bharatdalvi@hotmail.com [Glenmark Cardiac Center, 10 Nandadeep, 209 Dr. Ambedkar Road, Matunga (East), Mumbai, Maharashtra (India)

    2012-01-01

    To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT. This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT. Of 76 patients, nine were found to have PDA with Eisenmenger's syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2. The follow up was available in 56 (86%) with a mean follow up period of 65 ± 34 months. All the patients had complete closure of the PDA at 6 months follow up. Mild obstruction of left pulmonary artery (n=3) and aortic isthmus flow (n=6) was noted at the time of discharge. During the follow up, partial or complete resolution of PHT was observed in all the patients in whom Doppler-derived right ventricular systolic pressure was recorded (available in 40 of 56 patients). TCC of large PDA with severe PHT and significant left to right shunt was found to be effective and safe in the short and intermediate term.

  10. Transcatheter aortic valve implantation and off-pump coronary artery bypass surgery: an effective hybrid procedure in selected patients.

    Science.gov (United States)

    Mayr, Benedikt; Firschke, Christian; Erlebach, Magdalena; Bleiziffer, Sabine; Krane, Markus; Joner, Michael; Herold, Ulf; Nöbauer, Christian; Lange, Rüdiger; Deutsch, Marcus-André

    2018-02-26

    Simultaneous surgical off-pump coronary revascularization and transcatheter aortic valve implantation (TAVI) as a hybrid procedure may be a therapeutic option for patients with a TAVI indication who are not suitable for percutaneous coronary intervention and for patients who have an indication for combined surgical aortic valve implantation and coronary artery bypass grafting but present with a porcelain aorta. Early outcomes of these patients are analysed in this study. From February 2011 to April 2017, hybrid TAVI/off-pump coronary artery bypass (OPCAB) was performed in 12 (60%) patients, hybrid TAVI/minimally invasive direct coronary artery bypass in 6 (30%) patients and staged TAVI/OPCAB in 2 (10%) patients. Endpoints of this study were 30-day mortality, device success and postoperative adverse events as defined by the updated Valve Academic Research Consortium (VARC-2). The median age at the time of surgery was 77 years [interquartile range (IQR), 70-81] with a median logistic EuroSCORE and Society of Thoracic Surgeons' Predicted Risk score of 16.1% (IQR, 9.3-28.1) and 3.9% (IQR, 2.2-5.6), respectively. The median Synergy between PCI with Taxus and Cardiac Surgery score was 16.5 (IQR, 9.8-22.8). TAVI implantation routes were transaortic in 9 (45%) patients, transapical and transfemoral in 5 (25%) patients each and transsubclavian in 1 (5%) patient. Complete myocardial revascularization was achieved in 75% of patients. Device success rate was 100%. Paravalvular aortic regurgitation did not exceed mild in any patient. Stroke/transient ischaemic attack, vascular complications and myocardial infarction were not observed. Re-exploration for bleeding was required in 1 (5%) patient. Thirty-day mortality was 0%. Hybrid OPCAB/MIDCAB and TAVI prove to be a safe and effective alternative treatment option in selected higher risk patients.

  11. Improved arterial blood oxygenation following intravenous infusion of cold supersaturated dissolved oxygen solution.

    Science.gov (United States)

    Grady, Daniel J; Gentile, Michael A; Riggs, John H; Cheifetz, Ira M

    2014-01-01

    One of the primary goals of critical care medicine is to support adequate gas exchange without iatrogenic sequelae. An emerging method of delivering supplemental oxygen is intravenously rather than via the traditional inhalation route. The objective of this study was to evaluate the gas-exchange effects of infusing cold intravenous (IV) fluids containing very high partial pressures of dissolved oxygen (>760 mm Hg) in a porcine model. Juvenile swines were anesthetized and mechanically ventilated. Each animal received an infusion of cold (13 °C) Ringer's lactate solution (30 mL/kg/hour), which had been supersaturated with dissolved oxygen gas (39.7 mg/L dissolved oxygen, 992 mm Hg, 30.5 mL/L). Arterial blood gases and physiologic measurements were repeated at 15-minute intervals during a 60-minute IV infusion of the supersaturated dissolved oxygen solution. Each animal served as its own control. Five swines (12.9 ± 0.9 kg) were studied. Following the 60-minute infusion, there were significant increases in PaO2 and SaO2 (P < 0.05) and a significant decrease in PaCO2 (P < 0.05), with a corresponding normalization in arterial blood pH. Additionally, there was a significant decrease in core body temperature (P < 0.05) when compared to the baseline preinfusion state. A cold, supersaturated dissolved oxygen solution may be intravenously administered to improve arterial blood oxygenation and ventilation parameters and induce a mild therapeutic hypothermia in a porcine model.

  12. Impact of Multislice CT Angiography on Planning of Radiological Catheter Placement for Hepatic Arterial Infusion Chemotherapy

    International Nuclear Information System (INIS)

    Sone, Miyuki; Kato, Kenichi; Hirose, Atsuo; Nakasato, Tatsuhiko; Tomabechi, Makiko; Ehara, Shigeru; Hanari, Takao

    2008-01-01

    The objective of this study was to assess prospectively the role of multislice CT angiography (MSCTA) on planning of radiological catheter placement for hepatic arterial infusion chemotherapy (HAIC). Forty-six patients with malignant liver tumors planned for HAIC were included. In each patient, both MSCTA and intra-arterial digital subtraction angiography (DSA) were performed, except one patient who did not undergo DSA. Comparison of MSCTA and DSA images was performed for the remaining 45 patients. Detectability of anatomical variants of the hepatic artery, course of the celiac trunk, visualization scores of arterial branches and interobserver agreement, presence of arterial stenosis, and technical outcome were evaluated. Anatomical variations of the hepatic artery were detected in 19 of 45 patients (42%) on both modalities. The course of the celiac trunk was different in 12 patients. The visualization scores of celiac arterial branches on MSCTA/DSA were 3.0 ± 0/2.9 ± 0.2 in the celiac trunk, 3.0 ± 0/2.9 ± 0.3 in the common hepatic artery, 2.9 ± 0.2/2.9 ± 0.3 in the proper hepatic artery, 2.9 ± 0.3/2.9 ± 0.4 in the right hepatic artery, 2.8 ± 0.4/2.9 ± 0.4 in the left hepatic artery, 2.9 ± 0.2/2.9 ± 0.3 in the gastroduodenal artery, 2.1 ± 0.8/2.2 ± 0.9 in the right gastric artery, and 2.7 ± 0.8/2.6 ± 0.8 in the left gastric artery. No statistically significant differences exist between the two modalities. Interobserver agreement for MSCTA was equivalent to that for DSA. Two patients showed stenosis of the celiac trunk on both modalities. Based on these imaging findings, technical success was accomplished in all patients. In conclusion, MSCTA is accurate in assessing arterial anatomy and abnormalities. MSCTA can provide adequate information for planning of radiological catheter placement for HAIC

  13. Transcatheter arterial chemoembolization in combination with radiotherapy for unresectable hepatocellular carcinoma: A systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Meng Maobin; Cui Yaoli; Lu You; She Bin; Chen Yan; Guan Yongsong; Zhang Ruiming

    2009-01-01

    Background and Purpose: To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) plus radiotherapy (RT) for unresectable hepatocellular carcinoma (UHCC) using meta-analysis of data from the literature involving available randomized controlled trials of TACE in combination with RT compared with that of TACE alone (Therapy I versus II) in treating UHCC. Material and Methods: We searched the Cochrane Library, MEDLINE, CENTRAL, EMBASE, CBMdisc, and CNKI as well as employing manual searches. Meta-analysis was performed on the results of homogeneous studies. Analyses subdivided by study design were also performed. Results: We found 17 trials involving 1476 patients. 5 of total were Randomized Controlled Trials (RCTs) and 12 were Non-randomized Controlled Clinical Trials (CCTs). In terms of quality, 5 RCTs were graded B, and 12 CCTs were graded C. Our results showed that Therapy I, compared with Therapy II, significantly improved the survival and the tumor response of patients, and was thus more therapeutically beneficial. Serious adverse events were not increased exception for total bilirubin (TB) level. Conclusions: Therapy I was more therapeutically beneficial. However, considering the strength of the evidence, additional randomized controlled trials are needed before Therapy I can be recommended routinely.

  14. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Mitsunari, E-mail: mitunari@med-shimane.u.ac.jp; Yoshizako, Takeshi, E-mail: yosizako@med.shimane-u.ac.jp; Nakamura, Tomonori, E-mail: t-naka@med.shimane-u.ac.jp; Nakamura, Megumi, E-mail: megumi@med.shimane-u.ac.jp; Yoshida, Rika, E-mail: yoshidar@med.shimane-u.ac.jp; Kitagaki, Hajime, E-mail: kitagaki@med.shimane-u.ac.jp [Shimane University Faculty of Medicine, Department of Radiology (Japan)

    2016-03-15

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

  15. Severe primary postpartum hemorrhage due to genital tract laceration after operative vaginal delivery: successful treatment with transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Fargeaudou, Yann; Soyer, Philippe; Sirol, Marc; Dref, Olivier le; Boudiaf, Mourad; Dahan, Henri; Rymer, Roland [Hopital Lariboisiere-APHP-GHU Nord et Universite Diderot-Paris 7, Department of Abdominal and Interventional Imaging, Paris (France); Morel, Olivier [Hopital Lariboisiere-APHP-GHU Nord et Universite Diderot-Paris 7, Department of Obstetrics, Paris (France)

    2009-09-15

    The purpose of this study was to report our experience in the management of severe primary postpartum hemorrhage due to genital tract laceration following operative vaginal delivery with forceps using pelvic transcatheter arterial embolization (TAE). Ten women (mean age, 31.9 years) with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps were treated with TAE. TAE was indicated because of intractable bleeding that could not be controlled with uterotonic drugs, blood transfusion, attempted suturing and packing in all patients. Postdelivery perineal examination showed cervical or vaginal tears in all women and associated paravaginal hematoma in four. Angiography revealed extravasation of contrast material in six patients. TAE performed with gelatin sponge allowed to control the bleeding in all patients. Cervical and vaginal suturing was made possible and successfully achieved in the six women who had failed suturing attempts before TAE. Paravaginal hematoma was successfully evacuated in four patients in whom it was present after TAE. No complications related to TAE were noted. We conclude that in women with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps, TAE is effective and safe for stopping the bleeding and helps genital tract suturing and evacuation of hematoma. (orig.)

  16. Intractable Postpartum Bleeding: A Comparison of the Retrospective Analysis of Angiographic Findings and Transcatheter Arterial Embolization According to Delivery Pattern

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Eun Jung; Kim, Young Hwan; Kim, Si Hyung; Choi, Jin Soo; Park, Jun Cheol; Kwon, Sang Hun; Jo, Chi Heum; Cha, Soon Do [Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2008-12-15

    We evaluated the technical aspect and efficacy of transcatheter arterial embolization (TAE) in cases of intractable postpartum bleeding by comparing the angiographic findings women patients according to their delivery pattern. Between July of 2003 and March of 2008, 55 female patients were enrolled in this study. Of the 55 patients, 36 underwent a vaginal delivery (group 1), whereas 19 underwent a cesarean section delivery (group 2). We retrospectively evaluated the angiographic findings and the embolization technique between groups, using a Pearson Chi-Square test. Medical records and telephone interview findings were also reviewed to evaluate the efficacy of TAE and the outcome of fertility. Significantly greater positive angiographic findings were found in group 2 (63.2%) relative to group 1 (30.6%). For positive angiographic findings, except for AVM, the embolization was performed using coil or glue with gelfoam. For the negative angiographic findings or AVM, the gelfoam was the only embolic agent used. In all patients except for one, bleeding stopped after embolization. Major complications occurred in 2 patients only, and included uterine synechia and perforation. All patients except for one recovered after menstruation. In total, four patients became pregnant and one patient delivered a healthy infant. Positive angiographic findings requiring embolization with coil or glue, as well as gelfoam, were more commonly encountered in group 2 than in group 1. Based on the outcome of the study group, TAE is a safe and effective treatment for intractable postpartum bleeding and is also useful for preserving fertility.

  17. Severe primary postpartum hemorrhage due to genital tract laceration after operative vaginal delivery: successful treatment with transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Fargeaudou, Yann; Soyer, Philippe; Sirol, Marc; Dref, Olivier le; Boudiaf, Mourad; Dahan, Henri; Rymer, Roland; Morel, Olivier

    2009-01-01

    The purpose of this study was to report our experience in the management of severe primary postpartum hemorrhage due to genital tract laceration following operative vaginal delivery with forceps using pelvic transcatheter arterial embolization (TAE). Ten women (mean age, 31.9 years) with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps were treated with TAE. TAE was indicated because of intractable bleeding that could not be controlled with uterotonic drugs, blood transfusion, attempted suturing and packing in all patients. Postdelivery perineal examination showed cervical or vaginal tears in all women and associated paravaginal hematoma in four. Angiography revealed extravasation of contrast material in six patients. TAE performed with gelatin sponge allowed to control the bleeding in all patients. Cervical and vaginal suturing was made possible and successfully achieved in the six women who had failed suturing attempts before TAE. Paravaginal hematoma was successfully evacuated in four patients in whom it was present after TAE. No complications related to TAE were noted. We conclude that in women with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps, TAE is effective and safe for stopping the bleeding and helps genital tract suturing and evacuation of hematoma. (orig.)

  18. Intractable Postpartum Bleeding: A Comparison of the Retrospective Analysis of Angiographic Findings and Transcatheter Arterial Embolization According to Delivery Pattern

    International Nuclear Information System (INIS)

    Ahn, Eun Jung; Kim, Young Hwan; Kim, Si Hyung; Choi, Jin Soo; Park, Jun Cheol; Kwon, Sang Hun; Jo, Chi Heum; Cha, Soon Do

    2008-01-01

    We evaluated the technical aspect and efficacy of transcatheter arterial embolization (TAE) in cases of intractable postpartum bleeding by comparing the angiographic findings women patients according to their delivery pattern. Between July of 2003 and March of 2008, 55 female patients were enrolled in this study. Of the 55 patients, 36 underwent a vaginal delivery (group 1), whereas 19 underwent a cesarean section delivery (group 2). We retrospectively evaluated the angiographic findings and the embolization technique between groups, using a Pearson Chi-Square test. Medical records and telephone interview findings were also reviewed to evaluate the efficacy of TAE and the outcome of fertility. Significantly greater positive angiographic findings were found in group 2 (63.2%) relative to group 1 (30.6%). For positive angiographic findings, except for AVM, the embolization was performed using coil or glue with gelfoam. For the negative angiographic findings or AVM, the gelfoam was the only embolic agent used. In all patients except for one, bleeding stopped after embolization. Major complications occurred in 2 patients only, and included uterine synechia and perforation. All patients except for one recovered after menstruation. In total, four patients became pregnant and one patient delivered a healthy infant. Positive angiographic findings requiring embolization with coil or glue, as well as gelfoam, were more commonly encountered in group 2 than in group 1. Based on the outcome of the study group, TAE is a safe and effective treatment for intractable postpartum bleeding and is also useful for preserving fertility

  19. Parametric response mapping of dynamic CT for predicting intrahepatic recurrence of hepatocellular carcinoma after conventional transcatheter arterial chemoembolization

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Joon; Kim, Hyung Sik [Gachon University Gil Hospital, Department of Radiology, Incheon (Korea, Republic of); Kim, Jonghoon [Sungkyunkwan University, Department of Electronic Electrical and Computer Engineering, Suwon (Korea, Republic of); Seo, Jongbum [Yonsei University, Department of Biomedical Engineering, Wonju (Korea, Republic of); Lee, Jong-min [Hanyang University, Department of Biomedical Engineering, Seoul (Korea, Republic of); Park, Hyunjin [Sungkyunwkan University, School of Electronic and Electrical Engineering, Suwon (Korea, Republic of)

    2016-01-15

    The aim of our study was to determine the diagnostic value of a novel image analysis method called parametric response mapping (PRM) for prediction of intrahepatic recurrence of hepatocellular carcinoma (HCC) treated with conventional transcatheter arterial chemoembolization (TACE). This retrospective study was approved by the IRB. We recruited 55 HCC patients who achieved complete remission (CR) after TACE and received longitudinal multiphasic liver computed tomography (CT). The patients fell into two groups: the recurrent tumour group (n = 29) and the non-recurrent tumour group (n = 26). We applied the PRM analysis to see if this technique could distinguish between the two groups. The results of the PRM analysis were incorporated into a prediction algorithm. We retrospectively removed data from the last time point and attempted to predict the response to therapy of the removed data. The PRM analysis was able to distinguish between the non-recurrent and recurrent groups successfully. The prediction algorithm detected response to therapy with an area under the curve (AUC) of 0.76, while the manual approach had AUC 0.64. Adopting PRM analysis can potentially distinguish between recurrent and non-recurrent HCCs and allow for prediction of response to therapy after TACE. (orig.)

  20. Establishing an individual dosing system for patients undergoing interventional transcatheter arterial embolization: Radiochromic film and Monte Carlo simulation

    International Nuclear Information System (INIS)

    Tsai, Hui-Yu; Lai, Pei-Ling; Li, Yang-Ying; Tyan, Yeu-Sheng

    2011-01-01

    Less invasive imaging-guided vascular interventions with fluoroscopy and digital subtraction angiography have recently become widespread and have been successfully used for treating various diseases. However, interventional fluoroscopy procedures may present deterministic and stochastic radiation risks. The International Commission on Radiological Protection (ICRP) and the Food and Drug Administration have requested identifying procedures that may involve patient doses greater than the recommended thresholds. In this study, radiochromic dosimetric media, known as self-developing films, and measurement-based Monte Carlo simulations were used to establish an interventional radiology dosing system for individual patients undergoing interventional transcatheter arterial embolization. The peak skin dose, evaluated from the entrance surface dose distribution, was 21% less than the cumulated dose reported from the console. A 3D dose map incorporated into CT images was established. The organ doses and effective doses for individual patients were evaluated using this dosing system. This system could be applied very well to other fluoroscopic or interventional procedures for patient dose management.

  1. Progression of Treated versus Untreated Liver Imaging Reporting and Data System Category 4 Masses after Transcatheter Arterial Embolization Therapy.

    Science.gov (United States)

    Ronald, James; Gupta, Rajan T; Marin, Daniele; Wang, Qi; Durocher, Nicholas S; Suhocki, Paul V; Kim, Charles Y

    2018-05-01

    To compare outcomes of treated vs untreated Liver Imaging Reporting and Data System category 4 (LR-4) masses after transcatheter arterial embolization. In 167 patients undergoing embolization for HCC from January 2005 to December 2012, LR-4 masses were retrospectively identified on CT and MR imaging examinations performed before embolization. In 149 patients undergoing embolization from January 2013 to December 2016, masses prospectively classified as LR-4 were identified. In total, there were 81 LR-4 masses in 62 patients (16 women; mean age 62 y; range 29-83 y). Procedures were reviewed to determine whether LR-4 masses were within or outside the liver volume that received embolization during treatment of dominant masses. Time to progression to LR-5 and by modified Response Evaluation Criteria in Solid Tumors (mRECIST) was estimated for treated vs untreated LR-4 masses using the Kaplan-Meier method and compared using the log rank test. LR-4 masses averaged 1.8 cm; 88%, 60%, 14%, and 14% demonstrated arterial phase hyperenhancement, washout, a capsule, and growth. Of LR-4 masses, 62 were within the liver volume that received embolization and considered treated, and 19 were outside and considered untreated. Response rates according to mRECIST were 37% vs 21% for treated vs untreated masses (P = .27). The 6- and 12-month rates of progression to LR-5 were 7% and 26% for treated masses vs 27% and 75% for untreated masses (P = .001). According to mRECIST, 7% and 27% of treated masses progressed vs 30% and 65% of untreated masses (P = .001). LR-4 masses that receive embolization in the setting of dominant masses elsewhere show lower rates of progression compared with untreated masses. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  2. The role of CT in pelvic fracture. CT finding of retro-peritoneal hematoma and indication of transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Igarashi, Tsuneo; Hoshikawa, Yoshikazu; Saeki, Mitsuaki; Nakajima, Yasuo

    1998-01-01

    Although retro-peritoneal hematoma accompanying a pelvic fracture has been treated by arterial ligation formerly, it is associated with a high mortality rate and a transcatheter arterial embolization has now become the first choice of treatment. Meanwhile, the usefulness of computed tomography (CT) in traumatized patient has been reported frequently. Our hospital also employs CT positively as an examination following plain radiography in the cases with pelvic fracture. However, while indication of angiography is seen in several reports, the amount of retro-peritoneal hematoma as an index has not been reported. In the present study, we examined 112 patients given CT at the time of examination at the emergency center of our hospital between April 1, 1988, and June 30, 1997, and classified the amount of retro-peritoneal hematoma on CT into 5 groups to discuss indication of angiography. In the cases with moderate or massive amount of retro-peritoneal hematomas, cases with shock state exceeded 60% and the amount of hematoma was considered to reflect the circulation profile to a certain extent. As the amount of retro-peritoneal hematoma increased, the number of cases given embolization also increased; embolization was performed in 29 cases (61.7%) among those which had moderate or massive amount of hematoma. From the above findings, it was predicted that the amount of retro-peritoneal hematoma could be one of the deciding factors for indication of angiography. However, as there are cases falling into a shock state due to gradual increase of hematoma or associated with injuries in other organs, careful observation is needed for the cases judged out of indication. (author)

  3. Daily concurrent preoperative chemoradiotherapy using new superselective intra-arterial infusion via superficial temporal artery for oral cancer. Cervical lymph node metastasis

    International Nuclear Information System (INIS)

    Yamamoto, Noriyuki; Mitsudo, Kenji; Tohnai, Iwai

    2007-01-01

    Seventeen oral cancer patients with cervical lymph node metastasis were treated by preoperative chemoradiotherapy using superselective intra-arterial infusion via the superficial temporal artery. Radiotherapy (total dose: 40 Gy/4 weeks) and superselective intra-arterial infusion chemotherapy using docetaxel (DOC) (total dose: 60 mg/m 2 , 15 mg/m 2 /week) and cisplatin (CDDP) (total dose: 100 mg/m 2 , 5 mg/m 2 /day) were performed, followed by surgery. The pathological effects of resected lymph node metastasis after surgery were grade III, IV (Oboshi-Shimosato classification) in level I, II. This method is a promising strategy for oral cancer with cervical lymph node metastasis. (author)

  4. Transcatheter Embolization of Pulmonary Artery False Aneurysm Associated with Primary Pulmonary Hypertension

    International Nuclear Information System (INIS)

    Hiraki, T.; Kanazawa, S.; Mimura, H.; Yasui, K.; Okumura, Y.; Dendo, S.; Yoshimura, K.; Takahara, M.; Hiraki, Y.

    2004-01-01

    A 29-year-old woman with primary pulmonary hypertension presented with recurrent hemoptysis. Contrast-enhanced CT of the chest demonstrated the enhanced mass surrounded by consolidation related to parenchymal hemorrhage. Pulmonary angiography suggested that the mass was a pulmonary artery false aneurysm. After a microcatheter was superselectively inserted into the parent artery of the falseaneurysm, the false aneurysm was successfully treated by transcatheterembolization with coils. Her hemoptysis has never recurred

  5. Transcatheter Treatment of “Pulmonary Artery Hypertension” due to Patent Ductus Arteriosus and Pulmonary Artery Stenosis

    OpenAIRE

    Gaio, Gianpiero; Santoro, Giuseppe; D'Alto, Michele; Palladino, Maria Teresa; Russo, Maria Giovanna; Caianiello, Giuseppe; Calabrò, Raffaele

    2006-01-01

    The association between large, left-sided patent ductus arteriosus and severe, peripheral, right pulmonary artery stenosis with no other cardiac malformation is an unreported condition that might be misdiagnosed as pulmonary hypertension due to long-standing ductal shunt. A 57-year-old man with supposed hypertensive patent ductus arteriosus underwent confirmatory cardiac catheterization. At angiography, a severe pre-hilar right pulmonary artery stenosis (peak pressure gradient, 65 mmHg) was f...

  6. Clinical nursing of pelvic neoplasm treated with infusion chemotherapy by using an anti-reflux arterial port-catheter system

    International Nuclear Information System (INIS)

    Xing Li; Yuan Chanjuan

    2011-01-01

    Objective: To discuss the clinical nursing care for patients with pelvic neoplasm who were treated with infusion chemotherapy by using an anti-reflux arterial port-catheter system. Methods: After the implantation of an anti-reflux arterial port-catheter system was successfully completed, intra-arterial infusion chemotherapy was carried out in 17 patients with pelvic neoplasm and the infusion chemotherapy was repeated for several times. The pre-procedural clinical nursing care was well done and the technique of proper placement was well grasped. The side effects of chemotherapy drugs and complications were dealt with in time. Medical orientation at discharge time included the protection methods for port-catheter system. Results: Seventeen patients received infusion chemotherapy successfully several times (ranged from 3 to 8 times) with a scheduled regular interval time. No severe complications occurred. No catheter leakage nor obvious irritation and compression symptoms of local skin developed during infusion period. Of the 17 patients, 6 had a complete response, 9 achieved a partial response, while the remaining 2 failed to respond. Conclusion: In accordance with characteristics of infusion chemotherapy by using an anti-reflux arterial port-catheter system, the reasonable and effective nursing care is important to guarantee the achievement of a successful performance and a satisfactory therapeutic result. (authors)

  7. Changes in distribution of hepatic blood flow induced by intra-arterial infusion of angiotensin II in human hepatic cancer

    International Nuclear Information System (INIS)

    Sasaki, Y.; Imaoka, S.; Hasegawa, Y.

    1985-01-01

    Changes in the distribution of the hepatic blood flow induced by intra-arterial infusion of angiotensin II (AT-II) were studied in human hepatic cancers using extremely short-lived radioisotope (RI) (krypton 81 m [/sup 81m/Kr]; half-life, 13 seconds). After the start of continuous infusion of AT-II, the radioactivity of the tumor showed about a two-fold increase, whereas that of the nontumor region decreased to about one half as much as the level before the infusion. Consequently, the mean ratio of the arterial blood flow in the tumor region to that in the nontumor region (T/N ratio) increased to 3.30 (P less than 0.001). The T/N ratio showed a peak before the peripheral blood pressure reached the maximum, and thereafter tended to decrease. Intra-arterial infusion of AT-II raised the T/N ratio more obviously than did intravenous infusion of the drug, with less rise in the peripheral blood pressure. It is believed that intra-arterial infusion chemotherapy with local use of AT-II enables better accessibility of chemotherapeutic drugs to tumors

  8. Transcatheter arterial chemoembolization plus {sup 131}I-labelled metuximab versus transcatheter arterial chemoembolization alone in intermediate/advanced stage hepatocellular carcinoma: A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Ze Xin; Liao, Ming Heng; Huang, Ji Wei [Dept. of Liver Surgery, Liver Transplantation Division, West China Hospital, Sichuan University, Chengdu (China); Wang, Xiao Xue [Dept. of Dermatovenereology, West China Hospital, Sichuan University, Chengdu (China)

    2016-11-15

    The aim of the study was to compare transcatheter arterial chemoembolization (TACE) plus 131I-labelled metuximab with TACE alone for hepatocellular carcinoma (HCC). A comprehensive search was conducted in PubMed, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Chinese BioMedical Literature Database with published date from the earliest to February 29th, 2016. No language restrictions were applied, but only prospective randomized controlled trials (RCTs) or non-RCTs were eligible for a full-text review. The primary outcome was the overall survival (OS) and effective rate (the rate of partial atrophy or complete clearance of the tumor lesion). The odds ratios (ORs) were combined using either the fixed-effects model or random-effects model. Eight trials (3 RCTs and 5 non-RCTs) were included, involving a total of 1121 patients. Patients receiving combined therapy of TACE plus {sup 131}I-labelled metuximab showed significant improvement in effective rate [OR = 4.00, (95% confidence interval [CI]: 2.40-6.66], p < 0.001), 1-year OS (OR = 2.03 [95% CI: 1.55-2.67], p < 0.001) and 2-year OS (OR = 2.57 [95% CI: 1.41-4.66], p = 0.002]. TACE plus {sup 131}I-labelled metuximab is more beneficial for treating advanced HCCs than TACE alone in terms of tumor response and OS. Large, multi-center, and blinded randomized trials are required to confirm these findings.

  9. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension in adults: immediate and two-year follow-up results.

    Science.gov (United States)

    Zhang, Cao-Jin; Huang, Yi-Gao; Huang, Xin-Sheng; Huang, Tao; Huang, Wen-Hui; Xia, Chun-Li; Mo, Yu-Jing

    2012-11-01

    Transcatheter closure of patent ductus arteriosus (PDA) is a well established procedure and an accepted treatment modality for small to moderate-sized PDA. This study aimed to evaluate the immediate and follow-up results of transcatheter closure of large PDAs with severe pulmonary arterial hypertension (PAH) in adults. After a complete hemodynamic evaluation differentiating from the reversibility of severe PAH, transcatheter closure of PDA was performed. Patients were followed up clinically and echocardiographically at 24 hours, 1 month, 3 months, 6 months, 12 months and 24 months after occlusion. Twenty-nine patients had successful occlusion, pulmonary artery pressure (PAP), left ventricular ejection fraction (LVEF) and fractional shortening (FS) significantly decreased immediately after occlusion ((106 ± 25) mmHg vs. (50 ± 14) mmHg, P closure, the signs and symptoms improved markedly in all 29 patients, and PDAs were completely closed and remained closed during the follow-up. Eighteen patients having different degrees of dyspnea were treated with angiotensin converting enzyme inhibitor (ACEI) and/or digoxin after occlusion. Nine patients whose pulmonary vascular resistence (PVR) > 6 Wood units accepted targeted PAH therapy. After 1 to 3 months of peroral drug therapy, their exercise tolerance improved from New York Heart Association (NYHA) class III-IV to NYHA class I. During follow-up, no latent arrhythmias were found, the left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular mass index (LVMI) and pulmonary artery systolic pressure (PASP) decreased significantly (P closure of large PDA with severe PAH is feasible, effective, and safe in adults. Significant left ventricular systolic changes may occur after closure of large PDA, and left ventricular function usually recovers within a few months.

  10. Transcatheter Closure of a Chronic Iatrogenic Arteriovenous Fistula Between the Carotid Artery and the Brachiocephalic Vein with an Amplatzer Duct Occluder in Combination with a Carotid Stent

    International Nuclear Information System (INIS)

    Stasek, Josef; Lojik, Miroslav; Bis, Josef; Horak, David; Dusek, Jaroslav; Brtko, Miroslav; Polansky, Pavel; Babu, Anush; Vojacek, Jan

    2009-01-01

    We report an original method of transcatheter closure of an arteriovenous fistula using the combination of an Amplatzer PDA occluder and a carotid stent. The fistula was between the left carotid artery and the brachiocephalic vein. The patient had significant left-to-right shunt and was highly symptomatic. Due to the large orifice and pseudoaneurysmatic enlargement of the fistula, we had to use a large Amplatzer PDA occluder and the protruding part of the PDA device disk had to be covered with a carotid stent. The fistula was completely closed. The patient stopped having symptoms and, 2 years after the procedure, the effect persists.

  11. Gelatin sponge particle used as an embolic agent in transcatheter arterial chemoembolization treatment for primary hepatocellular carcinoma: its current situation in research

    International Nuclear Information System (INIS)

    Ao Jin; Zhang Yuewei; Xu Ke

    2011-01-01

    Transcatheter arterial chemoembolization (TACE) is one of the most commonly used therapeutic procedures for primary hepatocellular carcinoma (HCC). As an important and easily-available embolic agent, gelatin sponge (Gelfoam) particles have been constantly and widely employed in clinical practice. Various types of embolic agents have been continuously developed and effectively used in TACE for liver cancers. For recent years, great progress has been made in the clinical use of gelatin sponge particles, as the most traditional embolic agent, in the interventional therapeutic field for HCC. This article aims to make a comprehensive review about gelatin sponge. (authors)

  12. Transcatheter arterial embolization with trisacryl gelatin microspheres (Embosphere®) leads to life-threatening tumor lysis syndrome in a rectal carcinoid patient with hepatic metastases

    International Nuclear Information System (INIS)

    Lo, Yuan-Hao; Tsai, Ming-Tsun; Kuo, Chen-Yu; Liu, Wen-Sheng; Lee, Rheun-Chuan; Yeh, Yi-Chen; Li, Chung-Pin; Chen, Jinn-Yang; Chao, Yee

    2012-01-01

    The incidence of gastrointestinal carcinoids appears to be increasing, and the rectum is the third most common location. Transcatheter arterial embolization (TAE) with trisacryl gelatin microspheres (Embosphere ® ) has been reported as an effective method for hepatic metastases of rectal carcinoids. Complications are uncommon and usually of minor consequence. We report an unusual case of a 34-year-old man with tumor lysis syndrome following TAE with Embosphere ® in a patient with multiple hepatic metastases of a rectal carcinoid. Early detection and effective treatment are essential for this rare but potentially catastrophic complication

  13. Combination of transcatheter arterial chemoembolization and interrupted dosing sorafenib improves patient survival in early–intermediate stage hepatocellular carcinoma

    Science.gov (United States)

    Lee, Teng-Yu; Lin, Chen-Chun; Chen, Chiung-Yu; Wang, Tsang-En; Lo, Gin-Ho; Chang, Chi-Sen; Chao, Yee

    2017-01-01

    Abstract Background/Objective: The survival benefit of treatment for unresectable hepatocellular carcinoma (HCC) with transcatheter arterial chemoembolization (TACE) combined with sorafenib remains uncertain. We compared the survival of patients treated with TACE and sorafenib with that of patients treated with TACE alone. Methods: This was a post hoc analysis of the Study in Asia of the Combination of TACE with Sorafenib in Patients with HCC (START) trial. All patients who received TACE and interrupted dosing of sorafenib for early or intermediate-stage HCC in Taiwan from 2009 to 2010 were recruited into the TACE and sorafenib group. They were randomly matched 1:1 by age, sex, Child–Pugh score, tumor size, tumor number, and tumor stage with patients from Taichung Veterans General Hospital in Taiwan who received TACE alone and who fulfilled the selection criteria of the START trial during the same time period (control group). Patient survival [cumulative incidence and hazard ratio (HR)] of the 2 groups were analyzed and compared. Results: The baseline characteristics of the 36 patients in each group were similar. Tumor response rates were significantly better in the TACE and sorafenib group (P < .04). Overall survival of the TACE and sorafenib group was also significantly better than that of the control (TACE alone) group over the 2 years [78%, 95% confidence interval (95% CI) 64–91 vs 49, 95% CI 32–66; P = .012]. In the multivariate regression analysis, TACE and sorafenib was found to be independently associated with a decreased risk of mortality (HR 0.33, 95% CI 0.12–0.89; P = .015). Multivariate stratified analyses verified this association in each patient subgroup (all HR < 1.0). Conclusion: With a high patient tolerance to an interrupted sorafenib dosing schedule, the combination of TACE with sorafenib was associated with improved overall survival in early–intermediate stage HCC when compared with treatment with TACE alone. PMID

  14. Risk factors for the leakage of chemotherapeutic agents into systemic circulation after transcatheter arterial chemoembolization of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Ming-Yen Hsieh

    2011-10-01

    Full Text Available This prospective study was to investigate the possible risk factors for the leakage of chemotherapeutic agent into the systemic circulation after transcatheter arterial chemoembolization (TACE of hepatocellular carcinoma (HCC. Peripheral plasma concentrations of chemotherapeutic agents were determined at 1 hour and 72 hours after TACE by high-performance liquid chromatography in 53 patients. HCC were divided into three types namely single nodule (<5 cm, multiple nodules (all <5 cm, and main nodule measuring 5 cm or more. Forty-four patients (83% showed detectable chemotherapeutic concentrations within 72 hours after TACE. Patients with single nodular-type HCC had lower incidence of detectable plasma chemotherapeutic agents after TACE than the other two groups (all p<0.05. The injected doses of lipiodol, epirubicin, and mitomycin C were lower in patients without detection than in patients with detectable chemotherapeutic agents (all p<0.05. Multivariate logistic regression showed that tumor type and injected dose of lipiodol were two independent risk factors for the leakage of mitomycin C at 1 hour after TACE (all p<0.05, and the injected dose of mitomycin C was the risk factor for the leakage of epirubicin at 1 hour after TACE (p<0.05. In conclusion, multiple nodular type and large nodule measuring 5 cm or more have a risk of leakage of mitomycin C after TACE. Injected dose of lipiodol and mitomycin C as risk factor for the leakage of mitomycin C and epirubicin respectively may be because of competition of their injected volume within the limited space of target.

  15. Clinical effect of systemic chemotherapy combined with transcatheter arterial chemoembolization in treatment of breast cancer with liver metastases

    Directory of Open Access Journals (Sweden)

    LI Liye

    2016-01-01

    Full Text Available ObjectiveTo investigate the clinical effect of systemic chemotherapy combined with transcatheter arterial chemoembolization (TACE in the treatment of breast cancer with liver metastases. MethodsA total of 86 female breast cancer patients with liver metastases who were treated in the Affiliated Hospital of Shandong Academy of Medical Sciences from December 2012 to December 2014 were selected and equally divided into experimental group and control group. The patients in the control group received systemic chemotherapy, and those in the experimental group received systemic chemotherapy combined with TACE. The clinical effect, changes in lesions, and patients′ quality of life (QOL scores after treatment were compared between two groups. The t-test was applied for comparison of continuous data between the two groups, and the chi-square test was applied for comparison of categorical data between the two groups. ResultsThe experimental group had a significantly higher overall response rate than the control group (90.70% vs 58.14%, χ2=13.07, P=0.001. Compared with the control group, the experimental group had significantly smaller diameters of tumors and lymph nodes after treatment (t=4.26 and 4.63, both P<0.001, as well as significantly higher QOL scores at 3 and 6 months after treatment (t=6.30 and 3.89, both P<0001. ConclusionSystemic chemotherapy combined with TACE has a significant therapeutic effect in breast cancer patients with liver metastases, and can improve patients′ symptoms, reduce adverse drug reactions, and improve QOL. As a safe and reliable therapeutic method, it is worthy of clinical application.

  16. Outcome evaluation of intra-arterial infusion of urokinase for acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Hai Bin [First Affiliated Hospital of Nanjing Medical University, Nanjing (China); Suh, Dae Chul; Lim, Soo Mee [Asan Medical Center, College of Medicine, University of Ulsan, Seoul (Korea, Republic of); And Others

    2000-06-01

    To evaluate the results of intra-arterial urokinase thrombolysis in cases of acute ischemic stroke and to define the factors affecting prognosis. Forty-eight patients with angiographically proven occlusion of the intracranial arteries were treated with local intra-arterial infusion of urokinase within six hours of the onset of symptoms. Neurologic status was evaluated on admission and on discharge using the NIH (National Institute of Health) stroke scale score (SSS). When the SSS decreased by at least four points, this was considered indicative of an improved clinical outcome. Complete recanalization was achieved in 17/48 patients (35%), including 8 of 13 (62%) with occlusion of the vertebrobasilar artery (VBA), 9 of 20 (45%) with occlusion of the middle cerebral artery (MCA), and none of 15 with occlusion of the internal carotid artery (ICA). Neurologic status improved in 12 (60%) of patients with MCA occlusion, in five (38%) of those with VBA occlusion and in three (20%) of those with ICA occlusion (p less than 0.005). Patients in whom occluded MCA was completely recanalized showed greater clinical improvement than those with partial or no recanalization (p less than 0.05). The overall mortality rate was 21%, 43% (9/21) in patients in whom CT revealed signs of early infarct, but only 4% (1/27) in those without this sign (p less than 0.05). The mortality rate of patients with parenchymal hematoma (4/5) was higher than that of those with hemorrhagic infarct (3/9) or without hemorrhage (3/34) (p less than 0.005). In patients in whom occluded MCA was completely recanalized, the clinical outcome was better, while patients with VBA occlusion did not benefit from recanalization. The presence on CT scans of signs of early infarct and of parenchymal hematoma after thrombolysis correlated with a high mortality rate. (author)

  17. Clinical application of radiofrequency ablation combined with bronchial artery infusion of docetaxel in treating non-small cell lung cancer

    International Nuclear Information System (INIS)

    Lu Xiong; Chen Fang; Lin Yun; Tan Taikang; Wei Wei

    2010-01-01

    Objective: To discuss the clinical application of radiofrequency ablation combined with bronchial artery infusion of docetaxel in treating non-small cell lung cancer and to summarize the experience of using this therapy in clinical practice. Methods: Radiofrequency ablation was performed in twenty-one patients with lung cancer. The diagnosis was confirmed by CT-guided percutaneous needle biopsy or bronchoscopic biopsy in all patients. One week after radiofrequency ablation treatment, bronchial artery infusion of docetaxel was conducted. The therapeutic results were observed and evaluated. Results: After the treatment, the lesion's size was markedly reduced and the clinical symptoms were dramatically improved in all patients. Conclusion: Radiofrequency ablation combined with bronchial artery infusion of docetaxel is a safe, effective and simple technique with excellent therapeutic results for the treatment of non-small cell lung cancer. It is really worth popularizing this technique in clinical practice. (authors)

  18. Lack of tolerance of headache and radial artery diameter during a 7 hour intravenous infusion of nitroglycerin

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Nielsen, T H; Tfelt-Hansen, P

    1993-01-01

    . The intensity of the headache was mild to medium (median headache score 3, range 1-7). The mean dilatation of the radial artery was 36%. The dilatation in each individual, was stable over time, both during NTG and placebo, and it did not change with the double infusion rate. The headache score in each......Nitroglycerin-(NTG)-induced headache and dilatation of the radial artery were followed in a double blind, randomized, placebo-controlled, cross-over study in 6 healthy volunteers. NTG 0.5 microgram.kg-1 x min-1 or saline were infused i.v. for 7 h, and subsequently the infusion rate was doubled...... individual was more fluctuant. No tolerance either to the NTG-induced headache or arterial dilatation was observed....

  19. Efficacy of transcatheter uterine artery embolization for treating emergency hemorrhage obstetrics and gynecology

    International Nuclear Information System (INIS)

    Li Hongwei

    2011-01-01

    Objective: To evaluate the efficacy of selective iliac artery embolization (TAE) or uterine artery embolization (UAE) for treatment of emergency hemorrhage in obstetrics and gynecology. Methods: Selective bilateral TAE or UAE were performed on 59 patients with acute cervical hemorrhage from postpartum hemorrhage (30), cervical cancer (16), endometrial cancer (8), and choriocarcinoma (5). Gelfoam particles were used in postpartum hemorrhage; chemotherapeutics and Iodipin suspension were used in malignancy. Results: Bleeding was stopped completely in all 59 patients with TAE or UAE procedure time of 30-50 minutes (mean: 42.17±4.78 minutes). There were no serious complications. Conclusion: TAE or UAE are effective for treating emergency hemorrhage in obstetrics and gynecology. (authors)

  20. Investigation of transfection efficacy with transcatheter arterial transporting transferring to enhance p53 gene

    International Nuclear Information System (INIS)

    Lu Qin; Niu Huanzhang; Zhu Guangyu; An Yanli; Qiu Dinghong; Teng Gaojun

    2007-01-01

    Objective: To investigate the function of transferrin-DNA complex, transported by transferrin(Tf) and trans-arterial injection via interventional approach be the duel-target-orientated delivery and the transferring into malignant cells to get more effective therapy. Methods: p53-LipofectAMINE ligand with different concentrations of Tf (0, 10, 25, 50, 100 μg)transfected the 4 strains including LM6,Hep3B,YY and L02 in vitro to evaluate the gene transfection efficiency through western blot. Then, after setting up the VX2 hepatocarcinoma models, we delivered the Tf-p53-LipofectAMlNE complex into the hepatic arteries via interventional techniques to analyse the transfection efficiency in vivo. Results: Tf, within the range of l0 100 μg, could increase gene transfection efficiency mediated by liposome, and the efficiency increases with the raise of Tf concentration. Combination with interventional technique to inject Tf-DNA complex into tumor arteries, gene transfection efficiency was enhanced in rabbit models. Conclusion: Tf can enhance gene-liposome transfection efficiency, furthermore with combination of interventional catheter technique, there would be a potential duel-target-orientated gene therapy method. (authors)

  1. Investigation of transfection efficacy with transcatheter arterial transporting transferring to enhance p53 gene

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Lu; Huanzhang, Niu; Guangyu, Zhu; Yanli, An; Dinghong, Qiu; Gaojun, Teng [Radiologic Department, Zhongda Hospital, Southeast Univ., Nanjing (China)

    2007-02-15

    Objective: To investigate the function of transferrin-DNA complex, transported by transferrin(Tf) and trans-arterial injection via interventional approach be the duel-target-orientated delivery and the transferring into malignant cells to get more effective therapy. Methods: p53-LipofectAMINE ligand with different concentrations of Tf (0, 10, 25, 50, 100 {mu}g)transfected the 4 strains including LM6,Hep3B,YY and L02 in vitro to evaluate the gene transfection efficiency through western blot. Then, after setting up the VX2 hepatocarcinoma models, we delivered the Tf-p53-LipofectAMlNE complex into the hepatic arteries via interventional techniques to analyse the transfection efficiency in vivo. Results: Tf, within the range of l0 100 {mu}g, could increase gene transfection efficiency mediated by liposome, and the efficiency increases with the raise of Tf concentration. Combination with interventional technique to inject Tf-DNA complex into tumor arteries, gene transfection efficiency was enhanced in rabbit models. Conclusion: Tf can enhance gene-liposome transfection efficiency, furthermore with combination of interventional catheter technique, there would be a potential duel-target-orientated gene therapy method. (authors)

  2. Radiation exposure to patient and radiologist during transcatheter arterial embolization therapy for hepatocellular carcinoma. Multicenter study in Japan

    International Nuclear Information System (INIS)

    Ishiguchi, T.; Nakamura, H.; Okazaki, M.

    2000-01-01

    Transcatheter arterial embolization (TAE) is now most commonly used as a treatment of hepatocellular carcinoma. Present multicenter study was carried out to evaluate radiation exposure to patients and interventional radiologists during the procedure. Thirty-nine procedures of TAE for hepatocellular carcinoma in eight institutes were analyzed. Radiation exposure to the patients and the interventional radiologists were evaluated with LiF thermoluminescence dosimeters (TLDs) placed on the patient's skin at the posterior hepatic portion and the pelvis and the operator's forehead and abdomen (in front and back of the lead apron). A real-time dosimeter was also used to evaluate skin dose of the patient. TAE was performed by angiographic techniques, using a microcatheter advanced to the hepatic artery branch(es) under the guidance of X-ray fluoroscopy and digital subtraction angiography (DSA), and then injecting chemotherapeutic agents mixed with oily contrast material and followed by gelatin sponge particles. The mean fluoroscopic time was 21 minutes and the mean number of DSA acquisition was 6. TLD dosimetry showed that the mean entrance surface dose of the patient at the hepatic portion was 973±681 mSv (mean±SD), and the anterior skin dose at the pelvis was 0.98±0.69 mSv. The doses of the radiologist were 0.04±0.04 mSv at the forehead, 0.15±0.19 mSv at the abdomen in front of the lead apron, and 0.005±0.01 mSv behind it. The real-time dosimetry showed that 56% of the surface dose at the hepatic portion was from DSA and 44% was from fluoroscopy. The radiation exposure to the patients and the interventional radiologists during TAE for hepatocellular carcinoma was considered to be acceptable when proper techniques are used. Further effort to reduce radiation doses during the procedure will be directed toward both digital angiographic and fluoroscopic techniques. (author)

  3. Preoperative balloon occluded arterial infusion chemotherapy for locally invasive bladder cancer. Accurate staging for bladder preservation

    International Nuclear Information System (INIS)

    Hayashi, Norio; Arima, Kiminobu; Kawamura, Juichi; Tochigi, Hiromi

    1999-01-01

    The possibility of bladder preservation by preoperative balloon occluded arterial infusion (BOAI) chemotherapy was studied in 111 patients with locally invasive bladder cancer. BOAI was performed by blocking the blood flow of the internal iliac artery and by performing intra-arterial infusion of adriamycin (50 mg/body) and cisplatin (100 mg/body). Before BOAI the clinical diagnosis was T2 in 36, T3a in 29, T3b in 27, T4 in 11 and after BOAI it was T0 in 1, T1 in 27, T2 in 25, T3a in 20, T3b in 20, and T4 in 10. Down staging was observed on diagnostic images in 46.6%. Thirty patients (27.0%) received transurethral resection of bladder tumor (TUR-Bt) and their bladder could be preserved. The 5-year cancer-specific survival rate was 100% in pT0 (n=9), 97.5% in pT1 (n=47), 79.9% in pT2 (n=21), 80.0% in pT3a (n=6), 39.9% in pT3b (n=18) and 51.9% in pT4 cases (n=9). For the bladder preservation, accurate staging diagnosis is required. Since 1992, endorectal magnetic resonance imaging (MRI) has been used in addition to imaging diagnosis for improving the accuracy of staging diagnosis. The accuracies of staging diagnosis with and without endorectal MRI were 62.5% and 44.0%, respectively. BOAI as a neoadjuvant chemotherapy has the possibility of bladder-preserving therapy in locally invasive bladder cancer. Also, the endorectal MRI can improve the accuracy of staging diagnosis, which is important for the bladder preservation. (author)

  4. Bleeding after dilatation and curettage: the efficacy of transcatheter uterine artery embolisation

    International Nuclear Information System (INIS)

    Song, Y.; Shin, J.H.; Yoon, H.-K.; Kim, J.W.; Ko, G.-Y.; Won, H.-S.

    2015-01-01

    Aim: To evaluate safety and clinical outcomes of uterine artery embolisation (UAE) for bleeding after dilatation and curettage (D&C) performed for abortion or termination. Materials and methods: The outcomes were analysed in 11 patients who underwent UAE for bleeding after D&C for missed abortions (n=8), caesarean scar pregnancies (n=2), or planned termination (n=1) between October 2001 and December 2013. Angiograms and medical records were retrospectively reviewed in order to obtain the patients' baseline characteristics, technical/clinical success rate, complications, and follow-up data regarding menstruation. Results: Technical success, defined as successful catheterisation of both uterine arteries with embolisation to haemostasis, was 100%, whereas clinical success, defined as cessation of bleeding after the initial session of UAE and without the need for additional UAE or surgery for the purpose of haemostasis, was 81.8% (nine of 11). In the two patients with clinical failure due to recurrent vaginal bleeding after UAE, one patient underwent repeat UAE and showed a successful outcome, whilst the other patient required hysterectomy with pathological results of placenta increta. Two other patients underwent hysterectomy for placenta percreta or hydatidiform mole-mimicking remnant placenta. None of the patients included in the present series had procedure-related complications. Menstruation resumed in all eight patients with an intact uterus during the mean follow-up period. Conclusion: UAE may be a safe and effective treatment for bleeding after D&C, especially for women who wish to preserve their fertility; however, hysterectomy may be indicated for patients with a placental abnormality. - Highlights: • We evaluate outcomes of uterine artery embolization for bleeding after D&C. • UAE may be a safe and effective treatment for bleeding after D&C. • Hysterectomy may be indicated for patients with a placental abnormality.

  5. Daily concurrent chemoradiotherapy using superselective intra-arterial infusion via superficial temporal artery. Preoperative therapy for stage III, IV oral cancer

    International Nuclear Information System (INIS)

    Tohnai, Iwai; Mitsudo, Kenji; Nishiguchi, Hiroaki; Fukui, Takafumi; Yamamoto, Noriyuki; Ueda, Minoru; Fuwa, Nobukazu

    2005-01-01

    Recently, daily concurrent chemoradiotherapy using new superselective intra-arterial infusion via superficial temporal arterial artery is attracting attention. The catheter with curved tip is inserted superselectively to the feeding artery of the tumor via the superficial temporal artery, allowing long-term catheterization. Forty-one patients with stage III, IV oral cancer were treated. Radiotherapy (total dose: 40 Gy/4 weeks) and superselective intra-arterial infusion chemotherapy using docetaxel (total dose: 60 mg/m 2 , 15 mg/m 2 /week) and cisplatin (total dose: 100 mg/m 2 , 5 mg/m 2 /day) were concurrently performed daily, followed by surgery. In 35 patients, intra-arterial infusion was successful (success rate: 85.4%) and no major complication was observed. The clinical effects were complete response (CR) in 29 patients (82.9%), and pathological effects of resected tumor after surgery were pathological CR in 31 (88.6%). This method promises to be a new strategy of choice for the treatment of oral cancer. (author)

  6. Treatment with continuous subcutaneous insulin infusion is associated with lower arterial stiffness

    DEFF Research Database (Denmark)

    Vestergaard Rosenlund, Signe; Theilade, Simone; Hansen, Tine Willum

    2014-01-01

    AIMS: To investigate the relationship between arterial stiffness and insulin treatment mode [continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI)] in type 1 diabetes patients. METHODS: Cross-sectional study, from 2009 to 2011, including 601 Caucasian type 1...... diabetes patients, 58 and 543 treated with CSII and MDI, respectively. Arterial stiffness was measured as pulse wave velocity (PWV) (SphygmoCor, AtCor Medical). Adjustment included gender, age, diabetes duration, HbA1c, heart rate, mean arterial pressure, P-creatinine, urinary albumin excretion rate (UAER......-treated patients were 48 versus 57 % men, 51 ± 11 versus 54 ± 13 years old (mean ± SD), had 33 ± 12 versus 32 ± 16 years diabetes duration and HbA1c 7.8 ± 0.9 % (62 ± 10 mmol/mol) versus 8.0 ± 1.2 % (64 ± 13 mmol/mol) (P ≥ 0.08 for all). PWV was lower in CSII- versus MDI-treated patients (9.3 ± 2.8 vs. 10.4 ± 3...

  7. The Usefulness of Three-Dimensional Angiography with a Flat Panel Detector of Direct Conversion Type in a Transcatheter Arterial Chemoembolization Procedure for Hepatocellular Carcinoma: Initial Experience

    International Nuclear Information System (INIS)

    Kakeda, Shingo; Korogi, Yukunori; Hatakeyama, Yoshihisa; Ohnari, Norihiro; Oda, Nobuhiro; Nishino, Kazuyoshi; Miyamoto, Wataru

    2008-01-01

    The purpose of this study was to assess the usefulness of a three-dimensional (3D) angiography system using a flat panel detector of direct conversion type in treatments with subsegmental transcatheter arterial chemoembolization (TACE) for hepatocellular carcinomas (HCCs). Thirty-six consecutive patients who underwent hepatic angiography were prospectively examined. First, two radiologists evaluated the degree of visualization of the peripheral branches of the hepatic arteries on 3D digital subtraction angiography (DSA). Then the radiologists evaluated the visualization of tumor staining and feeding arteries in 25 patients (30 HCCs) who underwent subsegmental TACE. The two radiologists who performed the TACE assessed whether the additional information provided by 3D DSA was useful for treatments. In 34 (94.4%) of 36 patients, the subsegmental branches of the hepatic arteries were sufficiently visualized. The feeding arteries of HCCs were sufficiently visualized in 28 (93%) of 30 HCCs, whereas tumor stains were sufficiently visualized in 18 (60%). Maximum intensity projection images were significantly superior to volume recording images for visualization of the tumor staining and feeding arteries of HCCs. In 27 (90%) of 30 HCCs, 3D DSA provided additional useful information for subsegmental TACE. The high-quality 3D DSA with flat panel detector angiography system provided a precise vascular road map, which was useful for performing subsegmental TACE .of HCCs

  8. Effect of intra arterial nimodipine infusion for the treatment of symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Lee, Jin Young; Shin, Hwa Seon; Choi, Hye Young; Chung, Sung Hoon; You, Jin Jong; Choi, Dae Seob; Son, Seung Nam; Ryu, Jae Wook

    2012-01-01

    Symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage (SAH) is one of the major factors which cause morbidity and mortality of patients. The purpose of this study was to evaluate the effectiveness of intra-arterial nimodipine (IAN) infusion therapy in patients with symptomatic cerebral vasospasm. Between February 2005 and April 2011, fifty patients with symptomatic cerebral vasospasm following an aneurysmal SAH were treated with IAN infusion. After selective arterial catheterization, nimodipine was infused at a rate of 0.1 mg/min and a total of 2-3 mg per vessel was infused. We retrospectively reviewed the immediate angiographic results and clinical outcome at discharge. A grade of 5 and 4 in the Glasgow Outcome Scale (GOS) were considered favorable outcomes. In 50 patients, 117 procedures of IAN infusion (1-7; mean, 2.3)were done. After the treatment, immediate angiographic improvement was achieved in 113 (96.6%) of 117 procedures. No major complications occurred. At discharge, 38 (76%) patients showed a favorable clinical outcome in the GOS. IAN infusion therapy is safe and effective for the treatment of cerebral vasospasm following an aneurysmal SAH. However, the limitation is that repeated treatment is needed

  9. Transcatheter arterial chemoembolization (TACE) combined with γ-knife compared to TACE or γ-knife alone for hepatocellular carcinoma.

    Science.gov (United States)

    Cai, Yeyu; Chang, Qian; Xiao, Enhua; Shang, Quan-Liang; Chen, Zhu

    2018-06-01

    To compare the clinical efficacies and adverse reactions between transcatheter arterial chemoembolization (TACE), γ-ray 3-dimensional fractionated stereotactic conformal radiotherapy (FSCR), and TACE combined with FSCR for primary hepatocellular carcinoma.The study was approved by the Institutional Review Board, and informed consent was waived due to the retrospective study design. About 121 patients met the inclusion criteria and were included in this study, from March 2008 to January 2010, in the Second Xiangya Hospital. Forty-six patients underwent TACE alone, 36 patients underwent γ-knife alone, and 39 were treated by γ-knife combined with TACE. Short-term effects, overall survival rates, adverse reactions, and survival times were compared between the 3 treatment groups.Short-term effects were observed in 41.3% of the TACE group, 33.3% of the γ-knife group, and 64.1% of the TACE combined γ-knife group (P = .020). Overall survival rates at 6,12, 18, and 24 months were 50%, 34.8%, 28.3%, and 21.7% for the TACE group, 36.1%, 30.6%, 16.7%, and 11.1% for γ-knife group, and 84.6%, 71.8%, 61.5%, and 30.8% for TACE combined γ-knife group, respectively. The differences in the overall survival rates at 6, 12, and 18 months between the 3 groups were statistically significant (P = 0), but the overall survival rates at 24 months in the 3 groups were not significantly different (P = .117). The median survival time was 7 months for the TACE group, 3 months for the γ-knife group, and 20 months for the TACE combined γ-knife group (P = 0). There were statistically significant differences (P = .010) of leukopenia between the 3 groups, and no statistically significant differences of (P > .05) thrombocytopenia, anemia, nausea, vomiting, and liver function lesions.TACE combined with γ-knife for primary hepatocellular carcinoma is superior to TACE or γ-knife alone in short-term and long-term effects. This procedure is a mild, safe, and effective

  10. Analysis of adverse reactions and complications of transcatheter uterine artery embolization (TUAE) for uterine fibroids

    International Nuclear Information System (INIS)

    Chen Xiaoming; Luo Pengfei; Du Juan; Zuo Yuewei; Hu Xiaoping; Hong Danhua; Lin Huahuan; Li Gaowen; Liu Suyun

    2002-01-01

    Objective: To investigate the adverse reactions and complications as well as their preventive and therapeutic measures of TUAE for uterine fibroids. Methods: One hundred and eighty-two patients with uterine fibroids were treated by TUAE. Bilateral uterine arteries were embolized using lipiodol-pingyangmycin emulsion (LPE), together with Gelfoam particles. All patients were hospitalized for 3 to 10 days after TUAE and were followed up for 1 to 24 months to observe the adverse reactions and complications. Results: Adverse reactions of TUAE included postembolization syndrome ( n 182); urinary irritation ( n = 24), and hyporrhea of vagina ( n = 25 ) . Complications of TUAE included expelling of necrotic fibroids per vagina ( n = 5 ); urinary retention ( n = 10); urinary tract infection ( n = 1 ); ulcer of labia minora ( n = 1 ); ecchymosis and ulceration on buttock ( n = 1), and secondary infection of chocolate cyst of ovary. ( n = 1 ). All the above-mentioned side effects of TUAE recovered to normal after expectant or especial treatment without any sequels left. Conclusion: The adverse reactions of TUAE are reversible and the complications of TUAE are preventable and curable

  11. Percutaneous implantation of intra-arterial port system for regional drug infusion: results and complications in 110 cases

    International Nuclear Information System (INIS)

    Won, Je Hwan; Lee, Jong Hyuk; Ko, Kyung Hee; Won, Jong Yoon; Park, Sung Il; Lee, Do Yun; Kang, Byung Chul

    2000-01-01

    To investigate the feasibility and complications of a percutaneously implantable port system for regional drug infusion. For intra-arterial drug infusion, a 5.8 or 5-F pediatric venous port system was implanted in 110 patients with hepatocellular carcinoma (n=79), liver metastasis (n=16), gallbladder cancer (n=4), stomach cancer (n=3), pancreatic cancer (n=3), Burger's diseases mellitus (n=2), or lymphoma (n=1). All intra-arterial port implantations were performed percutaneously in an angiographic ward through the common femoral artery (n=98), left subclavian artery (n=10), or left superficial femoral artery (n=2). Complications were evaluated during the follow-up period, which ranged from 21 to 530 (mean, 163) days. The technical success rate for percutaneous implantation of the system was 97.3% (107 of 110 patients). The tips of the port catheter were located in the common hepatic artery (n=34), proper hepatic artery (n=49), right hepatic artery quick resulthepatic artery (n=1), descending aorta at T9 level (n=10), left popliteal artery (n=2), right external iliac artery (n=1), left external iliac artery (n=1), or left deep femoral artery (n=1). Complications were encountered in 24 patients (22.4%), namely chamber site infection (n=7), catheter dislodgement (n=7), catheter occlusion (n=3), migration of coil (n=2), disconnection between chamber and catheter (n=1), kinking of catheter (n=1), arterial occlusion (n=1), necrosis of overlying skin (n=1), and leakage around port chamber (n=1). Outcomes of complications included removal of port systems or cessation of therapy in 12 cases (11.2%), correction of catheter location using a guide wire in five (4.7%), thrombolysis with urokinase in three (2.8%), and straightening using a snare in one (0.9%). In three patients, the port system was used without reintervention. Percutaneous implantation of an intra-arterial port system showed a high technical success rate and a low rate of serious complications. The method may be

  12. Prospect of drug distribution to hepatic cancer in intra-arterial infusion chemotherapy. Examination by infusion of sup(81m)Kr and /sup 133/Xe via catheter into hepatic artery

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Y; Imaoka, S; Matsui, Y; Ishikawa, O; Taniguchi, K [Osaka Prefectural Center for Adult Diseases (Japan)

    1982-04-01

    Cannulation into the hepatic artery under laparotomy was performed to nine patients of non-resectable hepatic cancer (eight of hepatocellular carcinoma, and one of cholangiocellular carcinoma), and injected sup(81m)Kr (Tsub(1/2) = 13 sec.) continuously via catheter into hepatic artery as the model of continuous intra-arterial infusion chemotherapy, and /sup 133/Xe (Tsub(1/2) = 5.3 days) by bolus injection as the model of one-shot ones. During and immediately after injection, sequential scintigrams were carried out and simultaneously images were acquired on a medical computer. Higher radioactivities of both sup(81m)Kr and /sup 133/Xe were observed in tumor than non-tumor region in seven of eight patients of hepatocellular carcinoma. The radioactive ratio of tumor to non-tumor (T/C ratio) was over 1.0 in these cases. This result indicated that there was more arterial blood flow in tumor than non-tumor region, and it could be expected to obtain higher distribution of drugs in tumor on both continuous and one-shot infusion chemotherapy. The pattern of distribution of sup(81m)Kr changed according to positions of patients, and in some cases T/C ratio was higher in other positions than supine position. The most effective position of the intra-arterial infusion chemotherapy could be selected by this method. This technique seems to make it possible to prospect the arrival of drugs to the tumor and presume the effectiveness of intra-arterial infusion chemotherapy.

  13. Intra-arterial infusion of MTX for the treatment of cesarean scar pregnancy: a comparative study between different doses

    International Nuclear Information System (INIS)

    Gu Weijin; Wang Haiyun; Wan Jun; Zhang Lei; Wang Ying; Wang Wei; Ji Fang; Ji Lihua

    2010-01-01

    Objective: To investigate the effective dose of methotrexate (MTX) via intra-arterial infusion for the treatment of cesarean scar pregnancy. Methods: Thirty-six cases of incisional scar pregnancy at the gestational age of 5-9 weeks received bilateral uterine arterial infusion of MTX. According to the dose of MTX used, the patients were randomly and equally divided into four groups with MTX dose of 60, 100, 150 and 200 mg respectively. After the perfusion was completed the embolization of both uterine arteries with Gelfoam was carried out until the uterine arteries were no longer visualized on DSA. Uterine curettage was conducted within 1-7 days after the treatment. Results: In one week after the procedure, the difference in the decreasing rate of serum β-HCG and progesterone between group 60 mg and group 200 mg was of statistical significance (P 0.05). The hospitalization days of group 60 mg was the longest, while that of group 200 mg was the shortest. Conclusion: The recommended dose of MTX used via intra-arterial infusion in treating cesarean scar pregnancy is 200 mg. The interventional procedure can kill the embryo tissue and quickly lower the serum β-HCG and progesterone levels,it can also shorten the patient's hospitalization time. (authors)

  14. Daily concurrent preoperative chemoradiotherapy using superselective intra-arterial infusion via superficial temporal artery for advanced oral cancer. Histological evaluation of metastatic cervical lymph nodes

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Yamamoto, Noriyuki; Shigetomi, Toshio

    2010-01-01

    Superselective intra-arterial chemotherapy via a superficial temporal artery has become feasible for daily concurrent radiotherapy and chemotherapy in patients with oral cancer. In this study, histopathological effects on metastatic cervical lymph nodes in cases of advanced oral cancer using superselective intra-arterial chemoradiotherapy were evaluated. Thirty-seven oral cancer patients with cervical lymph node metastasis were treated with preoperative chemoradiotherapy using superselective intra-arterial infusion via the superficial temporal artery. The treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m 2 ; cisplatin, total 100-150 mg/m 2 ) and concurrent radiotherapy (total 40-60 Gy) for 4-6 weeks, followed by surgery. In cases in which the catheter was inserted into the facial artery, grade III or IV (Oboshi-Shimosato classification) in the cervical lymph node metastasis was obtained in 20 (83.3%) of 24 patients. And, forty-six (88.5%) of 52 metastatic lymph nodes showed grade III or IV. This method was an effective regimen for oral cancer with cervical lymph node metastasis. (author)

  15. Experimental study on intra-arterial infusion of basic fibroblast growth factor in the ischemic limbs of rabbit model

    International Nuclear Information System (INIS)

    Zhang Jing; Yang Wenduo

    2005-01-01

    Objective: To evaluate the effect of intra-arterial infusion of basic fibroblast growth factor (bFGF) on improving neovascularization, vascular perfusion and the function of partially ischemic limbs of rabbits. Methods: Twenty-seven New Zealand male rabbits were selected. Partial ischemia model was induced by surgical ligation of the primary branches of right femoral artery in each animal, and the left hind limb of each animal was served as a nonischemic control. Then, 27 rabbits were randomly assigned to three groups: intra-arterial (IA) infusion of bFGF (n=9), intravenous (IV) infusion of bFGF and IA infusion of saline (n=9). Infusion was separately performed immediately after vascular ligation, 8th and 15th days post-surgery with 10 μg (4 ml) of bFGF per-time (or the same volume of saline). The differences between three groups and between ischemic and nonischemic limbs of the same group were compared and evaluated by the following indexes: (1) vessel section count (VSC), vessel section surface area (VSS) and vessel section perimeter (VSP) in the field of ischemic muscle tissues taken at 22nd day postoperatively; (2) capillary refilling time of ischemic limbs; and (3) functional and trophic changes of ischemic limbs. Statistical differences were evaluated by one-way ANOVA and T test. Results: VSC, VSS and VSP of the IA-bFGF group were significantly increased than those of the IV-bFGF and IA-saline groups (P<0.01). At 22nd day postoperatively, the capillary refilling time, new hair growth, the appearance and function of all ischemic limbs in IA-bFGF group were approximately normal. However, in IA-saline group, the ischemic changes, capillary refilling time and the function of ischemic limbs were not improved significantly. All the indexes of IV-bFGF group showed no difference statistically from those of IA-saline group. Conclusions: This experimental study identifies that intra-arterial infusion of bFGF may significantly promote neovascularization and vascular

  16. High contrast enhancement aspect of dynamic computed tomography with arterial infusion - DCT-AI

    International Nuclear Information System (INIS)

    Kato, Seishi; Iwasaki, Naoya; Matsumura, Yoshimitsu; Kuramae, Shigeru; Mishiro, Tadashi

    1983-01-01

    Dynamic computed tomography was performed on 112 cases possibly having hepatic tumors with intraarterial infusion of undiluted contrast into a selectively placed catheter following angiographies. Our dynamic program could evaluate not only early phase of enhancement but also late phase up to 120 sec. Reconstructed views from early scans and magnified views were very useful to evaluate minute sequential changes. Hepatic masses less than 5 cm in size were found in thirty-one cases. Patterns of tumor enhancement and time-density curves have been analysed to correlate them with histology. Four types of tumor enhancement were noted: (1) homogeneous (2) patchy (3) mottled (4) ringed. Characteristic changes were observed in hepatocellular carcinoma - HCC - (mostly mottled) and haemangioma (mostly patchy). The former was divided in two groups reflecting the cellular maturity. The metastatic tumor could be enhanced in a ringed form with dendritic pattern of supplying vascularities in some cases. To support the use of undiluted contrast and to investigate the diagnostic efficacy of high contrast enhancement, experiments were performed by taking transaxial views of an acrylic phantom immersed in different concentrations of contrast. Analysis of CT images taken at different HU values ranging from 0 to 450 demonstrated that the higher the concentration of contrast, the better the spatial resolution was. Also larger magnification could be expected by using higher concentration of contrast. Although our Dynamic Computed Tomography with Arterial Infusion of Contrast still has drawbacks and limited indications, we advocate it as a better way of enhancement to detect and evaluate the hepatic masses, which sometimes elude the examiner's grasp with conventional way of enhancement. (author)

  17. Influence of the catheter-top-position upon the distribution pattern of continuous intra-arterially infused chemotherapeutic agent

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    Ichinohe, Hyobu

    1980-01-01

    The whole body scanning showed the distribution pattern of infused drug in continuous intra-arterially infused chemotherapy by using a gamma camera and infused RI (sup(99m)Tc-MAA) from catheter. I measured the whole body scanning counts without shield (A) and with lead shield (B) on ROI and natural back ground counts (BG). Then I calculated the distribution ratio on ROI as following. [(A-B)/(A-BG)] x 100(%). It was easy to find a certain relation between the catheter-top-position and the distribution ratio. As a result of investigating data, there were about 4 catheter-top-positions in aorta. Case by case, we putted the catheter-top in better position and prevented technical side effects and measured roughly total dose on ROI. (author)

  18. The study of combination therapy for arterial infusion chemotherapy and radiation therapy in unresectable gallbladder cancer

    International Nuclear Information System (INIS)

    Goto, Takuma; Saito, Hiroya; Yanagawa, Nobuyuki; Fujinaga, Akihiro; Saito, Yoshinori

    2013-01-01

    In this study, we investigated an effective strategy of treatment for unresectable gallbladder cancer (GBC) by the retrospective analysis of prognostic factors and anti-tumor therapies, especially combination therapy of arterial infusion chemotherapy and radiation therapy (AI+PT). Forty-three patients with unresectable GBC were enrolled, and prognostic factors were investigated by multivariate analysis using a proportional hazard model. In addition, we examined the indication and after-therapy by analyzing the each factor cumulative survival rates and anti-tumor effect about the AI + RT group (n=24). AI + RT and the responders to the first-line therapy were significant prognostic factors. In AI + RT group, median survival time, progression-free survival and the 1-year survival rate, the response and disease control rates was 15.5 months, 7.1 months, 62.5%. 54.2% and 95.8%, respectively; which suggested prolonged survival and high anti-tumor effect. Cumulative survival rate was significantly shorter in cases with distant metastasis except liver metastases, and has been tendency to extend in the group who underwent systemic chemotherapy as after-therapy. The treatment strategy, using the Al + RT as first-line with the systemic chemotherapy as after-therapy, suggested contribute to the prolonged survival in locally advanced and liver metastases cases of GBC. (author)

  19. Efficacy of superselective intra-arterial infusion chemotherapy with concomitant radiotherapy for advanced hypopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Bandoh, Nobuyuki; Takahara, Miki; Moriai, Shigetaka; Katayama, Akihiro; Katada, Akihiro; Hayashi, Tatsuya; Harabuchi, Yasuaki; Nagasawa, Kenichi

    2008-01-01

    Patients with advanced hypopharyngeal carcinoma still have a poor outcome in spite of radical surgery with chemoradiotherapy. We started superselective intra-arterial infusion chemotherapy with concomitant radiotherapy (IA chemoradiation) for advanced hypopharyngeal carcinoma in 2003. The complete response (CR) rate for local and neck lesions was 94.1% and 60%, respectively. After neck dissection the total CR rate was 82.4%. There was no significant difference in survival rates between groups with IA chemoradiation (n=22) and with surgery with preoperative chemoradiotherapy (n=57). However, Kaplan-Meier analysis showed that the cause-specific survival rate in N3 patients and larynx preservation rate was significantly higher in patients treated with IA chemoradiation than in those with surgery with preoperative chemoradiotherapy (p<0.05 and p<0.001). Subjective symptoms are not so severe in patients without the disease after IA chemoradiation. IA chemoradiation is effective for patients with advanced hypopharyngeal carcinoma to maintain quality of life such as voice and swallowing. (author)

  20. Neoadjuvant chemotherapy by bronchial arterial infusion in patients with unresectable stage III squamous cell lung cancer.

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    Zhu, Jun; Zhang, Hai-Ping; Jiang, Sen; Ni, Jian

    2017-08-01

    We investigated the effects of neoadjuvant chemotherapy administered via bronchial arterial infusion (BAI) on unresectable stage III lung squamous cell carcinoma (SCC). This was a single-arm retrospective study of chemotherapy with gemcitabine plus cisplatin (GP) administered via BAI to patients with unresectable lung SCC. Data regarding the post-treatment response rate, downstage rate, and surgery rate, as well as progression-free survival (PFS), overall survival (OS), quality of life, and post-BAI side effects were collected. A total of 36 patients were enrolled in this study between August 2010 and May 2014. The response rate was 72.2%, and the downstage rate was 22.2%. Among the patients who were downstaged, 16 (44.4%) patients were because of their T stage, and 5 (13.9%) patients were downstaged due to to their N stage. The surgery rate was 52.8%, the 1-year survival rate was 75.4%, and the 2-year survival rate was 52.1%. The median PFS was 14.0 months [95% confidence interval (CI): 8.6-19.4], and the median OS was 25.0 months (95% CI: 19.1-30.9). The quality of life was significantly improved, and the chemotherapy was well tolerated. Compared with intravenous neoadjuvant chemotherapy, BAI chemotherapy significantly improved the surgery rate, prolonged PFS and OS, and improved the quality of life in patients with unresectable stage III lung SCC.

  1. Indications for intra-arterial infusion of urokinase in the treatment of acute gut ischaemia in patients with heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Y; Schichijo, Y; Ibukuro, K

    1985-12-01

    The poor prognosis of acute mesenteric artery occlusion can be improved by reaching a rapid angiographic diagnosis and by instituting treatment at an early stage. In addition to operative embolectomy, success may be expected from the use of urokinase infused superselectively into the superior mesenteric artery. This treatment is only likely to be successful if it is carried out within ten hours of the onset of clinical signs and symptoms. In patients with heart disease, angiography is recommended as soon as there is any suspicion of mesenteric occlusion, in order to confirm the diagnosis, localise the embolus and decide on the form of treatment. Urokinase treatment can be successful for embolic occlusion of the main branches or peripheral branches of the superior mesenteric artery. However, complete occlusion of the main superior mesenteric artery should be treated operatively. A contra-indication to urokinase therapy is occlusion due to infected emboli from an endocarditis.

  2. Radical resection for low rectal carcinoma combined with infusion pump chemotherapy via internal iliac artery

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    Bo YANG

    2011-10-01

    Full Text Available Objective To evaluate the effects and practicability of radical resection for low rectal carcinoma with infusion pump chemotherapy via internal iliac artery,and explore the correlation factors influencing the therapeutic effects.Methods Data of 316 patients with low rectal carcinoma,admitted from Oct.1997 to Mar.2008,were retrospectively analyzed and assigned into 2 groups according to the treatment: Patients received infusion pump chemotherapy via internal iliac artery to target area combined with intravenous systemic chemotherapy were assigned into group A(n=249,and those receiving systemic chemotherapy alone following radical resection were assigned to group B(n=67.The timing of pump chemotherapy to target area in group A was set at day 12 after recovery of digestive function,with regimen of 5-FU at 0.5g per dose plus hydroxycamptothecin at 10-15mg per dose,twice a week,four times as a treatment course for a total of 6 courses,and it was followed by intravenously systemic chemotherapy with a regimen of FOLFIRI or FOLFOX.In group B,at day 12 right after recovery of digestive function,the intravenous sytemic chemotherapy was started with the same regimen as in group A.The local recurrence rate,metastasis rate and survival rate after 1,3 and 5 years in the two groups were respectively observed and compared,and the correlation between the clinicopathological features and the 5 year local recurrence rates and survival rates was analyzed in patients of group A.Results In group A,the local recurrence rate at year 1,3 and 5 was 0,1.68%(4/238 and 3.79%(8/211,respectively,the metastasis rate was 0.80%(2/249,4.62%(11/238 and 10.90%(23/211,respectively,and the survival rate was 100%,77.73%(185/238 and 72.04%(152/211,respectively.In group B,the local recurrence rate at year 1,3 and 5 was 0,9.52%(6/63 and 16.36%(9/55,respectively,the metastasis rate was 1.49%(1/67,15.87%(10/63 and 27.27%(15/55,respectively,and the survival rate was 100

  3. The efficacy of superselective intra-arterial infusion in patients with T4 oral cancer. Comparison with conventional chemotherapy

    International Nuclear Information System (INIS)

    Arakaki, Keiichi; Arasaki, Akira; Kano, Takeshi

    2009-01-01

    Since 1985, we have applied systematic treatment to improve radicality and postoperative oral dysfunction, as well as maxillofacial deformity. However, most T4 cases of oral cancer have remained difficult to treat, and diverse methods and results for progressive cancer have been reported by many institutions. For high-grade malignancy cases, we changed the treatment from bleomycin or cisplatin in induction chemotherapy to targeted intra-arterial infusions of carboplatin with radiation-combined therapy. In this study, we compared the effects of conventional therapy with targeted intra-arterial infusions of carboplatin for T4 cases of oral cancer. In this retrospective review, we analyzed a subset of patients who were treated with induction chemotherapy using bleomycin (BLM) and targeted intra-arterial infusions of carboplatin (CBDCA) with radiation-combined therapy patients who received treatment between June 1985 and December 2006. Of the 105 patients who had T4 disease, the proportion with grade IIb to IV in the carboplatin with radiation-combined therapy (88.9%) was higher than that in induction chemotherapy (45.0%). Targeted chemoradiation therapy followed by surgical salvage is a highly effective approach for the regional control of patients with T4, although additional strategies are required to address the problem of distant metastases. (author)

  4. A Novel External Carotid Arterial Sheath System for Intra-arterial Infusion Chemotherapy of Head and Neck Cancer.

    Science.gov (United States)

    Ii, Noriko; Fuwa, Nobukazu; Toyomasu, Yutaka; Takada, Akinori; Nomura, Miwako; Kawamura, Tomoko; Sakuma, Hajime; Nomoto, Yoshihito

    2017-07-01

    The purpose of this study was to describe a novel system for treating advanced head and neck cancer consisting of an external carotid arterial sheath (ECAS) and a microcatheter to inject drugs retrogradely into multiple feeding arteries through the superficial temporal artery (STA). Four consecutive patients with head and neck cancer that had more than one feeding artery were enrolled in this study. The ECAS was made of polyurethane and surface-coated with heparin resin to prevent thrombus formation, allowing it to remain in place for a prolonged period of time. The ECAS was inserted through the STA, and its tip was placed between the maxillary artery and facial artery. The tumor-feeding arteries were selected using a hooked-shaped microcatheter through the ECAS. A total of 13 target arteries were selected in the four patients. The microcatheter inserted via the ECAS was used to catheterize ten arteries (five lingual arteries and five facial arteries). The remaining three lingual arteries were directly selected by the catheter without ECAS. All of the target arteries were able to be catheterized superselectively. The technical success rate was 100%. Vascular occlusion, which might have been caused by the ECAS, was observed in one patient. No neurologic toxicities occurred. This ECAS system is a new approach for retrograde superselective intra-arterial chemotherapy that covers the entire tumor with anticancer drugs. It has the potential to increase the effectiveness of therapy for advanced head and neck cancer. Level 4, Case Series.

  5. A new therapeutic assessment score for advanced hepatocellular carcinoma patients receiving hepatic arterial infusion chemotherapy.

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    Issei Saeki

    Full Text Available Hepatic arterial infusion chemotherapy (HAIC is an option for treating advanced hepatocellular carcinoma (HCC. Because of the poor prognosis in HAIC non-responders, it is important to identify patients who may benefit from continuous HAIC treatment; however, there are currently no therapeutic assessment scores for this identification. Therefore, we aimed to establish a new therapeutic assessment score for such patients.We retrospectively analyzed 90 advanced HCC patients with elevated baseline alpha-fetoprotein (AFP and/or des-gamma-carboxy prothrombin (DCP levels and analyzed various parameters for their possible use as predictors of response and survival. AFP and DCP responses were assessed after half a course of HAIC (2 weeks; a positive-response was defined as a reduction of ≥ 20% from baseline.Multivariate analysis identified DCP response (odds ratio 16.03, p < 0.001 as an independent predictor of treatment response. In multivariate analysis, Child-Pugh class A (hazard ratio [HR] 1.99, p = 0.018, AFP response (HR 2.17, p = 0.007, and DCP response (HR 1.90, p = 0.030 were independent prognostic predictors. We developed an Assessment for Continuous Treatment with HAIC (ACTH score, including the above 3 factors, which ranged from 0 to 3. Patients stratified into two groups according to this score showed significantly different prognoses (≤ 1 vs. ≥ 2 points: median survival time, 15.1 vs. 8.7 months; p = 0.003.The ACTH score may be useful in the therapeutic assessment of HCC patients receiving HAIC.

  6. Radiofrequency ablation combined with transcatheter arterial embolisation in rabbit liver: investigation of the ablation zone according to the time interval between the two therapies.

    Science.gov (United States)

    Lee, I J; Kim, Y I; Kim, K W; Kim, D H; Ryoo, I; Lee, M W; Chung, J W

    2012-11-01

    This study was designed to evaluate the extent of the radiofrequency ablation zone in relation to the time interval between transcatheter arterial embolisation (TAE) and radiofrequency ablation (RFA) and, ultimately, to determine the optimal strategy of combining these two therapies for hepatocellular carcinoma. 15 rabbits were evenly divided into three groups: Group A was treated with RFA alone; Group B was treated with TAE immediately followed by RFA; and Group C was treated with TAE followed by RFA 5 days later. All animals underwent perfusion CT (PCT) scans immediately after RFA. Serum liver transaminases were measured to evaluate acute liver damage. Animals were euthanised for pathological analysis of ablated tissues 10 days after RFA. Non-parametric analyses were conducted to compare PCT indices, the RFA zone and liver transaminase levels among the three experimental groups. Group B showed a significantly larger ablation zone than the other two groups. Arterial liver perfusion and hepatic perfusion index represented well the perfusion decrease after TAE on PCT. Although Group B showed the most elevated liver transaminase levels at 1 day post RFA, the enzymes decreased to levels that were not different from the other groups at 10 days post-RFA. When combined TAE and RFA therapy is considered, TAE should be followed by RFA as quickly as possible, as it can be performed safely without serious hepatic deterioration, despite the short interval between the two procedures.

  7. Evaluation of Superselective Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate in Treating Lower Gastrointestinal Bleeding: A Retrospective Study on Seven Cases

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    Yuan Zhao

    2016-01-01

    Full Text Available Background. To investigate the safety and efficacy of superselective transcatheter arterial embolization (TAE with n-butyl cyanoacrylate (NBCA in treating lower gastrointestinal bleeding caused by angiodysplasia. Methods. A retrospective study was performed to evaluate the clinical data of the patients with lower gastrointestinal bleeding caused by angiodysplasia. The patients were treated with superselective TAE with NBCA between September 2013 and March 2015. Angiography was performed after the embolization. The clinical signs including melena, anemia, and blood transfusion treatment were evaluated. The complications including abdominal pain and intestinal ischemia necrosis were recorded. The patients were followed up to evaluate the efficacy in the long run. Results. Seven cases (2 males, 5 females; age of 69.55±2.25 were evaluated in the study. The embolization was successfully performed in all cases. About 0.2–0.8 mL (mean 0.48±0.19 mL NCBA was used. Immediate angiography after the embolization operation showed that the abnormal symptoms disappeared. The patients were followed up for a range of 2–19 months and six patients did not reoccur. No serious complications, such as femoral artery puncture point anomaly, vascular injury, and intestinal necrosis perforation were observed. Conclusion. For the patients with refractory and repeated lower gastrointestinal hemorrhage due to angiodysplasia, superselective TAE with NBCA seem to be a safe and effective alternative therapy when endoscopy examination and treatment do not work.

  8. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri; Yamamoto, Noriyuki; Itoh, Yoshiyuki; Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai

    2012-01-01

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m 2 ; CDDP, total 100-150 mg/m 2 ) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3 metastatic

  9. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Mitsudo, Kenji, E-mail: mitsudo@yokohama-cu.ac.jp [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Yamamoto, Noriyuki [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, Yoshiyuki [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)

    2012-08-01

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3

  10. Microballoon Occlusion Test to Predict Colonic Ischemia After Transcatheter Embolization of a Ruptured Aneurysm of the Middle Colic Artery

    International Nuclear Information System (INIS)

    Tajima, Tsuyoshi; Yoshimitsu, Kengo; Inokuchi, Hiroyuki; Irie, Hiroyuki; Nishie, Akihiro; Hirakawa, Masakazu; Ishigami, Kousei; Ushijima, Yasuhiro; Okamoto, Daisuke; Honda, Hiroshi; Itoh, Hiroyuki; Morita, Masaru; Kakeji, Yoshihiro

    2008-01-01

    A 76-year-old woman presented with sudden massive melena, and superior mesenteric arteriography showed an aneurysm in the middle colic artery (MCA). Because she had a history of right hemicolectomy and ligation of the inferior mesenteric artery (IMA) during open abdominal aortic aneurysm repair, embolization of the MCA aneurysm was considered to pose a risk comparable to that of colonic ischemia. A microballoon occlusion test during occlusion of the MCA confirmed retrograde visualization of the IMA branches through the collateral arteries by way of the left internal iliac artery, and embolization was successfully performed using microcoils. No colonic ischemia or aneurysm rupture occurred after embolization.

  11. Intervention of raltitrexed combined with epirubicin in hepatic arterial infusion and embolization in treatment of primary liver cancer

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    WANG Baoxin

    2015-05-01

    Full Text Available ObjectiveTo evaluate the therapeutic effect of intervention of raltitrexed combined with epirubicin in hepatic arterial infusion and embolization in the treatment of advanced primary liver cancer. MethodsA total of 80 patients with advanced primary liver cancer who were admitted to the Central Hospital of China National Petroleum Corporation from January 2011 to May 2013 and not suitable for surgical treatment were selected and randomly divided into study group (n=40 and control group (n=40. The study group was treated with intervention of raltitrexed combined with epirubicin in hepatic arterial infusion and embolization, while the control group was treated with intervention of fluorouracil (5-FU combined with epirubicin in hepatic arterial infusion and embolization. The treatment was given once every four weeks for a total of three to six circles. The response rate (RR, disease control rate (DCR, median time to progression, survival rate, and the decreases in alpha fetoprotein (AFP, carcinoembryonic antigen (CEA, transaminase, and bilirubin of the two groups were observed. Comparison of categorical data between the two groups was made by chi-square test, and comparison of continuous data was made by t test. ResultsThe RRs of the study group and control group were 52.5% and 22.5%, respectively, and the difference was significant (χ2=7.680, P=0.006; the DCRs of the study group and control group were 87.5% and 60.0%, respectively, and the difference was significant (χ2=7.813, P=0.005; the median time to progression of the study group and control group was 12.2 and 8.0 months, respectively, and the difference was significant (t=5.118, P=0.00; the 1- and 2-year survival rates of the study group were 85.0% and 60.0%, respectively, with the control group being 65.0% and 37.5%, and the difference was significant (χ2=4.267, P=0.039; χ2=4.053, P=0.044. One month after chemoembolization, the number of patients whose AFP, transaminase, and bilirubin

  12. [Effects of intra-arterial infusion of 3-bromopyruvate on metastases and survival benefit of hepatic VX2 tumor in rabbits].

    Science.gov (United States)

    Jiang, Xiong-ying; Zhang, Xiao-ping; Huang, Jin-hua; Luo, Rong-guang; Miao, Bi-jian; Wang, Yan

    2013-10-22

    To evaluate the metastasis and survival of an intra-arterial infusion of 3-bromopyruvate (3-BrPA) on hepatic VX2 tumor in rabbits. VX2 tumor was implanted in left lateral lobe of liver of 18 white New Zealand rabbits. The animals were randomized into 3 groups (n = 6 each) and underwent an intra-arterial infusion of phosphate-buffered saline or 3-BrPA via hepatic artery at 14 days post-implantation. At 28 days post-implantation, 3 rabbits in each group were sacrificed. The abdomen of these rabbits was opened and inspected for metastases. Then the survival of the remaining rabbits was observed. At 28 days post-implantation, in PBS group, there were intrahepatic metastasis and abdominal cavity dissemination (n = 3), renal metastases (n = 2) and lung metastases (n = 2); in early 3-BrPA infusion group, intrahepatic metastasis (n = 2), abdominal cavity dissemination (n = 1) and lung metastases (n = 1); in late 3-BrPA infusion group, intrahepatic metastasis (n = 1) and lung metastases (n = 1). The survival of the remaining animals was observed. Rabbits in early 3-BrPA infusion group survived significantly longer than those in PBS group [(27 ± 5) vs (17 ± 3) days, P = 0.041]; rabbits in late 3-BrPA infusion group [(42 ± 6) days] survived significantly longer than those in early 3-BrPA infusion group (P = 0.007). An intra-arterial infusion of 3-BrPA could reduce metastasis and prolong survival in rabbits with hepatic VX2 tumor. The earlier the infusion, the better the outcome.

  13. Effect of surgical resection combined with transcatheter arterial chemoembolization on postoperative serum tumor marker levels and stem cell characteristics during tumor recurrence

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    Sen Yang

    2017-05-01

    Full Text Available Objective: To study the effect of surgical resection combined with transcatheter arterial chemoembolization (TACE on postoperative serum tumor marker levels and stem cell characteristics during tumor recurrence. Methods: A total of 98 patients with liver cancer who received radical resection in our hospital between May 2013 and July 2015 were reviewed and divided into TACE group and control group according to whether they received TACE within two months after surgical resection. Serum levels of tumor markers were detected 4 weeks after operation; the tumor recurrence was followed up within 3 years after operation, and the expression of stem cell marker molecules and cell proliferation molecules in recurrent lesions were detected. Results: 4 weeks after radical hepatectomy, serum AFP, AFP-L3, GP73 and GPC3 levels in TACE group were significantly lower than those in control group; Nanog, CD133, EpCAM, PICK1, CyclinD1, C-myc and Survivin expression in surgically removed lesions of TACE group were not different from those of control group while Nanog, CD133, EpCAM, PICK1, CyclinD1, C-myc and Survivin expression in recurrent lesions were significantly lower than those of control group. Conclusion: Surgical resection combined with TACE can more effectively remove liver cancer lesions, reduce the tumor marker levels and inhibit the tumor stem cell characteristics and cell proliferation activity in recurrent lesions.

  14. Influence of sequential 125I particle chain implantation and transcatheter arterial chemoembolization on tumor cell killing effect in patients with liver cancer

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    Wei Dai

    2017-07-01

    Full Text Available Objective: To study the influence of sequential 125I particle chain implantation and transcatheter arterial chemoembolization (TACE on tumor cell killing effect in patients with liver cancer. Methods: A total of 82 cases of patients with advanced liver cancer who were treated in our hospital between September 2014 and December 2016 were collected, reviewed and then divided into the control group (n=45 who received TACE alone and the observation group (n=37 who received sequential 125I particle chain implantation and TACE. Serum levels of tumor markers, angiogenesis indexes and apoptosis molecules before and after treatments were compared between two groups of patients. Results: Before treatment, differences in serum levels of tumor markers, angiogenesis indexes and apoptosis molecules were not statistically significant between two groups of patients. After treatment, serum tumor markers AFP, CA199, CA153 and Ferritin levels in observation group were lower than those in control group; serum angiogenesis indexes VEGF, PEDF, ES and bFGF contents were lower than those in control group; serum apoptosis molecules p53 and Fas contents were higher than those in control group. Conclusion: Sequential 125I particle chain implantation and TACE treatment of advanced liver cancer can effectively reduce tumor malignancy and promote tumor apoptosis.

  15. Transcatheter arterial embolization of abnormal vessels as a treatment for lateral epicondylitis refractory to conservative treatment: a pilot study with a 2-year follow-up.

    Science.gov (United States)

    Iwamoto, Wataru; Okuno, Yuji; Matsumura, Noboru; Kaneko, Takao; Ikegami, Hiroyasu

    2017-08-01

    Abnormal vessels and accompanying nerves are possible sources of pain with lateral epicondylitis. The purpose of this study was to describe the safety and efficacy of transcatheter arterial embolization (TAE) for lateral epicondylitis resistant to conservative treatment. This prospective study was conducted in 24 patients with lateral epicondylitis resistant to conservative treatments for more than 3 months, with a symptom duration longer than 6 months, and with moderate to severe pain who were treated with TAE between March 2013 and October 2014. Two patients were lost to follow-up, and the remaining 22 patients were followed up for 2 years after TAE. Abnormal vessels were identified in all of the patients. No major adverse events were observed. The Quick Disabilities of the Arm, Shoulder and Hand scores at baseline significantly decreased at 1, 3, 6, and 24 months after treatment (50.8 vs 23.4, 8.3, 5.3, and 2.7, respectively; all P lateral epicondylitis that fails to improve with conservative treatments. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. Efficacy and safety of radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinomas compared with radiofrequency ablation alone: A time to event meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xin; Hu, Yanan; Ren, Mudan; Lu, Xin Lan; Lu, Gui Fang; He, Shui Xiang [Dept. of Gastroenterology, First Affiliated Hospital of Xi' an Jiaotong University, Xi' an (China)

    2016-02-15

    To compare the efficacy and safety of combined radiofrequency ablation (RFA) and transcatheter arterial chemoembolization (TACE) with RFA alone for hepatocellular carcinomas (HCC). Randomized controlled trial (RCT) studies that compared the clinical or oncologic outcomes of combination therapy of TACE and RFA versus RFA for the treatment of HCC were identified through literature searches of electronic databases (Pubmed, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, and Google Scholar). Hazard ratios (HRs) or odds ratios (ORs) with their corresponding 95% confidence interval (CI) were combined as the effective value to assess the summary effects. The strength of evidence was rated by the Grading of Recommendations Assessment, Development, and Evaluation system. Six RCTs with 534 patients were eligible for inclusion in this meta-analysis. The meta-analysis showed that the combination of TACE and RFA is associated with a significantly longer overall survival (HR = 0.62, 95% CI: 0.49-0.78, p < 0.001) and recurrence-free survival (HR = 0.55, 95% CI: 0.40-0.76, p < 0.001) in contrast with RFA monotherapy. The seemingly higher incidence of major complications in the combination group compared with RFA group did not reach statistical significance (OR = 1.17, 95% CI: 0.39-3.55, p = 0.78). In patients with HCC, the combination of TACE and RFA is associated with significantly higher overall survival and recurrence-free survival, as compared with RFA monotherapy, without significant difference in major complications.

  17. Evaluation of residual hepatocellular carcinoma after transcatheter arterial chemoembolization: Comparison between contrast-enhanced helical CT and contrast-enhanced power doppler ultrasonography

    International Nuclear Information System (INIS)

    Kim, Seung Hoon; Lim, Hyo Keun; Lee, Won Jae

    2001-01-01

    To evaluate the effectiveness of contrast-enhanced helical CT and contrast-enhanced power doppler ultrasonography (PDUS) in assessing the therapeutic effect of transcatheter arterial chemoembolization (TACE) in hepatocellular carcinomas (HCCs). The follow-up contrast-enhanced helical CT and contrast-enhanced PDUS were performed for twenty-nine nodular HCCs from twelve patients previously treated with TACE. We defined the residual HCCs as intratumoral enhancing area on contrast-enhanced helical CT and color signal on contrast-enhanced PDUS. The interval between two examinations was less than 2 weeks (mean, 9 days). Two radiologists evaluated two examinations by consensus, and the results of these two examination were compared with the findings of other examinations including CT, angiography, and/or pathology to calculate the sensitivity, specificity and accuracy of two examinations. Of the 29 HCCs, 20 had residual HCCs whereas no residual HCCs in 9 HCCs on pathologic examination and/or follow-up radiologic study. The sensitivity, sensitivity and accuracy of contrast-enhanced helical CT were 65 (13/20), 89 (8/9), and 72% (21/29) while those of contrast-enhanced PDUS were 100 (20/20), 89 (8/9) and 97% (28/29), respectively. A microbubble contrast-enhanced PDUS was more effective in the detection of residual tumor in HCCs following TACE than contrast-enhanced helical CT.

  18. Efficacy and safety of radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinomas compared with radiofrequency ablation alone: A time to event meta-analysis

    International Nuclear Information System (INIS)

    Wang, Xin; Hu, Yanan; Ren, Mudan; Lu, Xin Lan; Lu, Gui Fang; He, Shui Xiang

    2016-01-01

    To compare the efficacy and safety of combined radiofrequency ablation (RFA) and transcatheter arterial chemoembolization (TACE) with RFA alone for hepatocellular carcinomas (HCC). Randomized controlled trial (RCT) studies that compared the clinical or oncologic outcomes of combination therapy of TACE and RFA versus RFA for the treatment of HCC were identified through literature searches of electronic databases (Pubmed, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, and Google Scholar). Hazard ratios (HRs) or odds ratios (ORs) with their corresponding 95% confidence interval (CI) were combined as the effective value to assess the summary effects. The strength of evidence was rated by the Grading of Recommendations Assessment, Development, and Evaluation system. Six RCTs with 534 patients were eligible for inclusion in this meta-analysis. The meta-analysis showed that the combination of TACE and RFA is associated with a significantly longer overall survival (HR = 0.62, 95% CI: 0.49-0.78, p < 0.001) and recurrence-free survival (HR = 0.55, 95% CI: 0.40-0.76, p < 0.001) in contrast with RFA monotherapy. The seemingly higher incidence of major complications in the combination group compared with RFA group did not reach statistical significance (OR = 1.17, 95% CI: 0.39-3.55, p = 0.78). In patients with HCC, the combination of TACE and RFA is associated with significantly higher overall survival and recurrence-free survival, as compared with RFA monotherapy, without significant difference in major complications

  19. Volume-rendered hemorrhage-responsible arteriogram created by 64 multidetector-row CT during aortography: utility for catheterization in transcatheter arterial embolization for acute arterial bleeding.

    Science.gov (United States)

    Minamiguchi, Hiroki; Kawai, Nobuyuki; Sato, Morio; Ikoma, Akira; Sanda, Hiroki; Nakata, Kouhei; Tanaka, Fumihiro; Nakai, Motoki; Sonomura, Tetsuo; Murotani, Kazuhiro; Hosokawa, Seiki; Nishioku, Tadayoshi

    2014-01-01

    Aortography for detecting hemorrhage is limited when determining the catheter treatment strategy because the artery responsible for hemorrhage commonly overlaps organs and non-responsible arteries. Selective catheterization of untargeted arteries would result in repeated arteriography, large volumes of contrast medium, and extended time. A volume-rendered hemorrhage-responsible arteriogram created with 64 multidetector-row CT (64MDCT) during aortography (MDCTAo) can be used both for hemorrhage mapping and catheter navigation. The MDCTAo depicted hemorrhage in 61 of 71 cases of suspected acute arterial bleeding treated at our institute in the last 3 years. Complete hemostasis by embolization was achieved in all cases. The hemorrhage-responsible arteriogram was used for navigation during catheterization, thus assisting successful embolization. Hemorrhage was not visualized in the remaining 10 patients, of whom 6 had a pseudoaneurysm in a visceral artery; 1 with urinary bladder bleeding and 1 with chest wall hemorrhage had gaze tamponade; and 1 with urinary bladder hemorrhage and 1 with uterine hemorrhage had spastic arteries. Six patients with pseudoaneurysm underwent preventive embolization and the other 4 patients were managed by watchful observation. MDCTAo has the advantage of depicting the arteries responsible for hemoptysis, whether from the bronchial arteries or other systemic arteries, in a single scan. MDCTAo is particularly useful for identifying the source of acute arterial bleeding in the pancreatic arcade area, which is supplied by both the celiac and superior mesenteric arteries. In a case of pelvic hemorrhage, MDCTAo identified the responsible artery from among numerous overlapping visceral arteries that branched from the internal iliac arteries. In conclusion, a hemorrhage-responsible arteriogram created by 64MDCT immediately before catheterization is useful for deciding the catheter treatment strategy for acute arterial bleeding.

  20. Dual Energy Computed Tomography to Evaluate Hepatocellular Carcinoma Treated with Transcatheter Arterial Chemo-Embolization: Comparison between the Linear Blending and Nonlinear Moidal Blending Methods

    International Nuclear Information System (INIS)

    Shin, Sang Soo; Kim, Hyeong Wook; Lee, Daun; Kang, Heoung Keun; Kim, Jin Woong; Heo, Suk Hee; Jeong, Yong Yeon; Seon, Hyun Ju

    2012-01-01

    To compare the linear blending image with the nonlinear moidal blending image using dual energy CT for the evaluation of the viable portion of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). One-hundred and twenty three HCC patients incompletely treated after TACE were enrolled in this study. The dual energy mode (80 kVp and Sn140 kVp) was only applied in the late arterial phase scanning. A paired t-test was used to compare the lesion-to-liver contrast-to-noise ratio (CNR) and the image noise between the two blending images. Lesion conspicuity, image sharpness, image noise and the overall image quality between the two blending images were compared using the Wilcoxon matched-pair signed-ranks test. The lesion-to-liver CNR was significantly higher on the moidal blending image (5.6 ± 3.2) than on the linear blending image (2.7 ± 1.6) (p < 0.001). The image noise was significantly lower on the moidal blending image (10.9 ± 3.5) than on the linear blending image (17.5 ± 5.5) (p < 0.001). The lesion conspicuity and overall image quality were significantly better on the moidal blending image for both reviewers (p < 0.001). However, with respect to image sharpness, the linear blending image was significantly better for both reviewers (p < 0.01). The nonlinear moidal blending image of dual energy CT showed an increased lesion-to-liver CNR, decreased noise and improved overall image quality for the evaluation of the viable portion of HCC after TACE.

  1. Comparison of post-embolization syndrome in the treatment of patients with unresectable hepatocellular carcinoma: Trans-catheter arterial chemo-embolization versus Yttrium-90 glass microspheres

    International Nuclear Information System (INIS)

    Goin, J.E.; Roberts, C.A.; Dancey, J.E.; Sickles, C.J.; Leung, D.A.; Soulen, M.C.

    2004-01-01

    Post-embolization syndrome (PES) occurs in most patients who undergo trans-catheter arterial chemoembolization (TACE) for treatment of unresectable hepatocellular carcinoma (HCC). Intra-hepatic arterial administration of TheraSphere, yttrium-90 glass microspheres, is an alternative treatment for unresectable HCC that does not require embolization of major vessels and may have a more favorable toxicity profile than TACE. This paper compares the incidence of PES after TACE vs. TheraSphere treatment in unresectable HCC patients. Data for 29 TACE-treated and 34 TheraSphere-treated patients were evaluated for PES. PES toxicities (i.e., nausea, vomiting, fever in the absence of infection, and abdominal pain) were scored according to Southwest Oncology Group (SWOG) toxicity criteria. PES was defined as a total score for the four toxicities of 2 or greater. Survival was defined from the date of treatment to the date of death. TACE patients underwent one to seven treatment procedures; TheraSphere patients underwent one to two treatment procedures. The incidence of PES was 3.8-times (95% confidence interval 1.6-16.3) higher after TACE [20/29(69%)] than after TheraSphere [6/34 (18%)] treatment; this difference was statistically significant (p=.003). Median survival was similar for TheraSphere (N=20; 378 days, CI 209-719) and TACE (N=29; 343 days, CI 217-511) patients. It was concluded that treatment of unresectable HCC with TheraSphere results in a much lower incidence of PES compared to TACE. Since TheraSphere is a pure beta emitter; it can potentially be administered safely on an outpatient basis, and appears to be at least as efficacious as TACE on survival with fewer treatments per patient. (author)

  2. [POL-PAVTI--Polish report on transcatheter pulmonary artery valve implantation of Melody-Medtronic prosthesis in the first 14 patients in Poland].

    Science.gov (United States)

    Ruzyłło, Witold; Demkow, Marcin; Włodarska, Elzbieta K; Kowalski, Mirosław; Spiewak, Mateusz; Siudalska, Hanna; Wolski, Piotr; Miśko, Jolanta; Hoffman, Piotr; Kusa, Jacek; Szkutnik, Małgorzata; Białkowski, Jacek; Fiszer, Roland; Urbańska, Ewa; Sondergaard, Lars

    2009-10-01

    To assess the early results of the pulmonary artery valve transcatheter implantation (PAVTI) in pts included into POL-PAVTI registry. Detailed medical and economic analyses were performed. Pulmonary artery valve implantation was performed in 14 pts (9 men), aged 16-31 (mean 24.6 +/- 4.8) years, with pulmonary homograft dysfunction after total repair of tetralogy of Fallot (4 pts), pulmonary atresia (2 pts), pulmonary stenosis (1 pt), common arterial trunk type I (1 pt), Ross procedure (3 pts) and TGA - Rastelli operation (3 pts). Eleven pts underwent in the past 2-5 surgical or/and catheter interventions. Indication for PAVTI was based on clinical evaluation and echocardiographic studies. Assessment of morphological and functional features of the right ventricle (RV) and homograft with the use of cardiac magnetic resonance (CMR) was performed in 10 cases. Pulmonary stenosis (max. pulmonary gradient 32-119, mean 72 +/- 28 mmHg) was observed in 13 pts and/or significant pulmonary regurgitation in 10 pts. The procedure was performed in general anesthesia. The deployment of a valved stent in the pulmonary valve position was preceded by a metal stent implantation. Results were evaluated by echocardiography two days after the procedure and one month later. Four patients were evaluated 6 months after procedure. Time of the procedure varied 60-190 (mean 127 +/- 35) min, time of fluoroscopy ranged 12-31 (mean 21 +/- 11) min. PAVTI was successfully performed in all pts without serious complications. Patients were discharged from the hospital 48-293 (mean 120 +/- 71) h after procedure. Significant reduction of pulmonary gradient after the procedure assessed by echocardiography was observed on the second day (20-60, mean 38 +/- 12 mmHg, p < 0.0001) and one month (19-52, mean 34 +/- 9 mmHg, p < 0.0001). Mild pulmonary regurgitation was observed in 2 pts. In 5 pts evaluated 6 months after procedure haemodynamic parameters were unchanged; no late complications were observed

  3. The DSA diagnosis, artery embolization combined with low dose of vasopressin infusion treatment for lower digestive tract hemorrhage

    International Nuclear Information System (INIS)

    Huang Guoxin; Dou Yongchong; Zhang Yanfang; Shen Xinying; Xu Jianmin

    2005-01-01

    Objective: To evaluate the clinical value of digital subtraction angiography (DSA) diagnosis and interventional treatment for lower digestive tract hemorrhage of unknown reasons. Methods: DSA was performed in 32 patients with unknown etiologic lower digestive tract hemorrhage. The locations and causes of hemorrhage were determined by angiography according to the demonstration of contrast medium extravasation, abnormal vasculature and tumor staining. Superselective arterial embolization was performed with retaining catheter of low dose vasopressin infusion for 12 hours of hemostasis. Results: Seventy-five percent of the lesions were identified by DSA with 2 cases of intestinal typhoid, 1 intestinal tuberculosis, 14 cases of vascular malformation and 7 cases of tumor. Hemostasis was succeeded in 20 of 24 patients. The rate of success was 83.3%. Conclusions: DSA and interventional therapy are of great value in diagnosing and treating patients with lower digestive tract hemorrhage of unknown reasons and even those undergone unsuccessful conservative treatment. Low dose vasopressin infusion through retained catheter is safe and efficient after superselective arterial embolization. (authors)

  4. Combination of bronchial artery infusion chemotherapy and radiation therapy for locally advanced non-small cell lung cancer

    International Nuclear Information System (INIS)

    Li Shuping; Cai Yuecheng; Wang Xiangming; Luo Jianyun; Lian Yingni; Ouyang Mingxin

    2004-01-01

    Objective: To compare the efficacy between bronchial artery infusion (BAI) chemotherapy plus radiation therapy and systemic chemotherapy plus radiation for locally advanced non-small cell lung cancer (NSCLC). Methods: One hundred and twenty-one patients with stage III NSCLC were randomized into treatment group (58 cases) and control group (63 cases). In the treatment group, all patients were administered with BAI for 2-3 sessions, followed by irradiation 4-7 days after BAI. In the control group, altogether 4-6 cycles of standard systemic chemotherapy were given. Radiation was delivered alternately between the cycles of chemotherapy. Results: The short-term, long-term survival, median response duration and median survival time were similar between the two groups, except patients with stage IIIb who had a higher distant metastasis rate in the treatment group. The major side effects of chemotherapy and radiotherapy were hematological, gastrointestinal toxicities, pneumonitis, mediastinitis, and esophagitis, respectively. The side effects were milder, better tolerated and did not influence the regimen schedule in the treatment group, as compared with the control group. Seven patients withdrew from the control group, and in 28 patients, the scheduled chemotherapy and radiation was delayed or canceled. Conclusions: Bronchial artery infusion plus radiation is more advantageous over systemic chemotherapy plus radiation in less toxicities, better compliance, shorter treatment courses and more cost-effectiveness

  5. Comparison of fractional flow reserve measurements using intracoronary adenosine versus intracoronary sodium nitroprusside infusions in moderately stenotic coronary artery lesions

    Energy Technology Data Exchange (ETDEWEB)

    Safi, Morteza; Namazi, Mohammad Hasan; Fooladi, Esfandiar; Vakili, Hossein; Parsa, Saeed Alipour; Khaheshi, Isa [Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of); Abbasi, Mohammad Amin [Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of); Movahed, Mohammad Reza, E-mail: rmova@aol.com [CareMore, Arizona, Tucson, AZ (United States); University of Arizona, Sarver Heart Center, Tucson, AZ (United States)

    2016-10-15

    Introduction: The aim of this study was to investigate the efficacy and safety of intracoronary (IC) sodium nitroprusside infusion in comparison to IC adenosine for fractional flow reserve (FFR) measurement in moderately diseased coronary artery lesions for functional assessment. Methods: During a nine month period, a consecutive of 98 patients with suspected or known coronary artery disease with moderate stenosis found during angiography (40% to 70% stenosis), were enrolled in this study. Hyperemia was induced by bolus doses of IC adenosine followed by sodium nitroprusside for FFR measurement. Results: Both IC adenosine and IC sodium nitroprusside induced similar and significant reduction in FFR. There was no statistically difference in FFR values between adenosine vs sodium nitroprusside infusions (mean FFR 84.3 ± 6.3 vs 85.7 ± 6.2, p = 0.1) respectively. Furthermore, comparing different FFR cut-off points between the groups (FFR < 0.75, 0.75–0.8 and > 0.8) showed no significant differences (p value = 0.7). Conclusion: An IC bolus of sodium nitroprusside (0.6 μg/kg) infusion induces a similar degree of hyperemia to IC bolus of 100–300 μg of adenosine. Therefore, IC sodium nitroprusside could be considered as an alternative drug to adenosine for FFR measurement with lower side effect profile. - Highlights: • Intracoronary (IC) sodium nitroprusside was compared with IC adenosine for FFR test. • IC adenosine and IC sodium nitroprusside induced similar reduction in FFR. • Different FFR cut-off points between the groups showed no significant differences. • IC sodium nitroprusside could be considered as an alternative to adenosine for FFR.

  6. Daily concurrent chemoradiotherapy with docetaxel (DOC) and cisplatin (CDDP) using superselective intra-arterial infusion via superficial temporal artery for advanced oral cancer

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Fukui, Takafumi; Shigetomi, Toshio

    2007-01-01

    Superselective intra-arterial chemotherapy via superficial temporal artery (HFT method) is feasible for daily concurrent radiotherapy and chemotherapy for oral cancer. The possibility of organ preservation in cases of advanced oral cancer was evaluated. Treatment consisted of superselective intra-arterial infusions (docetaxel (DOC) total 60 mg/m 2 , cisplatin (CDDP) total 100 mg/m 2 ) and concurrent radiotherapy (total 40 Gy) for four weeks. Patients with T3 and T4 oral cancer were treated with four-week daily concurrent chemoradiotherapy, and the clinical response was evaluated after treatment. Clinical complete response (CR) of primary sites was obtained in 23 patients, and the same treatment was continued for one or two weeks. Local recurrence was observed in four patients (17.4%), all of whom all patients underwent salvage operation, and the final local control rate was 95.6% (22 of 23 cases). One patient died of neck metastasis, and one died of local recurrence. One-year and 3-year survival rates were estimated by Kaplan-Meier's method to be 95.5% and 79.5%, respectively. In this treatment, it is important to identify the tumor's feeding artery and deliver a sufficient amount of anticancer drug to the tumor. Superselective intra-arterial chemotherapy for oral cancer has the advantage of delivering a high concentration of chemotherapeutic agents into the tumor bed with fewer systemic toxic effects than seen with systemic chemotherapy. Superselective intra-arterial chemotherapy using the HFT method can preserve organs and minimize functional disturbance, thus contributing to patients' quality of life (QOL). (author)

  7. Analysis of cervical cancer cells treated with radiotherapy or arterial infusion chemotherapy

    International Nuclear Information System (INIS)

    Izutu, Toshihiko; Nishiya, Iwao

    1995-01-01

    The present study was designed to analyze cervical cancer cells treated with radiotherapy or intraarterial infusion of CDDP using image analysis. Total nuclear extinction (TE), 5 N-exceeding rate (5 NER) and nuclear area (NA) gradually increased following irradiation, in cervical cancer cases. TE and 5 NER increased markedly following radiotherapy in good response cases. TE, 5 NER and NA were not-changed following irradiation in poor response cases. 5 NER, in good prognostic cases was higher than in poor prognostic cases, significantly among cervical cancer cases treated with radiotherapy. 5 NER and NA increased dramatically in good response cases treated with intraarterial infusion of CDDP. (author)

  8. Significance of the Hepatic Artery Anatomy and Radionuclide Flow Data for the Technique and Results of Intra-arterial Infusion Chemotherapy in Patients with Liver Neoplasms

    International Nuclear Information System (INIS)

    Vaicekavicius, E.; Satkevicius, Z.; Kiudelis, J. and others

    2002-01-01

    The aim of this study was to evaluate the impact of different variations of liver vascular anatomy and hemodynamics in achieving the maximum effect of the hepatic artery infusion chemotherapy (HAIC) in patients with primary or metastatic hepatic malignancies. The retrograde analysis of hepatic artery (HA) anatomy and of radionuclide flow data on 23 patients treated by HAIC was performed. The HA anatomy was analysed according to two classification systems: the first one proposed by Michels, which describes 10 variants, and the second one proposed by Suzuki, which describes 3 variants - single, double or multiple HA with 3 subtypes of each variant (celiac, mesenteric and mixed). Additionally, before starting HAIC, 99mTc human macroalbumin was injected through the catheter at a slow rate into the HA of 10 patients with abnormal variants of HA anatomy. Radionuclide testing was performed with the aim to evaluate the subsequent intrahepatic distribution of chemotherapy agents. The intra-arterial regimen of HAIC for all patients consisted of a 5-day infusion of 5-ftorouracil or floxuridine with addition of doxorubicin or cisplatin. Such treatment was repeated every 3-4 weeks 3-6 times for every patient. The typical anatomy of HA branching was seen in 12 (52.2%) patients. The double origin of HA (according to Suzuki's classification) was seen in 9 (39.1%). In 5 (21.7%) of them the right HA was coming out from the superior mesenteric artery. In the remaining 4 (17.4%) patients the left HA was coming out from the left gastric artery. In one patient, multiple HA were observed, and there was no possibility to perform HAIC at all. The preliminary embolization of one of HA was performed in 3 patients with double HA according to Suzuki's classification. Redistribution of hepatic flow through intrahepatic collaterals was achieved in all 3 patients and assessed by radionuclide examination. The aberrant left HA was not embolized in 4 patients, because the metastatic tumours were

  9. Association of acetazolamide infusion with headache and cranial artery dilation in healthy volunteers

    DEFF Research Database (Denmark)

    Arngrim, Nanna; Schytz, Henrik Winther; Asghar, Mohammad Sohail

    2014-01-01

    under the curve for headache was increased after acetazolamide compared to placebo in the delayed phase (2-12 h) (P=.005). Compared to placebo, arterial circumference increased after acetazolamide in the basilar artery (P=.002) as well as the cerebral (P=.003), cavernous (P=.002), and cervical (P=.005...

  10. Impact of femoral artery puncture using digital subtraction angiography and road mapping on vascular and bleeding complications after transfemoral transcatheter aortic valve implantation.

    Science.gov (United States)

    El-Mawardy, Mohamed; Schwarz, Bettina; Landt, Martin; Sulimov, Dmitriy; Kebernik, Julia; Allali, Abdelhakim; Becker, Bjoern; Toelg, Ralph; Richardt, Gert; Abdel-Wahab, Mohamed

    2017-01-20

    The use of large-diameter sheaths carries the risk of significant vascular and bleeding complications after transfemoral transcatheter aortic valve implantation (TAVI). In this analysis, we sought to assess the impact of a modified femoral artery puncture technique using digital subtraction angiography (DSA) and road mapping during transfemoral TAVI on periprocedural vascular and bleeding events. This is a retrospective analysis of transfemoral TAVI patients included in a prospective institutional database. The modified femoral artery puncture technique using DSA-derived road mapping guidance was introduced in October 2012. Before the introduction of this technique, vascular puncture was acquired based on an integration of angiographic data, the bony iliofemoral landmarks and a radiopaque object. Consecutive patients who underwent TAVI with the road mapping technique (RM group, n=160) were compared with consecutive patients who underwent TAVI without road mapping (control group, n=160) prior to its introduction. A standardised strategy of periprocedural anticoagulation was adopted in both groups as well as the use of a single suture-based closure device. All endpoints were defined according to the VARC-2 criteria for event definition. The mean age in the RM group was 80±7.7 years compared to 81±5.9 years in the control group (p=0.19), and females were equally distributed between both groups (63.1% vs. 58.1%, p=0.36). The baseline logistic EuroSCORE was 20.7±14.4% vs. 24.9±15.2% in the RM and control group, respectively (p=0.01). Notably, sheath size was significantly larger in the RM compared to the control group due to the more frequent use of the 20 Fr sheath (23.8% vs. 1.8%, proad map group but did not reach statistical significance (8.1% vs. 13.8%, p=0.1). Other forms of vascular and bleeding complications as well as all-cause mortality were comparable in both groups. A modified femoral artery puncture technique using DSA and road mapping was associated

  11. Clinical evaluation of internal iliac artery anticancer drug infusion for the treatment of androgen-independent prostate cancer

    International Nuclear Information System (INIS)

    Cao Ye; Wang Jin; Nie Yong; Chen Hua; Huang Xinjie

    2008-01-01

    Objective: To evaluate the clinical efficacy of bilateral internal iliac artery chemotherapy infusion for the treatment of androgen-independent prostate cancer (ALPC). Methods: Thirty eight eases of confirmed AIPC were randomly divided into treatment group and control group. The patients in treatment group (23 cases) were treated with androgen deprivation therapy and regular internal iliac artery chemotherapy, while patients in control group (15 cases) were only received androgen deprivation therapy. The therapeutic efficacies of the two groups were compared and analyzed after completion of the treatment. Results: The clinical symptoms and maximum urine flow rates of' treatment group were improved rapidly 6 months later. After 2 years follow-up, the total efficacies of treatment group and control group were 65.2% and 26.7% respectively, showing a significant statistical difference (P<0.05). Conclusions: The treatment of AlPC with bilateral internal iliac artery chemotherapy is effective, providing melioration the quality of life and alleviation of the symptoms. (authors)

  12. Superselective transcatheter renal arterial embolization for acute renal bleeding in patients with renal insufficiency: its clinical efficacy and safety

    International Nuclear Information System (INIS)

    Hu Tingyang; Zhou Bing; Yu Wenqiang; Luo Zuyan; Mao Yingmin; Chen Fanghong; Li Bo; Yuan Jianhua

    2010-01-01

    Objective: To discuss the clinical efficacy and complications of super selective renal arterial embolization in treating acute renal arterial bleeding in patients with renal insufficiency, and to evaluate the influence of the treatment on the renal function. Methods: During the period of January 2000 December 2009, super selective renal arterial embolization was performed in our institution for acute renal bleeding in 13 patients with renal insufficiency. The complete clinical and imaging materials of all patients were properly collected. The clinical effectiveness, the renal function, the extent of embolization and the complications were observed and the relationship between each other was analyzed. Results: The embolization procedure was successfully completed in all patients with a technical success rate of 100%. The mean embolized territory was 22% of a single kidney. Three days after the procedure, the hemoglobin level, hematocrit, blood pressure and heart rate were considerably improved in all patients. Compared to the corresponding preoperative data, all the differences were statistically significant (P 0.05), while the blood urea nitrogen was markedly decreased (P=0.011). Post embolization syndrome occurred in 5 patients and progressive aggravation of the renal function was observed in one patient, who had to receive hemodialysis finally. The embolized territory in patients occurring complications was larger than that in patients without occurring complications (U=1.500, P=0.006). Conclusion: Super selective renal arterial embolization is an effective and safe treatment for acute renal arterial bleeding in patients with renal insufficiency, the therapy will not significantly worsen the renal function. Appropriate and reasonable extent of embolization, as small as possible, is the key point for reducing the complications. (authors)

  13. Effect of different dosages of nitroglycerin infusion on arterial blood gas tensions in patients undergoing on- pump coronary artery bypass graft surgery.

    Science.gov (United States)

    Masoumi, Gholamreza; Pour, Evaz Hidar; Sadeghpour, Ali; Ziayeefard, Mohsen; Alavi, Mostapha; Anbardan, Sanam Javid; Shirani, Shahin

    2012-02-01

    On-pump coronary artery bypass graft (CABG) surgery impairs gas exchange in the early postoperative period. The main object on this study was evaluation of changes in arterial blood gas values in patients underwent on pump CABG surgery receiving different dose of intravenous nitroglycerin (NTG). sixty-seven consecutive patients undergoing elective on-pump CABG randomly enrolled into three groups receiving NTG 50 μg/min (Group N1, n =67), 100 μg/min (Group N2, n = 67), and 150 μg/min (Group N3, n = 67). Arterial blood gas (ABG) tensions were evaluated just before induction of anesthesia, during anesthesia, at the end of warming up period, and 6 h after admission to the intensive care unit. Pao2 and PH had the highest value during surgery in Group N1, Group N2, and Group N3. No significant difference was noted in mean values of Pao2 and PH during surgery between three groups (P > 0.05). There was no significant difference in HCO3 values in different time intervals among three groups (P > 0.05). our results showed that infusing three different dosage of NTG (50, 100, and 150 μg/min) had no significant effect on ABG tensions in patients underwent on-pump CABG surgery.

  14. The clinical value of MR diffusion-weighted imaging in the follow-up observation of hepatocellular carcinoma after transcatheter arterial chemoembolization

    International Nuclear Information System (INIS)

    Li Zhenwu; Zhang Wei; Sun Lijun; Qi Shun

    2010-01-01

    Objective: To discuss the clinical value of MR diffusion-weighted imaging (DWI) in the follow-up of hepatocellular carcinoma after transcatheter arterial chemo embolization (TACE). Methods: MR DWI was performed in 16 patients with hepatocellular carcinoma after receiving TACE. The DWI findings were compared with DSA and/or CT signs. The mean apparent diffusion coefficient (ADC) value of each lesion was determined separately, and the mean ADC value of intra-hepatic metastatic lesion was compared with that of the primary lesion. Results: A total of 18 lesions were revealed in DSA, of which satisfactory iodinated oil deposit was seen in 11 (satisfactory group) and poor deposit in 7 (poor group). After TACE, the mean ADC value of normal hepatic parenchyma showed no obvious changes when compared to its preoperative value (t = 0.54, P > 0.05). The mean ADC value obtained in poor group was significantly lower than that obtained in satisfactory group (t = 4.81, P < 0.01). In satisfactory group the preoperative ADC values were higher than the postoperative ones (t = 6.81, P < 0.01), while in poor group no significant difference was found between preoperative and postoperative ADC values. In addition, twelve intra-hepatic metastases were detected on DWI. Statistically significant difference in the mean ADC value existed between the metastatic lesions and the primary lesions (t = 4.61, P < 0.01). Conclusion: DWI is very sensitive in detecting hepatic metastatic lesions and, therefore, can be used to evaluate the therapeutic effect of TACE. (authors)

  15. Clinical value of 18F-FDG PET/CT in detecting viable tumor, recurrence and metastases of hepato-cellular carcinoma after transcatheter arterial chemoembolization

    International Nuclear Information System (INIS)

    Hu Silong; Zhang Yingjian; Zhu Beiling; Shi Wei; Men Zhiqiang; Li Peilen; Jiang Guoliang

    2009-01-01

    Objective: Accurate evaluation of treatment result of transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) by conventional imaging is difficult. The objective of this study was to investigate the clinical value of 18 F-fluorodeoxyglucose (FDG) PET/CT for detecting residual viable tumor, recurrence and metastases in patients with HCC after TACE. Methods: Twenty-two patients with HCC after TACE were investigated with 18 F-FDG PET/CT. The accuracy of FDG PET/CT was determined by the histopathological results or evidences of clinical follow-up. Results: Of all 22 HCC patients after TACE, 18 had intra- and (or) extrahepatic lesions, detected by FDG PET/CT. Six-teen patients had intrahepatic FDG-avid lesion(s). Of the 16 patients, five had intrahepatic FDG-avid lesions located at both lipiodol-rich and -deprive regions, 13 had associated extrahepatic metastases. Of the two HCC patients who had no intrahepatic FDG-avid lesion, there were extrahepatic FDG-avid lesions at the retroperitoneal lymph nodes. In all, 15 HCC had extrahepatic lesions identified by FDG PET/CT. There were lung and lymph nodes (n = 9), bone (n = 2), tumor thrombus at portal vein (n - 1) and diaphragm crus (n = 1). Two patients were false negative. The sensitivity, specificity, accuracy of FDG PET/CT in detecting intra- and (or) extrahepatic lesions after TACE were 88.9% (16/18) vs 94.7 % (18/19), 4/4 vs 3/3, and 90.9% (20/22) vs 95.5% (21/22), respectively. Conclusion: 18 F-FDG PET/CT is potential useful for detection both intra- and (or) extrahepatic lesions in HCC patients after TACE. (authors)

  16. Correlation of Hypoxia-Inducible Factor 1α with Angiogenesis in Liver Tumors After Transcatheter Arterial Embolization in an Animal Model

    International Nuclear Information System (INIS)

    Liang Bin; Zheng Chuansheng; Feng, Gan-Sheng; Wu Hanping; Wang Yong; Zhao Hui; Qian Jun; Liang Huimin

    2010-01-01

    This study sought to determine the expression of hypoxia-inducible factor 1α (HIF-1α) and its relation to angiogenesis in liver tumors after transcatheter arterial embolization (TAE) in an animal model. A total of 20 New Zealand White rabbits were implanted with VX2 tumor in liver. TAE-treated group animals (n = 10) received TAE with polyvinyl alcohol particles. Control group animals (n = 10) received sham embolization with distilled water. Six hours or 3 days after TAE, animals were humanely killed, and tumor samples were collected. Immunohistochemical staining was performed to evaluate HIF-1α and vascular endothelial growth factor (VEGF) protein expression and microvessel density (MVD). Real-time polymerase chain reaction was performed to examine VEGF mRNA levels. The levels of HIF-1α protein were significantly higher in TAE-treated tumors than those in the control tumors (P = 0.001). HIF-1α protein was expressed in viable tumor cells that were located predominantly at the periphery of necrotic tumor regions. The levels of VEGF protein and mRNA, and mean MVD were significantly increased in TAE-treated tumors compared with the control tumors (P = 0.001, 0.000, and 0.001, respectively). HIF-1α protein level was significantly correlated with VEGF mRNA (r = 0.612, P = 0.004) and protein (r = 0.554, P = 0.011), and MVD (r = 0.683, P = 0.001). We conclude that HIF-1α is overexpressed in VX2 tumors treated with TAE as a result of intratumoral hypoxia generated by the procedure and involved in activation of the TAE-associated tumor angiogenesis. HIF-1α might represent a promising therapeutic target for antiangiogenesis in combination with TAE against liver tumors.

  17. Treatment of Small Hepatocellular Carcinoma (≤2 cm) in the Caudate Lobe with Sequential Transcatheter Arterial Chemoembolization and Radiofrequency Ablation

    International Nuclear Information System (INIS)

    Hyun, Dongho; Cho, Sung Ki; Shin, Sung Wook; Rhim, Hyunchul; Koh, Kwang Cheol; Paik, Seung Woon

    2016-01-01

    PurposeTo evaluate technical feasibility and treatment results of sequential transcatheter arterial chemoembolization (TACE) and cone-beam computed tomography-guided percutaneous radiofrequency ablation (CBCT-RFA) for small hepatocellular carcinoma (HCC) in the caudate lobe.Materials and MethodsInstitutional review board approved this retrospective study. Radiologic database was searched for the patients referred to perform TACE and CBCT-RFA for small caudate HCCs (≤2 cm) between February 2009 and February 2014. A total of 14 patients (12 men and 2 women, mean age; 61.3 years) were included. Percutaneous ultrasonography-guided RFA (pUS-RFA) and surgery were infeasible due to poor conspicuity, inconspicuity or no safe electrode pathway, and poor hepatic reserve. Procedural success (completion of both TACE and CBCT-RFA), technique efficacy (absence of tumor enhancement at 1 month after treatment), and complication were evaluated. Treatment results including local tumor progression (LTP), intrahepatic distant recurrence (IDR), overall survival (OS), and progression-free survival (PFS) were analyzed.ResultsProcedural success and technique efficacy rates were 78.6 % (11/14) and 90.9 % (10/11), respectively. Average follow-up period was 45.3 months (range, 13.4–64.6 months). The 1-, 3-, and 5-year LTP probabilities were 0, 12.5, and 12.5 %, respectively. IDR occurred in seven patients (63.6 %, 7/11). The 1-, 3-, and 5-year PFS probabilities were 81.8, 51.9, and 26 %, respectively. The 1-, 3-, and 5-year OS probabilities were 100, 80.8, and 80.8 %, respectively.ConclusionCombination of TACE and CBCT-RFA seems feasible for small HCC in the caudate lobe not amenable to pUS-RFA and effective in local tumor control.

  18. Effect of the Wnt/β-catenin signaling pathway on apoptosis, migration, and invasion of transplanted hepatocellular carcinoma cells after transcatheter arterial chemoembolization in rats.

    Science.gov (United States)

    Wang, Bao-Ming; Li, Nuo

    2018-05-01

    This study aims to investigate the influence of the Wnt/β-catenin signaling pathway on apoptosis, migration, and invasion of transplanted hepatocellular carcinoma (HCC) cells after transcatheter arterial chemoembolization (TACE) in rat models. A total of 80 rats were grouped into sham, TACE, Wnt-C59, and TACE + Wnt-C59 groups (n = 20). Ten days after model establishment, 10 rats in each group were executed to perform pathological examination and follow-up experiment, and the remaining 10 rats in each group were reared to observe the survival condition. RT-qPCR and Western blotting were applied to determine the expressions of Wnt1, β-catenin, cyclin D1, c-met, vimentin, E-cadherin, and vascular endothelial growth factor (VEGF). ELISA was performed to measure the serum alpha-fetoprotein (AFP) content of rats. Flow cytometry was used to evaluate cell apoptosis rate and transwell assay to examine cell migration and invasion. Compared with the TACE group, the Wnt-C59 and TACE + Wnt-C59 groups showed increased apoptosis and survival time (the TACE + Wnt-C59 group > the Wnt-C59 group). Compared with the sham group, the TACE + Wnt-C59 groups showed decreased cancer tissue weight and expressions of Wnt1, β-catenin, cyclin D1, vimentin, c-met, and VEGF, but increased E-cadherin expression. Compared with the TACE group, the Wnt-C59 and TACE + Wnt-C59 groups showed decreased AFP level, migration, and invasion (the TACE + Wnt-C59 group Wnt-C59 group). These findings indicate inhibition of the Wnt/β-catenin signaling pathway improves therapeutic effect on TACE via suppressing migration, invasion, and promoting apoptosis of transplanted HCC cells in rats. © 2017 Wiley Periodicals, Inc.

  19. Long-term efficiency and safety of trans-catheter uterine artery embolization by lipiodol-pingyingmycin emulsion for uterine fibroids

    International Nuclear Information System (INIS)

    Du Juan; Zuo Yuewei; Hong Nanhua; Chen Xiaoming; Li Yong

    2009-01-01

    Objective: To investigate the long-term efficiency and safety of trans-catheter uterine artery embolization using lipiodol-pingyingmycin emulsion (LPE-TUAE) for uterine fibroids. Methods: Two hundred and forty-three patients with uterine fibroids were treated by LPE-TUAE. Fourteen of them underwent hysterectomy or myomectomy 3 days to 6 months after LPE-TUAE. The specimens were studied pathologically. Another 229 patients were followed up for 1 to 4 years to observe the long-term outcomes. Results: Menorrhagia became normal or improved markedly in 96.0% (193/201). Lumbago and lower abdominal pain disappeared or relieved markedly in 949% (94/99). Bulk-related symptoms disappeared or lessened markedly in 96.0% (48/50). Ultrasound revealed that the average decreased rate in the largest fibroid volume were 60.7% at 1 year, 63.3% at 2 year, 65.6% at 3 year and 67.4% at 4 year after embolization, and the average decreased rate in the largest uterine volume were 49.6% at 1 year, 54.3% at 2 year, 55.2% at 3 year and 57.1% at 4 year after embolization. Reoccurrence rate of myoma was 10.8% 3-4 year after embolization. No significant difference was found in hormone level between pre- and post-embolization. Pathological studies of specimens showed that lipiodol was only accumulated in fibroids and was not seen in myometrium. Spotty necrosis 2 weeks after embolization and extensive patchy necrosis 3 weeks after embolization were occurred in fibroids. Necrosis was not showed in myometrium. No serious complications occurred. Conclusion: LPE-TUAE possesses a good long-term effectiveness for uterine fibroids, which doesn't cause the damage on ovarian function and normal myometrium or serious complications. (authors)

  20. Transcatheter arterial chemoembolization combined with radiofrequency ablation can improve survival of patients with hepatocellular carcinoma with portal vein tumour thrombosis: Extending the indication for ablation?

    International Nuclear Information System (INIS)

    Zheng, J.-S.; Long, J.; Sun, B.; Lu, N.-N.; Fang, D.; Zhao, L.-Y.; Du, N.

    2014-01-01

    Aim: To retrospectively assess long-term survival benefit and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients with portal vein tumour thrombosis (PVTT), and to evaluate factors that significantly affect outcomes of these patients. Materials and methods: One hundred and thirty-four HCC patients (118 men and 16 women; mean age 54.8 years, range 26–79 years) with PVTT were retrospectively assessed. Patients were treated with TACE combined with RFA. Data analysed included patient demographics, liver volume, Child–Pugh score, and Cancer of the Liver Italian Programme (CLIP) score and imaging findings. Survival time (from occurrence of PVTT to last follow-up) was calculated using the Kaplan–Meier method, predictive factors and its correlation with survival was assessed using the multivariate Cox proportional hazards regression method. Results: The median overall survival (OS) time was 29.5 months (range 16.6–42.4 months), the 1, 3, and 5 year OS were 63%, 40%, and 23%. Cox hazards regression analysis revealed that functional remnant liver volume (FRLV), remnant liver volume (RLV)/total liver volume (TLV), radiation, tumour number, vascular endothelial growth factor (VEGF) distribution, and gross type were the only independent predictive factors of outcome (p = 0.039, 0.010, 0.009, 0.034, 0.031, and 0.000, respectively). Conclusion: TACE combined with RFA was found to be an effective therapy, FRLV and RLV/TLV have close correlation with survival for HCC patients with PVTT type I, II, or partial III and Child–Pugh A or B

  1. Treatment of Small Hepatocellular Carcinoma (≤2 cm) in the Caudate Lobe with Sequential Transcatheter Arterial Chemoembolization and Radiofrequency Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Dongho; Cho, Sung Ki, E-mail: sungkismc.cho@samsung.com; Shin, Sung Wook; Rhim, Hyunchul [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center (Korea, Republic of); Koh, Kwang Cheol; Paik, Seung Woon [Sungkyunkwan University School of Medicine, Department of Medicine, Samsung Medical Center (Korea, Republic of)

    2016-07-15

    PurposeTo evaluate technical feasibility and treatment results of sequential transcatheter arterial chemoembolization (TACE) and cone-beam computed tomography-guided percutaneous radiofrequency ablation (CBCT-RFA) for small hepatocellular carcinoma (HCC) in the caudate lobe.Materials and MethodsInstitutional review board approved this retrospective study. Radiologic database was searched for the patients referred to perform TACE and CBCT-RFA for small caudate HCCs (≤2 cm) between February 2009 and February 2014. A total of 14 patients (12 men and 2 women, mean age; 61.3 years) were included. Percutaneous ultrasonography-guided RFA (pUS-RFA) and surgery were infeasible due to poor conspicuity, inconspicuity or no safe electrode pathway, and poor hepatic reserve. Procedural success (completion of both TACE and CBCT-RFA), technique efficacy (absence of tumor enhancement at 1 month after treatment), and complication were evaluated. Treatment results including local tumor progression (LTP), intrahepatic distant recurrence (IDR), overall survival (OS), and progression-free survival (PFS) were analyzed.ResultsProcedural success and technique efficacy rates were 78.6 % (11/14) and 90.9 % (10/11), respectively. Average follow-up period was 45.3 months (range, 13.4–64.6 months). The 1-, 3-, and 5-year LTP probabilities were 0, 12.5, and 12.5 %, respectively. IDR occurred in seven patients (63.6 %, 7/11). The 1-, 3-, and 5-year PFS probabilities were 81.8, 51.9, and 26 %, respectively. The 1-, 3-, and 5-year OS probabilities were 100, 80.8, and 80.8 %, respectively.ConclusionCombination of TACE and CBCT-RFA seems feasible for small HCC in the caudate lobe not amenable to pUS-RFA and effective in local tumor control.

  2. Transcatheter Arterial Embolization for Primary Postpartum Hemorrhage: Predictive Factors of Need for Embolic Material Conversion of Gelatin Sponge Particles to N-Butyl Cyanoacrylate

    International Nuclear Information System (INIS)

    Tanahashi, Yukichi; Goshima, Satoshi; Kondo, Hiroshi; Ando, Tomohiro; Noda, Yoshifumi; Kawada, Hiroshi; Kawai, Nobuyuki; Kotoku, Junichi; Furui, Shigeru; Matsuo, Masayuki

    2017-01-01

    PurposeTo identify predictive factors for embolic material conversion to N-butyl cyanoacrylate (NBCA) for the treatment of primary postpartum hemorrhage (PPH) after failed transcatheter arterial embolization (TAE) using gelatin sponge (GS).Materials and MethodsInstitutional review board approval was obtained. We retrospectively studied 62 consecutive women with primary PPH who underwent TAE between January 2006 and March 2015. Five of them were excluded for the following: cardiopulmonary arrest at arrival (n = 1), uterine inversion (n = 1), and hysterectomy after TAE (n = 3). Remaining 57 women (age range, 21–43 years; mean, 32.6 years) comprised study population. TAE was initially performed using GS in all cases and then converted to NBCA after two embolizations using GS with persistent hemodynamic instability or vaginal bleeding. The patients’ background, uterine height, vital signs, laboratory tests, disseminated intravascular coagulation score, and details of procedure were reviewed. Univariate and multivariate analyses were performed to determine factors related to embolic material conversion.ResultsTechnical success rate was 100%. Fourteen patients (25%) needed embolic material conversion to NBCA. Univariate analysis showed that uterine height, systolic blood pressure (sBP), and hemoglobin level were significantly related to embolic material conversion to NBCA (P = 0.029, 0.030, and 0.042). Logistic regression analysis showed that uterine height (odds ratio, 1.37; P = 0.025) and sBP (odds ratio, 0.96; P = 0.003) were associated with embolic material conversion to NBCA.ConclusionUterine height and sBP can be predictive factors for embolic material conversion to NBCA for the treatment of PPH.Level of EvidenceLevel 4, Case Control Study

  3. Transcatheter Arterial Embolization for Primary Postpartum Hemorrhage: Predictive Factors of Need for Embolic Material Conversion of Gelatin Sponge Particles to N-Butyl Cyanoacrylate

    Energy Technology Data Exchange (ETDEWEB)

    Tanahashi, Yukichi; Goshima, Satoshi, E-mail: gossy@par.odn.ne.jp [Gifu University Hospital, Department of Radiology (Japan); Kondo, Hiroshi [Teikyo University School of Medicine, Department of Radiology (Japan); Ando, Tomohiro; Noda, Yoshifumi; Kawada, Hiroshi; Kawai, Nobuyuki [Gifu University Hospital, Department of Radiology (Japan); Kotoku, Junichi [Teikyo University School of Medicine, Department of Radiological Technology, Faculty of Medical Technology (Japan); Furui, Shigeru [Teikyo University School of Medicine, Department of Radiology (Japan); Matsuo, Masayuki [Gifu University Hospital, Department of Radiology (Japan)

    2017-02-15

    PurposeTo identify predictive factors for embolic material conversion to N-butyl cyanoacrylate (NBCA) for the treatment of primary postpartum hemorrhage (PPH) after failed transcatheter arterial embolization (TAE) using gelatin sponge (GS).Materials and MethodsInstitutional review board approval was obtained. We retrospectively studied 62 consecutive women with primary PPH who underwent TAE between January 2006 and March 2015. Five of them were excluded for the following: cardiopulmonary arrest at arrival (n = 1), uterine inversion (n = 1), and hysterectomy after TAE (n = 3). Remaining 57 women (age range, 21–43 years; mean, 32.6 years) comprised study population. TAE was initially performed using GS in all cases and then converted to NBCA after two embolizations using GS with persistent hemodynamic instability or vaginal bleeding. The patients’ background, uterine height, vital signs, laboratory tests, disseminated intravascular coagulation score, and details of procedure were reviewed. Univariate and multivariate analyses were performed to determine factors related to embolic material conversion.ResultsTechnical success rate was 100%. Fourteen patients (25%) needed embolic material conversion to NBCA. Univariate analysis showed that uterine height, systolic blood pressure (sBP), and hemoglobin level were significantly related to embolic material conversion to NBCA (P = 0.029, 0.030, and 0.042). Logistic regression analysis showed that uterine height (odds ratio, 1.37; P = 0.025) and sBP (odds ratio, 0.96; P = 0.003) were associated with embolic material conversion to NBCA.ConclusionUterine height and sBP can be predictive factors for embolic material conversion to NBCA for the treatment of PPH.Level of EvidenceLevel 4, Case Control Study.

  4. Three-Dimensional Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy Combined With Transcatheter Arterial Chemoembolization for Locally Advanced Hepatocellular Carcinoma: An Irradiation Dose Escalation Study

    International Nuclear Information System (INIS)

    Ren Zhigang; Zhao Jiandong; Gu Ke; Chen Zhen; Lin Junhua; Xu Zhiyong; Hu Weigang; Zhou Zhenhua; Liu Luming; Jiang Guoliang

    2011-01-01

    Purpose: To determine the maximum tolerated dose (MTD) of three-dimensional conformal radiation therapy (3DCRT)/intensity-modulated radiation therapy (IMRT) combined with transcatheter arterial chemoembolization for locally advanced hepatocellular carcinoma. Methods and Materials: Patients were assigned to two subgroups based on tumor diameter: Group 1 had tumors <10 cm; Group II had tumors ≥10 cm. Escalation was achieved by increments of 4.0 Gy for each cohort in both groups. Dose-limiting toxicity (DLT) was defined as a grade of ≥3 acute liver or gastrointestinal toxicity or any grade 5 acute toxicity in other organs at risk or radiation-induced liver disease. The dose escalation would be terminated when ≥2 of 8 patients in a cohort experienced DLT. Results: From April 2005 to May 2008, 40 patients were enrolled. In Group I, 11 patients had grade ≤2 acute treatment-related toxicities, and no patient experienced DLT; and in Group II, 10 patients had grade ≤2 acute toxicity, and 1 patient in the group receiving 52 Gy developed radiation-induced liver disease. MTD was 62 Gy for Group I and 52 Gy for Group II. In-field progression-free and local progression-free rates were 100% and 69% at 1 year, and 93% and 44% at 2 years, respectively. Distant metastasis rates were 6% at 1 year and 15% at 2 years. Overall survival rates for 1-year and 2-years were 72% and 62%, respectively. Conclusions: The irradiation dose was safely escalated in hepatocellular carcinoma patients by using 3DCRT/IMRT with an active breathing coordinator. MTD was 62 Gy and 52 Gy for patients with tumor diameters of <10 cm and ≥10 cm, respectively.

  5. Celiac artery stenosis/occlusion treated by interventional radiology

    International Nuclear Information System (INIS)

    Ikeda, Osamu; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki

    2009-01-01

    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  6. Celiac artery stenosis/occlusion treated by interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Osamu [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)], E-mail: osamu-3643ik@do9.enjoy.ne.jp; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)

    2009-08-15

    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  7. Continuous intra-arterial nimodipine infusion in patients with severe refractory cerebral vasospasm after aneurysmal subarachnoid hemorrhage: a feasibility study and outcome results.

    Science.gov (United States)

    Bele, Sylvia; Proescholdt, Martin A; Hochreiter, Andreas; Schuierer, Gerhard; Scheitzach, Judith; Wendl, Christina; Kieninger, Martin; Schneiker, Andre; Bründl, Elisabeth; Schödel, Petra; Schebesch, Karl-Michael; Brawanski, Alexander

    2015-12-01

    Severe cerebral vasospasm is a major cause of death and disability in patients with aneurysmal subarachnoid hemorrhage. No causative treatment is yet available and hypertensive hypervolemic therapy (HHT) is often insufficient to avoid delayed cerebral ischemia and neurological deficits. We compared patients receiving continuous intra-arterial infusion of the calcium-antagonist nimodipine with a historical group treated with HHT and oral nimodipine alone. Between 0.5 and 1.2 mg/h of nimodipine were continuously administered by intra-arterial infusion via microcatheters either into the internal carotid or vertebral artery or both, depending on the areas of vasospasm. The effect was controlled via multimodal neuromonitoring and transcranial Doppler sonography. Outcome was determined by means of the Glasgow Outcome Scale at discharge and 6 months after the hemorrhage and compared to a historical control group. Twenty-one patients received 28 intra-arterial nimodipine infusions. Six months after discharge, the occurrence of cerebral infarctions was significantly lower (42.6 %) in the nimodipine group than in the control group (75.0 %). This result was reflected by a significantly higher proportion (76.0 %) of patients with good outcome in the nimodipine-treated group, when compared to 10.0 % good outcome in the control group. Median GOS was 4 in the nimodipine group and 2 in the control group (p = 0.001). Continuous intra-arterial nimodipine infusion is an effective treatment for patients with severe cerebral vasospasm who fail to respond to HHT and oral nimodipine alone. Key to the effective administration of continuous intra-arterial nimodipine is multimodal neuromonitoring and the individual adaptation of dosage and time of infusion for each patient.

  8. Superselective intra-arterial infusion chemotherapy for stage III/IV squamous cell carcinomas of the oral cavity: Midterm results

    International Nuclear Information System (INIS)

    Ikushima, I.; Korogi, Y.; Ishii, A.; Hirai, T.; Yamura, M.; Nishimura, R.; Baba, Y.; Yamashita, Y.; Shinohara, M.

    2008-01-01

    Purpose: We performed superselective intra-arterial infusion chemotherapy (SIC) according to a protocol in which drug distribution is evaluated by the use of interventional radiology (IVR)-computed tomography (CT) system, and the chemotherapy is combined with medium-dose conformal radiation therapy (CRT). We analyzed retrospectively the factors that affect the midterm survival ratio, including local response, for stage III and IV squamous cell carcinomas of the oral cavity. Materials and methods: Forty consecutive patients with stage III and IV squamous cell carcinomas of the oral cavity and who had undergone both SIC and CRT were enrolled. A microcatheter was placed in the appropriate feeding artery of the tumor and cisplatin (50 mg/body) was infused twice. CRT was administered with a dual-energy (4 and 10 MV) linear accelerator. The total and daily doses delivered were 30 and 2.0 Gy, respectively. Histopathologic effects were classified into five grades: grade 0 or 1 was defined as a poor response, and grade II or higher as a good response. Age, sex, stage, local response to treatment, mode of invasion and lymph node metastasis were analyzed, and differences in the midterm survival ratio were assessed. Results: The 3-year survival ratio of the 40 cases was 67%. A good local response (III or IV) was achieved in 75% of the cases. The survival ratio of the good local response group was significantly better than that of the poor response group (p = 0.04). Mode of invasion (p = 0.03) and lymph node metastasis (p = 0.01) were also predictive of survival. In the multivariable analysis of survival, however, no variables including good local response (p = 0.12), were predictive. Conslusion: Our new protocol improved local response, but it did not contribute to the survival ratio

  9. Safety and feasibility of thallium-201 myocardial SPECT with intravenous infusion of disodium adenosine triphosphate (ATP) in the diagnosis of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Moon Sun; Park, Chan H.; Yoon, Seok Nam; Kim, Won; Kim, Han Soo [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1998-08-01

    ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet bee sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-102 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Although 76.5% of he patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease.

  10. Safety and feasibility of thallium-201 myocardial SPECT with intravenous infusion of disodium adenosine triphosphate (ATP) in the diagnosis of coronary artery disease

    International Nuclear Information System (INIS)

    Pai, Moon Sun; Park, Chan H.; Yoon, Seok Nam; Kim, Won; Kim, Han Soo

    1998-01-01

    ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet bee sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-102 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Although 76.5% of he patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease

  11. Transcatheter aortic valve replacement

    Science.gov (United States)

    ... gov/ency/article/007684.htm Transcatheter aortic valve replacement To use the sharing features on this page, please enable JavaScript. Transcatheter aortic valve replacement (TAVR) is surgery to replace the aortic valve. ...

  12. Clinical effects of transcatheter hepatic arterial embolization with holmium-166 poly(l-lactic acid) microspheres in healthy pigs

    Energy Technology Data Exchange (ETDEWEB)

    Vente, M.A.D.; Nijsen, J.F.W.; Wit, T.C. de; Schip, A.D. van het [University Medical Center Utrecht, Department of Nuclear Medicine, P.O. Box 85500, Utrecht (Netherlands); Seppenwoolde, J.H.; Seevinck, P.R. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Krijger, G.C. [Delft University of Technology, Department of Radiation, Radionuclides and Reactors, Faculty of Applied Sciences, Delft (Netherlands); Huisman, A. [University Medical Center Utrecht, Department of Clinical Chemistry and Haematology, Utrecht (Netherlands); Zonnenberg, B.A. [University Medical Center Utrecht, Department of Internal Medicine, Utrecht (Netherlands); Ingh, T.S.G.A.M. van den [TCCI Consultancy B.V., P.O. Box 85032, Utrecht (Netherlands)

    2008-07-15

    The aim of this study is to evaluate the toxicity of holmium-166 poly(l-lactic acid) microspheres administered into the hepatic artery in pigs. Healthy pigs (20-30 kg) were injected into the hepatic artery with holmium-165-loaded microspheres ({sup 165}HoMS; n = 5) or with holmium-166-loaded microspheres ({sup 166}HoMS; n = 13). The microspheres' biodistribution was assessed by single-photon emission computed tomography and/or MRI. The animals were monitored clinically, biochemically, and ({sup 166}HoMS group only) hematologically over a period of 1 month ({sup 165}HoMS group) or over 1 or 2 months ({sup 166}HoMS group). Finally, a pathological examination was undertaken. After microsphere administration, some animals exhibited a slightly diminished level of consciousness and a dip in appetite, both of which were transient. Four lethal adverse events occurred in the {sup 166}HoMS group due either to incorrect administration or comorbidity: inadvertent delivery of microspheres into the gastric wall (n = 2), preexisting gastric ulceration (n = 1), and endocarditis (n = 1). AST levels were transitorily elevated post-{sup 166}HoMS administration. In the other blood parameters, no abnormalities were observed. Nuclear scans were acquired from all animals from the {sup 166}HoMS group, and MRI scans were performed if available. In pigs from the {sup 166}HoMS group, atrophy of one or more liver lobes was frequently observed. The actual radioactivity distribution was assessed through ex vivo {sup 166m}Ho measurements. It can be concluded that the toxicity profile of HoMS is low. In pigs, hepatic arterial embolization with {sup 166}HoMS in amounts corresponding with liver-absorbed doses of over 100 Gy, if correctly administered, is not associated with clinically relevant side effects. This result offers a good perspective for upcoming patient trials. (orig.)

  13. Transcatheter arterial chemoembolization of colorectal liver metastases using degradable starch microspheres (Spherex registered). Own investigations and review to the literature

    International Nuclear Information System (INIS)

    Wasser, K.; Landwehr, P.

    2005-01-01

    Since two decades transarterial chemoembolization (TACE) of liver metastases has been investigated in numerous studies. However, no standardized therapeutic procedure exists so far. The present study retrospectively investigated survival, response and side effects after TACE of liver metastases in 21 patients with colorectal cancer and results are compared with previous literature. A total of 68 TACE procedures were performed. A suspension of degradable starch microspheres (DSM, Spherex registered ) and Mitomycin C was applied selectively into hepatic arteries via a transfemoral approach. DSM effect a temporary arterial occlusion. Follow-up studies were performed by contrast enhanced spiral computed tomography (CT). The median survival was 13.8 months. Therapeutic response (according to WHO) was observed only in three patients. The progression free interval was 5.8 months. Patients developed a postembolization-syndrome (abdominal pain, fever, nausea) and increased transaminases in 27-43% of all interventions. A gastric ulcer occurred after four, cholecystitis after two TACE. As already shown in most previous studies, regardless of the used agents, also this investigation underlines the moderate therapeutic effect of TACE on colorectal liver metastases. So far, no significant survival benefit has been shown in the literature and the response rates are rather limited. In general, complications of TACE seem to be rare, but should not to be underestimated. Compared to TACE with long or permanent arterial occlusion, postembolization syndrome seems to be less pronounced using DSM. As TACE is rather a palliative therapeutic approach, DSM therefore might be more suited. Further studies on TACE of liver metastases should focus on to the patients' quality of life. (orig.) [de

  14. Multiple Enlarged Aneurysms in Primary Racemose Hemangioma of the Bronchial Artery: Successful Prophylactic Transcatheter Arterial Embolization Using N-butyl-2-cyanoacrylate and Coils.

    Science.gov (United States)

    Saiga, Atsushi; Sugiura, Toshihiko; Higashide, Takashi; Tsuchiya, Satoshi; Nishiyama, Akira; Kubota, Yoshihiro; Horikoshi, Takuro; Uno, Takashi

    2018-05-01

    An asymptomatic 48-year-old man presented with multiple aneurysms in a primary racemose hemangioma of the right bronchial artery. Bronchial arteriography revealed a tortuous artery with four fusiform aneurysms of varying sizes and aneurysmal dilatation with marked thrombus formation in the long segment of the distal portion. Because the tip of catheter could not pass beyond the aneurysmal dilatation, we performed balloon-occluded embolization using a mixture of N-butyl-2-cyanoacrylate (NBCA) and iodized oil. For four other aneurysms, we performed embolization using a coil alone or with NBCA. After 6 months, right bronchial arteriography revealed no enhancement of the aneurysms. Despite the rarity of this procedure, embolization with NBCA is a good option for bronchial artery aneurysm embolization.

  15. Treatment of hemobilia by transcatheter vascular occlusion

    International Nuclear Information System (INIS)

    Vaughan, R.; Roesch, J.; Keller, F.S.; Antonovic, R.; Veterans Administration Medical Center, Portland, OR

    1984-01-01

    Four cases of hemobilia treated by transcatheter arterial occlusion are presented and reviewed with 30 similar cases reported in the literature. Transcatheter vascular occlusion successfully controlled hemorrhage in all 34 patients. No obvious liver parenchymal damage appeared in 26 patients; transient elevation of liver enzymes occurred in 6 patients (18%) including one in our series; two of the patients reviewed died of acute hepatic insufficiency following nonselective hepatic artery embolization. Hemobilia should be considered when gastrointestinal hemorrhage occurs after abdominal trauma, liver biopsy or other manipulative liver procedures. Hepatic angiography establishes the diagnosis and selective vascular occlusion is the treatment of choice for control of intractable or recurrent hemorrhage. Techniques and precautions for the diagnosis and transcatheter therapy of hemobilia are discussed. (orig.)

  16. Effect of dietary nitrogen content and intravenous urea infusion on ruminal and portal-drained visceral extraction of arterial urea in lactating Holstein cows

    DEFF Research Database (Denmark)

    Kristensen, Niels Bastian; Storm, Adam Christian; Larsen, Mogens

    2010-01-01

    Urea extraction across ruminal and portal-drained visceral (PDV) tissues were investigated using 9 rumen-cannulated and multi-catheterized lactating dairy cows adapted to low-N (12.9% crude protein) and high-N (17.1% crude protein) diets in a crossover design. The interaction between adaptation...... to arterial urea concentrations. Urea extraction increased more across the rumen wall than across the total PDV for low-N compared with high-N, which implies that a larger proportion of total PDV uptake of arterial urea is directed toward the rumen with decreasing N intake. The ruminal vein - arterial (RA......) concentration difference for ammonia increased instantly (first sampling 15 min after initiation of infusion) to the primed intravenous infusion when cows were adapted to the low-N diet. The RA difference for ammonia correlated poorly to the ventral ruminal concentration of ammonia (r = 0.55). Relating the RA...

  17. Clinical Observation of Recombinant Human Vascular Endostatin Durative Transfusion Combined with Window Period Arterial Infusion Chemotherapy in the Treatment of 
Advanced Lung Squamous Carcinoma

    Directory of Open Access Journals (Sweden)

    Yuan LV

    2015-08-01

    Full Text Available Background and objective Lung cancer is one of the most common malignant tumors in China. The aim of this study is to observe the efficacy and safety of recombinant human vascular endostatin (endostar durative transfusion combined with window period arterial infusion chemotherapy in the treatment of advanced lung squamous carcinoma. Methods From February 2014 to January 2015, 10 cases of the cytological or histological pathology diagnosed stage IIIb - stage IV lung squamous carcinoma were treated with recombinant human vascular endostatin (30 mg/d durative transfusion combined with window period arterial infusion chemotherapy. Over the same period of 10 cases stage IIIb - stage IV lung squamous carcinoma patients for pure arterial perfusion chemotherapy were compared. Recombinant human vascular endostatin was durative transfused every 24 hours for 7 days in combination group, and in the 4th day of window period, the 10 patients were received artery infusion chemotherapy, using docetaxel combined with cisplatin. Pure treatment group received the same arterial perfusion chemotherapy regimen. 4 weeks was a cycle. 4 weeks after 2 cycles, to evaluate the short-term effects and the adverse drug reactions. Results 2 groups of patients were received 2 cycles treatments. The response rate (RR was 70.0%, and the disease control rate (DCR was 90.0% in the combination group; In the pure treatment group were 50.0%, 70.0% respectively, there were no statistically significant difference (P=0.650, 0.582. The adverse reactions of the treatment were mild, including level 1-2 of gastrointestinal reaction and blood toxicity, there were no statistically significant difference (P=0.999, P=0.628. In the combination group, 1 patient occurred level 1 of cardiac toxicity. Conclusion Recombinant human vascular endostatin durative transfusion combined with window period arterial infusion chemotherapy in the treatment of advanced lung squamous carcinoma could take a

  18. Higher dose intra-arterial milrinone and intra-arterial combined milrinone-nimodipine infusion as a rescue therapy for refractory cerebral vasospasm.

    Science.gov (United States)

    Duman, Enes; Karakoç, Fatma; Pinar, H Ulas; Dogan, Rafi; Fırat, Ali; Yıldırım, Erkan

    2017-12-01

    Background Cerebral vasospasm (CV) is a major cause of delayed morbidity and mortality in patients with subarachnoid hemorrhage (SAH). Various cerebral protectants have been tested in patients with aneurysmal SAH. We aimed to research the success rate of treatment of CV via intra-arterial milrinone injection and aggressive pharmacological therapy for refractory CV. Methods A total of 25 consecutive patients who received intra-arterial milrinone and nimodipine treatment for CV following SAH between 2014 and 2017 were included in the study. Patients who underwent surgical clipping were excluded. Refractory vasospasm was defined as patients with CV refractory to therapies requiring ≥3 endovascular interventions. Overall, six patients had refractory CV. Long-term neurological outcome was assessed 6-18 months after SAH using a modified Rankin score and Barthel index. Results The median modified Rankin scores were 1 (min: 0, max: 3) and Barthel index scores were 85 (min: 70, max: 100) From each vasospastic territory maximal 10-16 mg milrinone was given to patients; a maximum of 24 mg milrinone was given to each patient in a session and a maximum of 42 mg milrinone was given to a patient in a day. Both milrinone and nimodipine were given to three patients. There was a large vessel diameter increase after milrinone and nimodipine injections. No patient died due to CV; only one patient had motor dysfunction on the right lower extremity. Conclusion Higher doses of milrinone can be used effectively to control refractory CV. For exceptional patients with refractory CV, high dose intra-arterial nimodipine and milrinone infusion can be used as a rescue therapy.

  19. Dynamic study of efficacy of transcatheter arterial chemoembolization (TACE) of primary liver carcinoma with the MR diffusion-weighted imaging (DWI)

    International Nuclear Information System (INIS)

    Shang Quanliang; Xiao Enhua; He Zhong; Tan Lihua; Situ Weijun; Bao Moliao; Yuan Shiwen; Du Wanping

    2006-01-01

    Objective: To dynamically evaluate the efficacy of treatment of primary liver carcinoma (PLC) by transcatheter arterial ehemoembolization(TACE) with the MR diffusion-weighted imaging(DWI). Methods: DWI and the measurement of mean apparent diffusion coeffecient (ADC) value were performed in 25 masses of PLC with the same SE-EPI sequence (b=800 s/mm 2 and 0) at 1.5 T MRI within the 24- 48 hours before TACE (group A) and 36-48 hours, 7-10 days, 30-38 days after TACE (group B, group C, group D). The differences of the mean ADC values of PLC between groups were analyzed. Results: The mean ADC values of the three groups after TACE the mean ADC value of group B: (1.598±0.012) x 10 -3 mm 2 /s, the mean ADC value of group C: (1.723±0.012) x 10 -3 mm 2 /s, the mean ADC value of group D: (1.684±0.012) x 10 -3 mm 2 /s were significantly greater than that of the group before TACE the mean ADC value of group A: (1.376±0.012) x 10 -3 mm 2 /s (p<0.05). The mean ADC values of the group C and the group D were significantly greater than that of the group B (P<0.05). The mean ADC values of the group D was lower than that of the group C (P<0.05). Through contrasting the digital subtraction angiography (DSA) imaging of the second TACE with that of the first TACE, we found that every PLC whose mean ADC value after 30-38 days of the TACE was lower than that after 7-10 days of the TACE could be found the recurrence, especially in those PLC whose mean ADC values were decreased greatly. Conclusion: With the measurement of ADC value of the different time of the PLC we could excellently evaluate the necrosis and the recurrence of the PLC after the operation of the TACE. (authors)

  20. Brain SPECT by intraarterial infusion of 99mTc-HMPAO for assessing the cerebral distribution of carotid artery infusions in patient with brain tumor

    International Nuclear Information System (INIS)

    Kosuda, Shigeru; Kusano, Shoichi; Aoki, Shigeki

    1993-01-01

    In order to assess the cerebral distribution of intracarotid chemotherapy, 17 postoperative patients with brain tumor underwent brain SPECT obtrained by intraarterial infusion of 18.5 MBq of 99m Tc-d,l,-hexamethylpropyleneamine oxime ( 99m Tc-HMPAO). Injection methods were continuous (5.0 ml/min) or pulsatile infusion with supra- or infraophthalmic catheterization. The findings obtained by brain SPECT were frequently different from those of angiography and/or DSA. In supraophthalmic catheterization with continuous infusion, only 2 of 10 studies (20%) had homogeneous distribution and 5 of them (50%) had maldistribution of 99m Tc-HMPAO which appears in association with laminar flow effect. The remaining 3 studies showed localized distribution (two: tumor localization, one: healthy brain localization). On the other hand, all of 5 studies with pulsatile infusion had homogeneous distribution of 99m Tc-HMPAO. In infraophthalmic catheterization, all but one of 5 studies had homogeneous distribution with continuous infusion. These results suggest that pulsatile infusion may be effective in eliminating maldistribution of 99m Tc-HMPAO in supraophthalmic catheterization. In conclusion, we are convinced that 99m Tc-HMPAO is a useful intraarterial agent for assessing cerebral distribution of intracarotid chemotherpay. (author)

  1. Effect of open-label infusion of an apoA-I-containing particle (CER-001) on RCT and artery wall thickness in patients with FHA[S

    Science.gov (United States)

    Kootte, Ruud S.; Smits, Loek P.; van der Valk, Fleur M.; Dasseux, Jean-Louis; Keyserling, Constance H.; Barbaras, Ronald; Paolini, John F.; Santos, Raul D.; van Dijk, Theo H.; Dallinga-van Thie, Geesje M.; Nederveen, Aart J.; Mulder, Willem J. M.; Hovingh, G. Kees; Kastelein, John J. P.; Groen, Albert K.; Stroes, Erik S.

    2015-01-01

    Reverse cholesterol transport (RCT) contributes to the anti-atherogenic effects of HDL. Patients with the orphan disease, familial hypoalphalipoproteinemia (FHA), are characterized by decreased tissue cholesterol removal and an increased atherogenic burden. We performed an open-label uncontrolled proof-of-concept study to evaluate the effect of infusions with a human apoA-I-containing HDL-mimetic particle (CER-001) on RCT and the arterial vessel wall in FHA. Subjects received 20 infusions of CER-001 (8 mg/kg) during 6 months. Efficacy was assessed by measuring (apo)lipoproteins, plasma-mediated cellular cholesterol efflux, fecal sterol excretion (FSE), and carotid artery wall dimension by MRI and artery wall inflammation by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography scans. We included seven FHA patients: HDL-cholesterol (HDL-c), 13.8 [1.8–29.1] mg/dl; apoA-I, 28.7 [7.9–59.1] mg/dl. Following nine infusions in 1 month, apoA-I and HDL-c increased directly after infusion by 27.0 and 16.1 mg/dl (P = 0.018). CER-001 induced a 44% relative increase (P = 0.018) in in vitro cellular cholesterol efflux with a trend toward increased FSE (P = 0.068). After nine infusions of CER-001, carotid mean vessel wall area decreased compared with baseline from 25.0 to 22.8 mm2 (P = 0.043) and target-to-background ratio from 2.04 to 1.81 (P = 0.046). In FHA-subjects, CER-001 stimulates cholesterol mobilization and reduces artery wall dimension and inflammation, supporting further evaluation of CER-001 in FHA patients. PMID:25561459

  2. Effect of open-label infusion of an apoA-I-containing particle (CER-001) on RCT and artery wall thickness in patients with FHA.

    Science.gov (United States)

    Kootte, Ruud S; Smits, Loek P; van der Valk, Fleur M; Dasseux, Jean-Louis; Keyserling, Constance H; Barbaras, Ronald; Paolini, John F; Santos, Raul D; van Dijk, Theo H; Dallinga-van Thie, Geesje M; Nederveen, Aart J; Mulder, Willem J M; Hovingh, G Kees; Kastelein, John J P; Groen, Albert K; Stroes, Erik S

    2015-03-01

    Reverse cholesterol transport (RCT) contributes to the anti-atherogenic effects of HDL. Patients with the orphan disease, familial hypoalphalipoproteinemia (FHA), are characterized by decreased tissue cholesterol removal and an increased atherogenic burden. We performed an open-label uncontrolled proof-of-concept study to evaluate the effect of infusions with a human apoA-I-containing HDL-mimetic particle (CER-001) on RCT and the arterial vessel wall in FHA. Subjects received 20 infusions of CER-001 (8 mg/kg) during 6 months. Efficacy was assessed by measuring (apo)lipoproteins, plasma-mediated cellular cholesterol efflux, fecal sterol excretion (FSE), and carotid artery wall dimension by MRI and artery wall inflammation by (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography scans. We included seven FHA patients: HDL-cholesterol (HDL-c), 13.8 [1.8-29.1] mg/dl; apoA-I, 28.7 [7.9-59.1] mg/dl. Following nine infusions in 1 month, apoA-I and HDL-c increased directly after infusion by 27.0 and 16.1 mg/dl (P = 0.018). CER-001 induced a 44% relative increase (P = 0.018) in in vitro cellular cholesterol efflux with a trend toward increased FSE (P = 0.068). After nine infusions of CER-001, carotid mean vessel wall area decreased compared with baseline from 25.0 to 22.8 mm(2) (P = 0.043) and target-to-background ratio from 2.04 to 1.81 (P = 0.046). In FHA-subjects, CER-001 stimulates cholesterol mobilization and reduces artery wall dimension and inflammation, supporting further evaluation of CER-001 in FHA patients. Copyright © 2015 by the American Society for Biochemistry and Molecular Biology, Inc.

  3. Comparison of Intrahepatic and Pancreatic Perfusion on Fusion Images Using a Combined SPECT/CT System and Assessment of Efficacy of Combined Continuous Arterial Infusion and Systemic Chemotherapy in Advanced Pancreatic Carcinoma

    International Nuclear Information System (INIS)

    Ikeda, Osama; Tamura, Yoshitaka; Nakasone, Yutaka; Shiraishi, Shinya; Kawanaka, Kouichi; Tomiguchi, Seiji; Yamashita, Yasuyuki; Takamori, Hiroshi; Kanemitsu, Keiichiro; Baba, Hideo

    2007-01-01

    Purpose. The purpose of this study was to compare intrahepatic and pancreatic perfusion on fusion images using a combined single-photon emission computed tomography (SPECT)/CT system and to evaluate the efficacy of combined continuous transcatheter arterial infusion (CTAI) and systemic chemotherapy in the treatment of advanced pancreatic carcinoma. Materials and Methods. CTAI was performed in 33 patients (22 men, 11 women; age range, 35-77 years; mean age, 60 years) with stage IV pancreatic cancer with liver metastasis. The reservoir was transcutaneously implanted with the help of angiography. The systemic administration of gemcitabine was combined with the infusion of 5-fluorouracil via the reservoir. In all patients we obtained fusion images using a combined SPECT/CT system. Pancreatic perfusion on fusion images was classified as perfusion presence or as perfusion absent in the pancreatic cancer. Using WHO criteria we recorded the tumor response after 3 months on multislice helical CT scans. Treatment effects were evaluated based on the pancreatic cancer, liver metastasis, and factors such as intrahepatic and pancreatic perfusion on fusion images. For statistical analysis we used the chi-square test; survival was evaluated by the Kaplan Meier method (log-rank test). Results. On fusion images, pancreatic and intrahepatic perfusion was recorded as hot spot and as homogeneous distribution, respectively, in 18 patients (55%) and as cold spot and heterogeneous distribution, respectively, in 15 (45%). Patients with hot spot in the pancreatic tumor and homogeneous distribution in the liver manifested better treatment results (p < 0.05 and p < 0.01, respectively). Patients with hot spot both in the pancreatic cancer and in the liver survived longer than those with cold spot in the pancreatic cancer and heterogeneous distribution in the liver (median ± SD, 16.0 ± 3.7 vs. 8.0 ± 1.4 months; p < 0.05). Conclusions. We conclude that in patients with advanced pancreatic

  4. Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System

    International Nuclear Information System (INIS)

    Hashimoto, Aya; Tanaka, Toshihiro; Sho, Masayuki; Nishiofuku, Hideyuki; Masada, Tetsuya; Sato, Takeshi; Marugami, Nagaaki; Anai, Hiroshi; Sakaguchi, Hiroshi; Kanno, Masatoshi; Tamamoto, Tetsuro; Hasegawa, Masatoshi; Nakajima, Yoshiyuki; Kichikawa, Kimihiko

    2016-01-01

    PurposePrevious reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer.Materials and Methods93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used.ResultsThe overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312).ConclusionsThe coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.

  5. Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Aya; Tanaka, Toshihiro, E-mail: toshihir@bf6.so-net.ne.jp [Nara Medical University, Department of Radiology (Japan); Sho, Masayuki [Nara Medical University, Department of Surgery (Japan); Nishiofuku, Hideyuki; Masada, Tetsuya; Sato, Takeshi; Marugami, Nagaaki [Nara Medical University, Department of Radiology (Japan); Anai, Hiroshi [Nara City Hospital, Department of Radiology (Japan); Sakaguchi, Hiroshi [Nara Prefectural Western Medical Center, Department of Radiology (Japan); Kanno, Masatoshi [Nara Medical University, Oncology Center (Japan); Tamamoto, Tetsuro; Hasegawa, Masatoshi [Nara Medical University, Department of Radiation Oncology (Japan); Nakajima, Yoshiyuki [Nara Medical University, Department of Surgery (Japan); Kichikawa, Kimihiko [Nara Medical University, Department of Radiology (Japan)

    2016-06-15

    PurposePrevious reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer.Materials and Methods93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used.ResultsThe overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312).ConclusionsThe coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.

  6. Quality of life in patients diagnosed with primary hepatocellular carcinoma: hepatic arterial infusion of Cisplatin versus 90-Yttrium microspheres (Therasphere).

    Science.gov (United States)

    Steel, Jennifer; Baum, Andrew; Carr, Brian

    2004-02-01

    The aims of the study were to test the difference in health-related quality (HRQL) of life and survival in patients diagnosed with primary hepatocellular carcionma (HCC) and treated with either hepatic arterial infusion (HAI) of Cisplatin or 90-Yttrium microspheres (Therasphere). The design of the study was a non-randomized parallel cohort study. Twenty-eight patients participated in the present study. HRQL was assessed by administration of the Functional Assessment of Cancer Therapy-Hepatobiliary. Survival was measured using Kaplan Meier methods. The results of present study suggest treatment with Therasphere) had an advantage in regard to HRQL and survival when compared to Cisplatin. At 3-month follow-up, patients who were treated with Therasphere had a higher level of functional well-being as well as overall quality of life when compared to patients treated with Cisplatin. At 6-month follow-up patients (treated with Therasphere) continued to have better functional well-being when compared to patients being treated with HAI of Cisplatin. At 6-month follow-up, survival was found to be similar for patients treated with Therasphere when compared to patients being treated with Cisplatin. Preliminary data suggest that treatment with Therasphere has a modest advantage in regard to HRQL when compared patients treated with HAI of Cisplatin. Future research with Therasphere, that includes a larger sample size and longer follow-up, is necessary to make definitive conclusions regarding the efficacy and effect on HRQL. Copyright 2003 John Wiley & Sons, Ltd.

  7. Antibody guided irradiation of brain glioma by arterial infusion of radioactive monoclonal antibody against epidermal growth factor receptor and blood group A antigen

    Energy Technology Data Exchange (ETDEWEB)

    Epenetos, A.A.; Courtenay-Luck, N.; Pickering, D.; Hooker, G.; Lavender, J.P.; McKenzie, C.G. (Hammersmith Hospital, London (UK)); Durbin, H. (Imperial Cancer Research Fund, London (UK). Labs.)

    1985-05-18

    In a patient with recurrent grade IV glioma of the brain resistant to conventional treatment an antibody guided isotopic scan showed uptake by the tumour of a monoclonal antibody (9A) that was developed against epidermal growth factor receptor but cross reacted with blood group A antigen. As a therapeutic attempt antibody labelled with 1665 MBq (45.0 mCi) iodine-131 was delivered to the tumour area by infusion into the internal carotid artery. Computed tomography showed regression of the tumour after treatment, and an appreciable and sustained clinical improvement was noted without any toxicity. Delivery of irradiation guided by monoclonal antibody delivered by arterial infusion of the tumour area may be of clinical value in the treatment of brain gliomas resistant to conventional forms of treatment.

  8. Acute interventional diagnosis and treatment of upper gastrointestinal arterial hemorrhage: its clinical value and influence factors

    International Nuclear Information System (INIS)

    Wang Yongli; Cui Shitao; Zhang Jiaxing; Ru Fuming; Xu Jiahua; Xu Jichong

    2009-01-01

    Objective: To evaluate emergent angiography and interventional management in treating massive upper gastrointestinal (GI) arterial hemorrhage, and to discuss the factors influencing the angiographic bleeding signs and the interventional therapeutic results. Methods: The clinical data of 56 patients with massive upper GI arterial hemorrhage, who underwent diagnostic arteriography and interventional management with trans-catheter vasopressin infusion and embolization, were retrospectively analyzed. Systolic blood pressure of both pre-and post-interventional therapy was recorded and statistically analyzed. The arteriographic positive rates were separately calculated according to the catheter tip's location, being placed at the 2nd grade branch or at the 3 rd -4 th grade branch of the artery, and the relation of the positive rate with the tip's location was analyzed. A comparison of the hemostatic effect between trans-catheter vasopressin infusion and trans-catheter embolization was made. Results: The average systolic blood pressure of pre-and post-procedure was (93.14 ± 18.63) mmHg and (11.64 ± 13.61) mmHg respectively, with a significant difference (P = 0.023). The angiographic bleeding signs were demonstrated in 12 cases (21.4%) with the catheter's tip at the 2nd grade branch and in 56 cases (100%) with the catheter's tip at the 3 rd -4 th grade branch,the difference between the two was of statistically significance (P < 0.05). The technical success rate and the clinical hemostasis rate of via catheter vasopressin infusion was 80% (16 / 20) and 55% (11/20) respectively. Of nine re-bleeding cases, seven were successfully controlled with embolization therapy by using microcatheter and two had to receive surgery because of arterial rupture which was proved by angiography. The technical and the clinical rates of success for transcatheter embolization therapy were 93% (42 / 45) and 89% (40 / 45) respectively. Recurrence of bleeding was seen in two patients who got

  9. Meta-analysis of hepatic arterial infusion for unresectable liver metastases from colorectal cancer: the end of an era?

    Science.gov (United States)

    Mocellin, Simone; Pilati, Pierluigi; Lise, Mario; Nitti, Donato

    2007-12-10

    The treatment of unresectable liver-confined metastatic disease from colorectal cancer (CRC) is a challenging issue. Although locoregional treatments such as hepatic arterial infusion (HAI) claim the advantage of delivering higher doses of anticancer agents directly into the affected organ, the benefit in terms of overall survival (OS) is unclear. We quantitatively summarized the results of randomized controlled trials (RCT) comparing HAI with systemic chemotherapy (SCT). To date, 10 RCTs have been published, for a total of 1,277 patients enrolled. For tumor response rates, relative risks (RR) and their 95% CIs were obtained from raw data; for OS, hazard ratios (HRs) and their 95% CIs were extrapolated from the Kaplan-Meier survival curves. HAI regimens were based on floxuridine (FUDR) in nine of 10 RCTs, whereas in one RCT, fluorouracil (FU) + leucovorin was used. SCT consisted of FUDR, FU, FU + leucovorin, or a miscellany of FU and best supportive care in three, one, four, and two studies, respectively. Pooling the data, tumor response rate was 42.9% and 18.4% for HAI and SCT, respectively (RR = 2.26; 95% CI, 1.80 to 2.84; P < .0001). Mean weighted median OS times were 15.9 and 12.4 months for HAI and SCT, respectively; the meta-risk of death was not statistically different between the two study groups (HR = 0.90; 95% CI, 0.76 to 1.07; P = .24). Currently available evidence does not support the clinical or investigational use of fluoropyrimidine-based HAI alone for the treatment of patients with unresectable CRC liver metastases, at least as a first-line therapy.

  10. Selective hepatic arterial infusion of In-111-DTPA-Phe{sup 1}-octreotide in neuroendocrine liver metastases

    Energy Technology Data Exchange (ETDEWEB)

    Limouris, Georgios S.; Kontogeorgakos, Dimitrios; Lyra, Maria; Dimitriou, Panagiotis; Stavraka, Anastasia [Athens Medical School, Divisions of Nuclear Medicine, Radiology I Department, Athens (Greece); Aretaieion University Hospital, Athens (Greece); Chatziioannou, Achilles; Mourikis, Dimitrios; Gouliamos, Athanassios; Vlahos, Lambros [Athens Medical School, Divisions of Angiography, Radiology I Department, Athens (Greece); Aretaieion University Hospital, Athens (Greece)

    2008-10-15

    The aim of this study is to evaluate the effectiveness of {sup 111}In-DTPA-Phe{sup 1}-octreotide infusions after selective catheterization of the hepatic artery in inoperable metastasised liver, sst{sub 2} receptor-positive neuroendocrine tumours due to the effect of {sup 111}In Auger electron emission, minimising in parallel the toxicity of non-target tissue. The average dose per session administered monthly to each patient (17 cases in total) was 6.3{+-}2.3 GBq. Repetitions did not exceed 12-fold, except in one case (15 sessions). Response assessment was classified according to the Response Evaluating Criteria in Solid Tumours. CT/MRI scans were performed as baseline before, during and after the end of treatment, and monthly ultrasound images for follow-up measurements. Toxicity (World Health Organization criteria) was measured using blood and urine tests of renal, hepatic and bone marrow function. Complete response was achieved in one (5.9%) patient and partial in eight (47.0%), and disease stabilization in 3(17.7%) patients; five (29.4%) did not respond. A 32-month median survival time was estimated in 12(70.5%). Nine of these 12 surviving had a mean target diameter shrinkage from 144 {+-} 81 to 60 {+-} 59 mm. Grade 1 erythro-, leuko- and thrombo-cytopenia occurred in three (17.6%) cases. In unresectable metastatic liver lesions positive for somatostatin receptors repeated, transhepatic high doses of {sup 111}In-DTPA-Phe{sup 1}-octreotide show an effective therapeutic outcome. Given the locoregional modality character of the administration technique plus the extremely short range of {sup 111}In Auger and internal conversion electrons emission, no nephro-, liver- or myelo-toxicity has so far been observed. (orig.)

  11. Radiotherapy following bronchial artery infusion (BAI) chemotherapy for lung cancer. Analysis of long-term treatment results of 168 patients

    International Nuclear Information System (INIS)

    Miyaji, Noriaki

    1995-01-01

    Local control is known to contribute to a better survival for non-small cell lung cancer (NSCLC). Radiotherapy with bronchial artery infusion (BAI) of anticancer agents was employed to improve the response rate and prognosis of lung cancer. One hundred and sixty-eight patients of lung cancer were treated by this combined therapy. There were 138 with NSCLC and 30 with small cell lung cancer (SCLC). The overall cumulative 5-year survival rate of NSCLC was 11.3% and median survival time (MST) was 12 months. The response rate of 84% was obtained by this combined therapy. CR cases showed a better result of 35% of 5-year survival. Histology did not influence survival. Stage IIIA patients showed a significantly better survival than stage IIIB patients (p<0.05). No significant difference in survival was observed in the MMC/ADM group and the CDDP group. In SCLC patients, the overall cumulative 5-year survival was 4% and MST was 12 months. In limited disease (LD) group, MST was 13 months and extensive disease (ED) showed 11 months of MST. Two-year survival of LD was 18%. The response rate of this combined therapy was 94% and CR rate was 31%. On patterns of failure, the lower local recurrence rate of 6% (1/18) suggested contribution of BAI in SCLC. However, the long-term survival of SCLC was not greatly improved by radiotherapy combined with BAI. Thus these results suggest that it is necessary for improvement of survival to achieve CR in NSCLC patients, but local control may not contribute to it in SCLC patients. (author)

  12. Prospective Evaluation of Transcatheter Arterial Chemoembolization (TACE) with Multiple Anti-Cancer Drugs (Epirubicin, Cisplatin, Mitomycin C, 5-Fluorouracil) Compared with TACE with Epirubicin for Treatment of Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Sahara, Shinya; Kawai, Nobuyuki; Sato, Morio, E-mail: morisato@mail.wakayama-med.ac.jp; Tanaka, Takami; Ikoma, Akira; Nakata, Kouhei; Sanda, Hiroki; Minamiguchi, Hiroki; Nakai, Motoki; Shirai, Shintaro; Sonomura, Tetsuo [Wakayama Medical University, Department of Radiology (Japan)

    2012-12-15

    Purpose: To compare the efficacy of transcatheter arterial chemoembolization (TACE) using multiple anticancer drugs (epirubicin, cisplatin, mitomycin C, and 5-furuorouracil: Multi group) with TACE using epirubicin (EP group) for hepatocellular carcinoma (HCC). Materials and Methods: The study design was a single-center, prospective, randomized controlled trial. Patients with unrespectable HCC confined to the liver, unsuitable for radiofrequency ablation, were assigned to the Multi group or the EP group. We assessed radiographic response as the primary endpoint; secondary endpoints were progression-free survival (PFS), safety, and hepatic branch artery abnormality (Grade I, no damage or mild vessel wall irregularity; Grade II, overt stenosis; Grade III, occlusion; Grades II and III indicated significant hepatic artery damage). A total of 51 patients were enrolled: 24 in the Multi group vs. 27 in the EP group. Results: No significant difference in HCC patient background was found between the groups. Radiographic response, PFS, and 1- and 2-year overall survival of the Multi vs. EP group were 54% vs. 48%, 6.1 months vs. 8.7 months, and 95% and 65% vs. 85% and 76%, respectively, with no significant difference. Significantly greater Grade 3 transaminase elevation was found in the Multi group (p = 0.023). Hepatic artery abnormality was observed in 34% of the Multi group and in 17.1% of the EP group (p = 0.019). Conclusion: TACE with multiple anti-cancer drugs was tolerable but appeared not to contribute to an increase in radiographic response or PFS, and caused significantly more hepatic arterial abnormalities compared with TACE with epirubicin alone.

  13. Transcatheter emboilization therapy of massive colonic bleeding

    International Nuclear Information System (INIS)

    Shin, G. H.; Oh, J. H.; Yoon, Y.

    1996-01-01

    To evaulate the efficacy and safety of emergent superselective transcatheter embolization for controlling massive colonic bleeding. Six of the seven patients who had symptom of massive gastrointestinal bleeding underwent emergent transcatheter embolization for control of the bleeding. Gastrointestinal bleeding in these patients was originated from various colonic diseases: rectal cancer(n=1), proctitis(n=1), benign ulcer(n=1), mucosal injury by ventriculoperitoneal shunt(n=1), and unknown(n=2). All patients except one with rectal cancer were critically ill. Superselective embolization were done by using Gelfoam particles and/or coils. The vessels embolized were ileocolic artery(n=1). superior rectal artery(n=2), inferior rectal artery (n=1), and middle and inferior rectal arteries(n=1). Hemostasis was successful immediately in all patients. Two underwnet surgery due to recurrent bleeding developed 3 days after the procedure(n=1) or in associalion with underlying rectal cancer(n=1). On surgical specimen of two cases, there was no mucosal ischemic change. Transcatheter embolization is a safe and effective treatment of method for the control of massive colonic bleeding

  14. Effect of dietary nitrogen content and intravenous urea infusion on ruminal and portal-drained visceral extraction of arterial urea in lactating Holstein cows.

    Science.gov (United States)

    Kristensen, N B; Storm, A C; Larsen, M

    2010-06-01

    Urea extraction across ruminal and portal-drained visceral (PDV) tissues were investigated using 9 rumen-cannulated and multi-catheterized lactating dairy cows adapted to low-N (12.9% crude protein) and high-N (17.1% crude protein) diets in a crossover design. The interaction between adaptation to dietary treatments and blood plasma concentrations of urea was studied by dividing samplings into a 2.5-h period without urea infusion followed by a 2.5-h period with primed continuous intravenous infusion of urea (0.493+/-0.012 mmol/kg of BW per h). Cows were sampled at 66+/-14 and 68+/-12 d in milk and produced 42+/-1 and 36+/-1 kg of milk/d with the high-N and low-N diets, respectively. The arterial blood urea concentration before urea infusion was 1.37 and 4.09+/-0.18 mmol/L with low-N and high-N, respectively. Dietary treatment did not affect the urea infusion-induced increase in arterial urea concentration (1.91+/-0.13 mmol/L). Arterial urea extraction across the PDV and rumen increased from 2.7 to 5.4+/-0.5% and from 7.1 to 23.8+/-2.1% when cows were changed from high-N to low-N, respectively. Urea infusion did not decrease urea extractions, implying that urea transport rates were proportional to arterial urea concentrations. Urea extraction increased more across the rumen wall than across the total PDV for low-N compared with high-N, which implies that a larger proportion of total PDV uptake of arterial urea is directed toward the rumen with decreasing N intake. The ruminal vein - arterial (RA) concentration difference for ammonia increased instantly (first sampling 15 min after initiation of infusion) to the primed intravenous infusion when cows were adapted to the low-N diet. The RA difference for ammonia correlated poorly to the ventral ruminal concentration of ammonia (r=0.55). Relating the RA difference for ammonia to a function of both ruminal ammonia concentration and the RA difference for urea markedly improved the fit (r=0.85), indicating that a large

  15. Evaluation for intravenous, arterial and local infusion of a hypoxic cell radiosensitizer RK28 on rabbit VX2 tumor system

    International Nuclear Information System (INIS)

    Kuramitsu, Tatsuya

    1993-01-01

    We evaluated the radiosensitizing effect of intraarterial, intravenous and local infusion of a hypoxic cell radiosensitizer RK28 on rabbit VX2 tumor system. Six rabbits were treated in each infusion group. VX2 tumor was implanted in the left hind leg. Tumor grown up to 3 cm in diameter was treated with 15 Gy of X-ray irradiation just after infusion of radiosensitizer RK28 (80 mg/kg.b.w.). Intratumoral and serum mean concentration of RK28 and its metabolites were measured. Tumor regression curve and survival time were analyzed. The following results were obtained. Mean concentration of RK28 was about 2.5 times greater in local infusion and 1.5 times in intraarterial infusion than in intravenous infusion. Significant regression of tumor was obtained in intraarterial infusion (p<0.01). There was no significant difference in survival time. These data suggest that the usefulness of intraarterial infusion of RK28 for local control using intraoperative radiation therapy and brachytherapy. (author)

  16. Transcatheter closure of patent ductus arteriosus: past, present and future.

    Science.gov (United States)

    Baruteau, Alban-Elouen; Hascoët, Sébastien; Baruteau, Julien; Boudjemline, Younes; Lambert, Virginie; Angel, Claude-Yves; Belli, Emre; Petit, Jérôme; Pass, Robert

    2014-02-01

    This review aims to describe the past history, present techniques and future directions in transcatheter treatment of patent ductus arteriosus (PDA). Transcatheter PDA closure is the standard of care in most cases and PDA closure is indicated in any patient with signs of left ventricular volume overload due to a ductus. In cases of left-to-right PDA with severe pulmonary arterial hypertension, closure may be performed under specific conditions. The management of clinically silent or very tiny PDAs remains highly controversial. Techniques have evolved and the transcatheter approach to PDA closure is now feasible and safe with current devices. Coils and the Amplatzer Duct Occluder are used most frequently for PDA closure worldwide, with a high occlusion rate and few complications. Transcatheter PDA closure in preterm or low-bodyweight infants remains a highly challenging procedure and further device and catheter design development is indicated before transcatheter closure is the treatment of choice in this delicate patient population. The evolution of transcatheter PDA closure from just 40 years ago with 18F sheaths to device delivery via a 3F sheath is remarkable and it is anticipated that further improvements will result in better safety and efficacy of transcatheter PDA closure techniques. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  17. Comparison of bolus and continuous infusion of esmolol on hemodynamic response to laryngoscopy, endotracheal intubation and sternotomy in coronary artery bypass graft

    Directory of Open Access Journals (Sweden)

    Esra Mercanooglu Efe

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVE: The aim of this randomized, prospective and double blinded study is to investigate effects of different esmolol use on hemodynamic response of laryngoscopy, endotracheal intubation and sternotomy in coronary artery bypass graft surgery. METHODS: After approval of local ethics committee and patients' written informed consent, 45 patients were randomized into three groups equally. In Infusion Group; from 10 min before intubation up to 5th minute after sternotomy, 0.5 mg/kg/min esmolol infusion, in Bolus Group; 2 min before intubation and sternotomy 1.5 mg/kg esmolol IV bolus and in Control Group; %0.9 NaCl was administered. All demographic parameters were recorded. Heart rate and blood pressure were recorded before infusion up to anesthesia induction in every minute, during endotracheal intubation, every minute for 10 minutes after endotracheal intubation and before, during and after sternotomy at first and fifth minutes. RESULTS: While area under curve (AUC (SAP × time was being found more in Group B and C than Group I, AUC (SAP × T int and T st and AUC (SAP × T2 was found more in Group B and C than Group I (p < 0.05. Moreover AUC (HR × T st was found less in Group B than Group C but no significant difference was found between Group B and Group I. CONCLUSION: This study highlights that esmolol infusion is more effective than esmolol bolus administration on controlling systolic arterial pressure during endotracheal intubation and sternotomy in CABG surgery.

  18. Significance of diagnosis of liver metastases from colorectal cancer by angio helical CT and intermittent hepatic arterial infusion chemotherapy after hepatic resection in terms of prognosis

    International Nuclear Information System (INIS)

    Hatsuse, Kazuo; Aoki, Hideki; Murayama, Michinori

    1997-01-01

    Seventy five cases had undergone hepatic resection for liver metastases from colorectal cancer from 1979 to 1994. Computed tomography during hepatic angiography (angio CT) was tried in 27 cases. At first, we compared detection ratios of angio CT for liver metastase to those of ultrasonography, conventional CT, and operative ultrasonography on these 27 cases. Next, the prognosis of seventy five cases was examined. They were divided into three groups; the HX group 29 cases with only hepatic resection; the HX+AP group of 19 cases with intermittent hepatic arterial infusion chemotherapy after hepatic resection; the angio CT group of 27 cases selected for hepatic resection by angio CT, followed by the same infusion chemotherapy as that given to the HX+AP group. Fifty metastases were diagnosed histopathologically in twenty seven cases that underwent hepatic resection after angio CT. Detection ratios for small metastases 1.0 cm or smaller in diameter were 8.3% with ultrasonography, 25% with CT, 75% with angio CT, and 50% with operative ultrasonography. Detection ratios of angio CT were superior to those of ultrasonography and CT. Recurrence rates of the remnant liver were significantly low and survival rates were significantly superior in the angio CT group compared to the other two groups (p<0.02). The prognosis with and without intermittent hepatic arterial infusion chemotherapy after hepatic resection were significantly different (p<0.03). The above data suggest that improvement of detection ratios for liver metastases by angio CT, and probably concomitant intermittent hepatic infusion chemotherapy contribute to decreased remnant liver recurrence and an increased survival rate. (author)

  19. Fluoropyrimidine-HAI (hepatic arterial infusion) versus systemic chemotherapy (SCT) for unresectable liver metastases from colorectal cancer.

    Science.gov (United States)

    Mocellin, Simone; Pasquali, Sandro; Nitti, Donato

    2009-07-08

    Although locoregional treatments such as hepatic arterial infusion (HAI) claim the advantage of delivering higher doses of anticancer agents directly into the metastatic organ as compared to systemic chemotherapy (SCT), the benefit in terms of overall survival (OS) is unclear. We quantitatively summarized the results of randomised controlled trials (RCT) comparing HAI to SCT for the treatment of unresectable liver metastatic disease from colorectal cancer (CRC). The aim of this work is to quantitatively summarize the results of RCT comparing HAI to SCT for the treatment of unresectable hepatic metastases from CRC. A systematic review of reports published until September 2008 on the findings of RCT that compared HAI to SCT for the treatment of unresectable CRC liver metastases was performed by searching the MEDLINE, Embase, Cancerlit, Cochrane and GoogleScholar electronic databases as well as other databanks collecting information on clinical trials. Inclusion criteria were patients with unresectable CRC liver metastases enrolled in RCT comparing HAI to SCT. The outcome measures were tumor response rate and overall survival. Two authors independently carried out study selection and assessment of methodological quality. A third author performed a concordance analysis in order to unravel potential systematic biases. Ten RCT were identified that met the eligibility criteria. HAI regimens were based on floxuridine (FUDR), 5-fluorouracil or either one of these two fluoropyrimidines in eight and one RCT, respectively. SCT consisted of FUDR or 5-fluorouracil in three and seven RCT, respectively. By pooling the summary data, tumor response rate resulted 42.9% and 18.4% for HAI and SCT, respectively (RR = 2.26; 95% CI, 1.80 to 2.84; P < 0.0001). Mean weighted median OS times were 15.9 and 12.4 months for HAI and SCT, respectively: the meta-risk of death was not statistically different between the two treatment groups (HR = 0.90; 95% CI, 0.76 to 1.07; P = 0.24). Currently

  20. [Arthroscopy-guided core decompression and bone grafting combined with selective arterial infusion for treatment of early stage avascular necrosis of femoral head].

    Science.gov (United States)

    Guo, Hao-Shan; Tian, Yi-Jun; Liu, Gang; An, Long; Zhou, Zhan-Guo; Liu, Huan-Zhen

    2018-01-25

    To observe the clinical effects of arthroscopy-guided core decompression and bone grafting combined with selective arterial infusion for early stage avascular necrosis of femoral head. From January 2010 to December 2014, 76 patients(76 hips) diagnosed as Ficat II stage avascular necrosis of femoral head were randomly divided into experimental group and control group. In the experimental group, there were 27 males and 8 females aged from 24 to 55 years old with an average of (43.96±6.81) years, treated with arthroscopic-guided core decompression and bone grafting combined with selective arterial infusion. Along the direction of the femoral neck, an 8 mm-diameter tunnel to necrotic areas was drilled, then curettage of necrotic bone was performed under arthroscope, and the iliac bone was grafted. In the control group, there were 29 males and 12 females aged from 26 to 56 years old with an average of (44.62±7.33) years, treated with percutaneous core decompression combined with selective arterial infusion. The preoperative and postoperative Harris scores were recorded and the changes of X-rays were analyzed. All the patients were followed up with an average of 30 months. Postoperative follow-up at 12 months showed that there was significant difference in imaging outcome between two groups( P 0.05), but there was significant difference in postoperative Harris score( P necrosis are effective. Using arthroscopic-guided core decompression method, the necrotic bone can be positioned and scraped more accurately, and can obtain better results. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

  1. Effects of lipopolysaccharide infusion on arterial levels and transcerebral exchange kinetics of glutamate and glycine in healthy humans

    DEFF Research Database (Denmark)

    Berg, Ronan M G; Taudorf, Sarah; Bailey, Damian M

    2012-01-01

    was calculated by multiplying CBF with the arterial to jugular venous differences. LPS induced a systemic inflammatory response with fever, neutrocytosis, and elevated arterial levels of tumour necrosis factor-α. This was associated with a decrease in the arterial levels of both glutamate and glycine; however...

  2. Transcatheter embolization therapy of the gastrointestinal hemorrhage

    International Nuclear Information System (INIS)

    Sim, Jae In; Park, Auh Whan; Ryeom, Hun Kyu; Kim, Yong Joo

    1994-01-01

    To evaluate the effectiveness of transcatheter embolization for the treatment of massive gastrointestinal arterial bleeding. The study was based on retrospective analysis of twelve cases(8 men, 4 woman) including two patients with hemobilia in which transcatheter embolization was attempted for the control of massive gastrointestinal bleeding from March 1987 to October 1993. Clinical diagnoses of these patients were peptic ulcer(5), pseudoaneurysm formation(3) following percutaneous transhepatic biliary drainage or traffic accident, stomach cancer(1), typhoid fever(1), duodenal leiomyoma(1) and Osler-Weber-Rendu disease (1). Embolized vessels are as follows: gastroduodenal artery(6), left gastric artery(2), ileocolic artery(2), and hepatic artery(2). Embolization was effective in immediate control of bleeding in all patients. Although five of the six patients who had undergone embolization of the gastroduodenal artery developed rebleeding within 24 hour, only 2 required surgery and none showed serious complication. Embolization therapy is safe and effective initial treatment of choice for life-threatening massive gastrointestinal bleeding

  3. Transcatheter embolization therapy of the gastrointestinal hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Sim, Jae In; Park, Auh Whan; Ryeom, Hun Kyu; Kim, Yong Joo [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    1994-05-15

    To evaluate the effectiveness of transcatheter embolization for the treatment of massive gastrointestinal arterial bleeding. The study was based on retrospective analysis of twelve cases(8 men, 4 woman) including two patients with hemobilia in which transcatheter embolization was attempted for the control of massive gastrointestinal bleeding from March 1987 to October 1993. Clinical diagnoses of these patients were peptic ulcer(5), pseudoaneurysm formation(3) following percutaneous transhepatic biliary drainage or traffic accident, stomach cancer(1), typhoid fever(1), duodenal leiomyoma(1) and Osler-Weber-Rendu disease (1). Embolized vessels are as follows: gastroduodenal artery(6), left gastric artery(2), ileocolic artery(2), and hepatic artery(2). Embolization was effective in immediate control of bleeding in all patients. Although five of the six patients who had undergone embolization of the gastroduodenal artery developed rebleeding within 24 hour, only 2 required surgery and none showed serious complication. Embolization therapy is safe and effective initial treatment of choice for life-threatening massive gastrointestinal bleeding.

  4. Intra-arterial cis-platinum infusion with sodium thiosulfate protection and angiotensin II induced hypertension for treatment of hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Onohara, S.; Kobayashi, H.; Itoh, Y.; Shinohara, S.

    Cis-diamminedichloroplatinum II (CDDP; 52-169 mg/m/sup 2/) mixed with angiotensin II (1.5-10 ..mu..g/min) was infused into the hepatic artery in 33 patients with hepatocellular carcinoma. Simultaneously, sodium thiosulfate (10-50 g) was administered intravenously in order to reduce the systemic toxicity of CDDP. Over 50% reduction in tumor size was obtained in 18 patients (55%). Complete response was achieved in 4 patients (12%). Serum alpha-fetoprotein (AFP) levels decreased by more than 75% in 10 of 18 patients in whom the previous AFP level was more than 200 mg/ml. The one year survival rate was estimated at 61% by the Kaplan-Meier method. Alimentary symptoms (nausea, vomiting) were mild or non-existent in nearly 90 per cent of treatments. Peptic ulcer and abdominal pain were manifested in small numbers. Severe changes in the laboratory data were not observed. High dosage arterial infusion of CDDP and angiotensin II and intravenous injection of sodium thiosulfate was well tolerated and gave effective therapy in hepatocellular carcinoma.

  5. Diagnosis of coronary artery disease by thallium-201 myocardial scintigraphy with intravenous infusion of SUNY4001 (adenosine) in effort angina pectoris. The clinical trial report at multi-center. Phase II

    International Nuclear Information System (INIS)

    Sakata, Yasushi; Kodama, Kazuhisa; Nishimura, Tsunehiko; Kajiya, Teishi; Kato, Kazuzo

    2004-01-01

    Forty-four patients with effort angina pectoris were evaluated with SUNY4001 (adenosine) thallium-201 ( 201 Tl) myocardial scintigraphy to detect coronary artery disease. These patients had single-vessel disease (≥American Heart Association (AHA) 90% stenosis) in either right coronary artery (RCA) or left anterior descending (LAD). Adenosine was infused at the rate of 120 or 140 μg/kg/min for six minutes. One hundred eleven MBq of 201 Tl was injected after three minutes of the start of the infusion. The early and delayed images were obtained by SPECT imaging. The sensitivity was 94.7% at 120 μg/kg/min and 84.2% at 140 μg/kg/min. Adenosine 201 Tl myocardial scintigraphy showed high accuracy for detecting significant coronary artery disease. Adverse reactions occurred in 77.3% of the patients. Regarding the rates of the adverse reactions, there was no significant difference between 120 and 140 μg/kg/min. Major adverse reactions were Chest pain/discomfort (52.3%) and Flushing/Feeling of warmth (27.3%). No serious complication was observed at any infusion rate. Most of adverse reactions disappeared shortly. Only two patients required treatment for moderate chest pain, which, however, disappeared in several minutes. One of the treatments was merely the termination of adenosine infusion, and the other was sublingual spray of nitroglycerin. Adenosine infusion caused slight decrease in blood pressure and increase in heart rate. The hemodynamic changes resolved within several minutes after the adenosine infusion. Decrease in systolic blood pressure of more than 20 mmHg from the base level occurred in 26.1% and 52.4% at 120 and 140 μg/kg/min infusion rate respectively. Therefore, the adenosine infusion at 120 μg/kg/min should be considered safe and useful for the diagnosis of coronary artery disease by pharmacologic stress imaging. (author)

  6. Development of a middle cerebral artery occlusion model in the nonhuman primate and a safety study of i.v. infusion of human mesenchymal stem cells.

    Directory of Open Access Journals (Sweden)

    Masanori Sasaki

    Full Text Available Most experimental stroke research is carried out in rodents, but given differences between rodents and human, nonhuman primate (NHP models may provide a valuable tool to study therapeutic interventions. The authors developed a surgical method for transient occlusion of the M1 branch of middle cerebral artery (MCA in the African green monkey to evaluate safety aspects of intravenous infusion of mesenchymal stem cells (hMSCs derived from human bone marrow.The left Sylvian fissure was exposed by a small fronto-temporal craniotomy. The M1 branch of the MCA was exposed by microsurgical dissection and clipped for 2 to 4 hours. Neurological examinations and magnetic resonance imaging (MRI were carried out at regular post-operative course. hMSCs were infused 1 hour after reperfusion (clip release in the 3-hour occlusion model.During M1 occlusion, two patterns of changes were observed in the lateral hemisphere surface. One pattern (Pattern 1 was darkening of venous blood, small vessel collapse, and blood pooling with no venous return in cortical veins. Animals with these three features had severe and lasting hemiplegia and MRI demonstrated extensive MCA territory infarction. Animals in the second pattern (Pattern 2 displayed darkening of venous blood, small vessel collapse, and reduced but incompletely occluded venous flow and the functional deficit was much less severe and MRI indicated smaller infarction areas in brain. The severe group (Pattern 1 likely had less extensive collateral circulation than the less severe group (Pattern 2 where venous pooling of blood was not observed. The hMSC infused animals showed a trend for greater functional improvement that was not statistically significant in the acute phase and no additive negative effects.These results indicate inter-animal variability of collateral circulation after complete M1 occlusion and that hMSC infusion is safe in the developed NHP stroke model.

  7. Long-term results of interventional treatment of large unresectable hepatocellular carcinoma (HCC): significant survival benefit from combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) compared to TACE monotherapy

    International Nuclear Information System (INIS)

    Lubienski, A.; Bitsch, R.G.; Grenacher, L.; Kauffmann, G.W.; Schemmer, P.; Duex, M.

    2004-01-01

    Purpose: A retrospective analysis of long-term efficacy of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) and TACE monotherapy was conducted in patients with large, non-resectable hepatocellular carcinoma (HCC). Methods and Materials: Fifty patients with large, unresectable HCC lesions underwent selective TACE. Liver cirrhosis was present in 42 patients, due to alcohol abuse (n = 22) and viral infection (n = 17). In three patients, the underlying cause for liver cirrhosis remained unclear. Child A cirrhosis was found in 22 and Child B cirrhosis in 20 patients. Repeated and combined TACE and PEI were performed in 22 patients and repeated TACE monotherapy was performed in 28 patients. Survival and complication rates were determined and compared. Results: The 6-, 12-, 24- and 36-month survival rates were 61%, 21%, 4%, and 4% for TACE monotherapy and 77%, 55%, 39% and 22% for combined TACE and PEI (Kaplan-Meier method). The kind of treatment significantly affected the survival rate (p=0.002 log-rank test). Severe side effects were present in two patients of the monotherapy group and in three patients of the combination therapy group. (orig.)

  8. Experimental research on treating hepatic carcinoma by arterial injection of liposome mediated p53 genes

    Energy Technology Data Exchange (ETDEWEB)

    Guangyu, Zhu; Qin, Lu; Gaojun, Teng; Jinhe, Guo; Hui, Yu; Gang, Deng; Shicheng, He; Wen, Fang; Guozhao, Li; Xiaoying, Wei [Zhongda Hospital, Southeast Univ., Nanjing (China)

    2007-02-15

    Objective: To investigate the transfection and expression of p53 genes mediated by liposome and its feasibility in treatment of liver cancer by transcatheter arterial injection on rabbit VX2 hepatocarcinoma model. Methods: pCMV-myc-p53 plasmids, LipofectAMINE and p53-LipofectAMINE complex were infused into tumor's feeding artery of rabbit VX2 hepatocarcinoma model, respectively, and then protein of cancer tissue was extracted, followed by measuring gene transfection and expression by western blot and immunohistochemistry, p53-LipofectAMlNE complex in different doses were infused into tumor's feeding artery of rabbit VX2 hepatocarcinoma model with the gene transfection and expression detected by the same way. Results: Liposome-mediated p53 gene injected through catheter could be successfully transfected and expressed in the cancer tissue of rabbit VX2 hepatocarcinoma model, with transfection efficiency higher than the gene delivery alone. The efficiency and the gene dose has dose-effect relationship. Conclusions: Treatment of liver cancer by transcatheter arterial injection of p53 genes mediated by liposome is a feasible and effective method, with wide prospect of application. (authors)

  9. Experimental research on treating hepatic carcinoma by arterial injection of liposome mediated p53 genes

    International Nuclear Information System (INIS)

    Zhu Guangyu; Lu Qin; Teng Gaojun; Guo Jinhe; Yu Hui; Deng Gang; He Shicheng; Fang Wen; Li Guozhao; Wei Xiaoying

    2007-01-01

    Objective: To investigate the transfection and expression of p53 genes mediated by liposome and its feasibility in treatment of liver cancer by transcatheter arterial injection on rabbit VX2 hepatocarcinoma model. Methods: pCMV-myc-p53 plasmids, LipofectAMINE and p53-LipofectAMINE complex were infused into tumor's feeding artery of rabbit VX2 hepatocarcinoma model, respectively, and then protein of cancer tissue was extracted, followed by measuring gene transfection and expression by western blot and immunohistochemistry, p53-LipofectAMlNE complex in different doses were infused into tumor's feeding artery of rabbit VX2 hepatocarcinoma model with the gene transfection and expression detected by the same way. Results: Liposome-mediated p53 gene injected through catheter could be successfully transfected and expressed in the cancer tissue of rabbit VX2 hepatocarcinoma model, with transfection efficiency higher than the gene delivery alone. The efficiency and the gene dose has dose-effect relationship. Conclusions: Treatment of liver cancer by transcatheter arterial injection of p53 genes mediated by liposome is a feasible and effective method, with wide prospect of application. (authors)

  10. Selected Arterial Infusion Chemotherapy Combined with Target Drugs 
for Non-small Cell Lung Cancer with Multiple Brain Metastase

    Directory of Open Access Journals (Sweden)

    Jinduo LI

    2012-05-01

    Full Text Available Background and objective The aim of this study is to evaluate the efficacy of selected arterial infusion chemotherapy in treating non-small cell lung cancer (NSCLC with multiple brain metastases and corresponding factors to influencing prognosis. Methods From September 2008 to October 2011, a total of 31 patients of NSCLC with multiple brain metastases (≥3 received selected incranial, bronchial and corresponding target arterial infusion chemotherapy combined with EGFR-TKIs. Interventional treatment was performed every four weeks, two-six cycles with synchronized or sequential targeted drugs (erlotinib, gefitinib or icotinib. Follow-up CT and MRI were regularly finished at interval of four weeks after two cycles of interventional treatment were finished or during taking targeted drugs in order to evaluate efficacy of the therapy. The procedure was stopped for the tumor disease was worse or the patient could not tolerate the toxity of drugs any longer. Results 31 patients was performed two to six cycles of interventional therapy, 3cycles at average. Response assessment showed that 5 (16.1% patients got a complete response (CR, 7 (22.6% had a partial response (PR, 11 (35.5% had a stable disease (SD and 8 (25.8% had a progressive disease (PD. The objective response rate (ORR was 38.7%, and the disease control rate was 74.2%. The median progression free survival (PFS and overall survival (OS were 13.1 months and 15.1 months. The 6-month survival rate, one-year survival rate and two-year survival rate were 79%, 61.1%, and 31.1%, respectively. The patients’ OS and PFS were influenced by smoking state, tumor pathology, extracranial metastases, period of targeted drug taking and performance status, not by sex, age, before therapy and the total of brain metastases. Conclusion Selected arterial infusion chemotherapy with targeted drugs is one of the most effective and safe treatment to NSCLC with multiple brain metastases. Smoking status, tumor

  11. Preoperative infusion of mitomycin-C in the bronchial artery in squamous cell carcinoma of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Hellekant, C; Boijsen, E; Svanberg, L [Departments of Diagnostic Radiology and Thoracic Sugery, Malmoe Allmaenna Sjukhus, Malmoe, Sweden

    1978-01-01

    Bronchial angiography was performed in 9 patients with squamous cell carcinoma of the lung. The tumour-feeding vessel was identified and infused with 10 mg of mitomycin-C (MMC) diluted in saline. At operation after 28 to 48 days complete remission of the tumour had occurred in 2 patients, almost complete in one, partial remission in 2 and a marked regression in 2. In 2 patients no change was noted. No side effects except moderate malaise and slight fever occurred.

  12. Regional intra-arterial infusion chemotherapy for pancreatic cancer of dogs with the mixture of lipid emulsion-cisplatin: an experimental study

    International Nuclear Information System (INIS)

    Li Qiang; Ao Guokun; Song Jingying; Wang Maoqiang; Duan Liuxin; Song Peng; Liao Hongbo

    2009-01-01

    Objective: To approach the mechanism and efficacy of regional intra-arterial infusion chemotherapy with the mixture of lipid emulsion-CDDP (LE-CDDP) for treatment of locally advanced pancreatic cancer. Methods: Twenty-four health dogs were divided into four groups (group A, B, C, and D). The dosage of CDDP was used in 4 mg/kg/body weight for each animal. The 20% LE, as a solvent, was used in the experimental animals with 2 ml/kg/body weight (group A) and 1 ml/kg/body weight (group B), respectively. Normal sodium (NS) as a solvent was used as control with 2 ml/kg/body weight (group C) and 1 ml/kg/body weight (group D), respectively. The LE-CDDP mixture and the NS-CDDP mixture were infused into the proximal segment of splenic artery under the DSA, with transfemoral arterial approach. Blood samples were collected after infusion at 0,3,5,10,20,30,40,50,60 min and the tissues were obtained after the 60 min's blood sample was collected. Blood samples, absorbent gland in peripancreas, liver, spleen, kidney, heart, portal vein, the superior segment of jejunal and pancreas and parapancreatic tissues were obtained for CDDP concentration analysis and histopathologic examination. Results: The values of the area under curve (AUC), the incipient serum concentration (C 0 ) and the elimination half-life (t 1/2 ) of the serum CDDP concentration-time curve in four groups were A (54.5 ± 10.1)%, (2.6 ± 0.5) mg/L, (16.7 ± 3.6) min; B (18.3 ± 6.0)%, (1.5 ± 0.2) mg/L, (47.9 ± 11.1) min; C (116.7 ± 20.6)%, (6.5 ± 0.4) mg/L, (10.5 ± 2.8) min and D (126.6 ± 30.7)%, (5.5 ± 0.4) mg/L, (10.1 ± 3.1) min, respectively. There were significant difference among these four groups (F (AUC) =42.42, F (C0) =249.61, F(t 1/2 )=12.48, P (AUC) =6.64, t (C0) =16.34, P (AUC) = 8.49, t (C0) =22.30, P 1/2 in the group A was significantly longer than that of in the group C (t=3.36, P 0 in the group B were significantly lower than those in the group A (t (AUC) =7.57, t (C0) =5.48, P 1/2 in the group

  13. The effect of continuous low dose methylprednisolone infusion on inflammatory parameters in patients undergoing coronary artery bypass graft surgery: a randomized-controlled clinical trial.

    Directory of Open Access Journals (Sweden)

    Abbas Ghiasi

    2015-02-01

    Full Text Available This trial was performed to determine if a continuous low-dose infusion of methylprednisolone is as effective as its bolus of high-dose in reducing inflammatory response. The study was single-center, double-blinded randomized clinical trial and performed in a surgical intensive care unit of an academic hospital. In this study, 72 consecutive patients undergoing elective coronary artery bypass grafting (CABG were assigned to receive either a methylprednisolone loading dose (1mg/kg followed by continuous infusion (2mg/Kg/24 hours for 1 day (low-dose regime or a single dose of methylprednisolone (15 mg/kg before cardiopulmonary bypass (high dose regime. Serum concentrations of IL-6 and C- reactive protein (CRP were measured preoperatively and 6, 24 and 48 hours after surgery, and serum creatinine was measured before the operation and 24, 48 and 72 hours postoperatively. The measurements were then compared between the groups to evaluate the efficacy of each regimen. The basic characteristics and measurements were not different between the study groups. There was no significant difference in IL-6 and CRP elevation (P=0.52 and P=0.46, respectively. Early outcomes such as the length of stay in the intensive care unit, intubation time, changes in serum creatinine and blood glucose levels, inotropic support, insulin requirements, and rate of infection were also similar in both groups. A continuous low dose infusion of methylprednisolone was as effective as a single high dose methylprednisolone in reducing the inflammatory response after CABG with extracorporeal circulation with no significant difference in the postoperative measurements and outcomes.

  14. Combined stent placement and high dose PGE1 drip infusion for chronic occlusion of the superficial femoral artery as a modality to salvage chronic critical limb ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Ikushima, Ichiro [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan)], E-mail: iku-i@fk.enjoy.ne.jp; Hirai, Toshinori [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan); Ishii, Akihiko [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan); Yamashita, Yasuyuki [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan)

    2008-04-15

    Purpose: To assess the initial effect, short-term patency, and limb salvage rates of combined stent placement and high-dose prostaglandin E-1 (PGE1) drip infusion for chronic occlusion of the superficial femoral artery (SFA). Materials and methods: A total of 15 arteriosclerotic occlusive lesions of the SFA were treated in 11 consecutive patients (mean age: 78.4 years old). All cases were of category 4 or 5, based on the criteria of the Society of Vascular Surgery and Intermittent Society for Cardiovascular Surgery (SVC/ISCVS). In all cases a self-expandable stainless steel stent was implanted. PGE1 treatment was started 3-5 days before stent placement and continued for 7-10 days after the intervention. The technical success, limb salvage outcomes, patency rates, and complications were examined. Results: In all cases, the technical success rate of the procedure was 100%. After stent implantation, the clinical status of all cases was improved by at least +2, and major amputation was not required in any cases. The 12-month primary, secondary patency rates, and limb salvage rate were 57%, 100%, and 100%, respectively. Conclusion: Combined stent placement and high-dose PGE1 drip infusion is a treatment of choice for salvaging the lower limb of a patient with chronic critical ischemia.

  15. The value of paradoxical uptake of hepatocellular carcinoma on the hepatobiliary phase of gadoxetic acid-enhanced liver magnetic resonance imaging for the prediction of lipiodol uptake after transcatheter arterial chemoembolization

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Woo, E-mail: pridebio@naver.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Lee, Chang Hee, E-mail: chlee86@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Park, Yang Shin, E-mail: pys797979@naver.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Seo, Tae Seok, E-mail: g1q1papa@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Song, Myung Gyu, E-mail: acube808@naver.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Ji Hoon, E-mail: kjhhepar@naver.com [Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Kyeong Ah, E-mail: kahkim@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Park, Cheol Min, E-mail: radpic@hanmail.net [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    Highlights: • HCC{sub para} shows more frequent initial compact lipiodol uptake after TACE than HCC{sub def}. • HCC{sub para} demonstrates less frequent early local recurrence after TACE. • HCC{sub para} has larger mean size, lower AER, and more frequent capsule appearance. - Abstract: Purpose: To compare the response to transcatheter arterial chemoembolization (TACE) between hepatocellular carcinoma (HCC) with paradoxical uptake on the hepatobiliary phase (HBP) (HCC{sub para}) and HCC with defect on the HBP (HCC{sub def}), and to identify some imaging features that can differentiate between two groups. Materials and methods: Ninety-three HCCs from 54 patients who underwent gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) prior to TACE were included. HCCs were classified into two groups according to the signal intensity (SI) on the HBP: HCC{sub para} and HCC{sub def}. Using post-TACE computed tomography (CT) as a reference standard, initial compact lipiodol uptake was assessed and compared between groups. The arterial enhancement ratio (AER), SI ratios of the arterial phase and HBP, and presence of the capsule appearance were compared between groups. After initial response, local tumor recurrence within 6 and 18 months was evaluated based on follow-up CT or MRI. Results: Fifteen HCC{sub para} and 78 HCC{sub def} were included. Compared to HCC{sub def}, HCC{sub para} showed more frequent initial compact lipiodol uptake (p = 0.009), larger mean size (p = 0.019), lower AER (p = 0.005), higher SI ratio of the HBP (p < 0.0001), and more frequent capsule appearance (p < 0.0001). Local tumor recurrence rate within 6 months was also significantly lower in HCC{sub para} than in HCC{sub def} (p = 0.008). Conclusion: Despite larger size and lower AER, HCC{sub para} showed more frequent initial compact lipiodol uptake and lower early local recurrence rate after TACE than did HCC{sub def}.

  16. CT imaging before transcatheter aortic valve implantation (TAVI) using variable helical pitch scanning and its diagnostic performance for coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Shunsuke; Yamada, Yoshitake; Hashimoto, Masahiro; Okamura, Teppei; Jinzaki, Masahiro [Keio University School of Medicine, Department of Diagnostic Radiology, Shinanomachi, Shinjuku-ku, Tokyo (Japan); Yamada, Minoru [Keio University School of Medicine, Research Park, Tokyo (Japan); Yashima, Fumiaki; Hayashida, Kentaro; Fukuda, Keiichi [Keio University School of Medicine, Department of Cardiology, Tokyo (Japan)

    2017-05-15

    To evaluate the effectiveness of CT before TAVI using variable helical pitch (VHP) scanning and its diagnostic performance for coronary artery disease (CAD). Sixty patients (84.4 ± 4.6 years) scheduled for TAVI underwent CT using VHP scanning with the contrast material (CM) volume calculated as scanning time x weight [kg] x 0.06 mL. Retrospective electrocardiography (ECG)-gated scanning was utilized to examine the thorax, and non-ECG-gated scanning of the abdomen immediately followed. We analyzed CT attenuation values of the coronary arteries, aorta, iliac and femoral arteries. The coronary CT angiography images were evaluated for the presence of stenosis (≥50 %); invasive coronary angiography served as a reference standard. The average attenuations of all of the arteries were greater than 400 HU. We could evaluate the peripheral access vessels and dimensions of the ascending aorta, aortic root, and aortic annulus in all patients. The average volume of CM was 38.7 ± 8.5 mL. On per-patient and vessel analysis, CT showed 91.7 % and 89.5 % sensitivity, and 91.3 % and 97.4 % negative predictive value (NPV). CT using VHP scanning with an average CM volume of 38.7 mL is useful before TAVI and had a high sensitivity and NPV in excluding obstructive CAD. (orig.)

  17. Successful intra-arterial alteplase infusion is a predictor of 12-month limb survival in patients with lower limb arterial occlusion

    International Nuclear Information System (INIS)

    Disini, L.; Wilson, P.; Cockburn, J.F.

    2008-01-01

    Aim: To determine the factors predicting amputation of the affected lower limb 12 months after thrombolysis for acute arterial occlusion. Materials and methods: The clinical endpoints of 39 patients (24 men, 15 women; average age 69 years) 1 year after catheter-directed thrombolysis with alteplase (mean dose 30 mg, mean duration 24 h) for lower limb arterial occlusion (30 native arteries, nine grafts) from January 2001 to June 2005 were assessed. The amputation rate at 12 months was analysed in relation to the thrombolytic outcome, type of vessel occluded, presence or absence of complications, and subsequent requirement for additional surgery on an elective basis using Fischer's exact test. Results: Successful thrombolysis, defined as complete clot dissolution based on angiographic imaging, was achieved in 64.1% of cases (19 native artery, six bypass graft) with a total complication rate of 23% (n = 9). The incidence of major haemorrhage was 7.5% (n = 3, hypotension and haematemesis, groin haematoma and hypotension, haematemesis). No patient had an intracranial bleed. One year after thrombolysis, 28.2% (n = 11) had further surgery (bypass graft, fasciotomy, embolectomy) and the amputation rate was 20.5% (n = 8). Statistical analysis showed that the amputation rate was significantly higher for patients with failed compared with successful thrombolysis (p = 0.02). The amputation rates did not reach statistical significance in relation to native artery or graft occlusion, presence or absence of complications, and whether or not additional surgery was required. Conclusion: Successful thrombolysis was a predictor for limb survival up to 12 months post-thrombolysis regardless of the type of vessel occlusion, presence of complications or additional surgical requirement

  18. Clinical Application of a New Indwelling Catheter with a Side-Hole and Spirally Arranged Shape-Memory Alloy for Hepatic Arterial Infusion Chemotherapy

    International Nuclear Information System (INIS)

    Yagihashi, Kunihiro; Takizawa, Kenji; Ogawa, Yukihisa; Okamoto, Kyoko; Yoshimatsu, Misako; Fujikawa, Atsuko; Shimamoto, Hiroshi; Nakajima, Yasuo

    2010-01-01

    A new indwelling catheter, G-spiral (GSP), was developed for hepatic arterial infusion chemotherapy (HAIC) by way of an implanted catheter-port system (CPS). Here we evaluated its physical properties and the outcomes of its clinical use. The GSP vessel-fixing power and its ability to follow a guidewire were determined with a vascular in vitro model, and Student t test was used to determine statistical significance (P < 0.05). A retrospective analysis was performed to evaluate the technical success rate and to identify the clinical complications associated with radiologic CPS implantation with GSP in 65 patients with unresectable hepatic tumors. The mean vessel-fixing power of the GSP (14.4 g) significantly differed from that of a GSP with a cut shape-memory alloy (3.3 g). The mean resistance to following the guidewire displayed by the GSP (88.5 g) was significantly less than that for a 5F W-spiral (106.3 g) or 4F Cobra-type angiographic catheter (117.8 g). The CPS was placed successfully in 64 of 65 cases (98.5%). Hepatic artery occlusion was observed in one case. Occlusion, cracking, and infection of CPS were observed in one, two, and one case, respectively. The GSP is a highly useful indwelling catheter that can be used for HAIC.

  19. Daily concurrent chemoradiotherapy with docetaxel (DOC) and cisplatin (CDDP) using superselective intra-arterial infusion via the superficial temporal artery for stage III and IV oral cancer. Possibility of organ preservation in advanced oral cancer

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Tohnai, Iwai; Fuwa, Nobukazu

    2006-01-01

    Superselective intra-arterial chemotherapy via the superficial temporal artery has become feasible for daily concurrent radiotherapy and chemotherapy for head and neck cancer. This novel method was used for oral cancer, and its efficacy was evaluated. Treatment consisted of superselective intra-arterial infusions (Docetaxel (DOC) total 60 mg/m 2 , Cisplatin (CDDP) total 100 mg/m 2 ) and concurrent radiotherapy (total 40 Gy) for four weeks as preoperative therapy. Thirty-four patients with stage III and IV oral cancer received surgery after this treatment, and pathological CR was obtained in 31 patients (91%). The possibility of organ preservation for advanced oral cancer was evaluated from this result. Patients with oral cancer stage III and IV were treated for four-week daily concurrent chemoradiotherapy, and the clinical response was evaluated after treatment. Clinical CR of primary sites was obtained in 15 patients, and the same treatment was continued one or two weeks. Thirteen patients (80%) were disease-free in the primary sites, and two (20%) relapsed. Two patients died of distant metastasis, and one died of local recurrence. This method can preserve organs and minimize functional disturbance, thus contributing to patient QOL. (author)

  20. High contrast enhancement aspect of dynamic computed tomography with arterial infusion - DCT-AI. Its clinical applications on hepatic tumors and basic experiments

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Seishi; Iwasaki, Naoya; Matsumura, Yoshimitsu; Kuramae, Shigeru; Mishiro, Tadashi

    1983-06-01

    Dynamic computed tomography was performed on 112 cases possibly having hepatic tumors with intraarterial infusion of undiluted contrast into a selectively placed catheter following angiographies. Our dynamic program could evaluate not only early phase of enhancement but also late phase up to 120 sec. Reconstructed views from early scans and magnified views were very useful to evaluate minute sequential changes. Hepatic masses less than 5 cm in size were found in thirty-one cases. Patterns of tumor enhancement and time-density curves have been analysed to correlate them with histology. Four types of tumor enhancement were noted: (1) homogeneous (2) patchy (3) mottled (4) ringed. Characteristic changes were observed in hepatocellular carcinoma - HCC - (mostly mottled) and haemangioma (mostly patchy). The former was divided in two groups reflecting the cellular maturity. The metastatic tumor could be enhanced in a ringed form with dendritic pattern of supplying vascularities in some cases. To support the use of undiluted contrast and to investigate the diagnostic efficacy of high contrast enhancement, experiments were performed by taking transaxial views of an acrylic phantom immersed in different concentrations of contrast. Analysis of CT images taken at different HU values ranging from 0 to 450 demonstrated that the higher the concentration of contrast, the better the spatial resolution was. Also larger magnification could be expected by using higher concentration of contrast. Although our Dynamic Computed Tomography with Arterial Infusion of Contrast still has drawbacks and limited indications, we advocate it as a better way of enhancement to detect and evaluate the hepatic masses, which sometimes elude the examiner's grasp with conventional way of enhancement. (author).

  1. Value of Micronester coils in port-catheter implantation for continuous hepatic arterial infusion chemotherapy with fixed catheter tip method

    International Nuclear Information System (INIS)

    Yamagami, Takuji; Kato, Takeharu; Hirota, Tatsuya; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko; White, Robert I.

    2008-01-01

    To retrospectively evaluate the use of Micronester coils in port-catheter implantation with the fixed catheter tip method in comparison with other previously used coils. The cohort of this study was 143 consecutive patients with unresectable advanced liver cancer for whom a port-catheter system was percutaneously implanted. In the most recent 32 patients, Micronester coils were used for catheter tip fixation. Details of embolic agents for fixation, persistent blood flow beyond the distal end of the indwelling catheter, and complications were compared between cases without and with Micronester coils. In all, percutaneous port-catheter placement was successful. Mean number of coils used for fixation was 4.2 without Micronester coils vs. 2.5 with Micronester coils. N-butyl cyanoacrylate (NBCA)-Lipiodol was additionally used for catheter tip fixation in 85.6% of 111 procedures without Micronester coils and in 50% of 32 using Micronester coils. The gastroduodenal artery beyond the distal end was not detected at the final examination after any procedure. Catheter dislocation occurred in five and hepatic arterial obstruction or severe stenosis in eight. The number of coils used and necessity of NBCA-Lipiodol could be decreased with usage of Micronester coils without decreasing fixation ability compared to other coils. (orig.)

  2. Abnormal uterine bleeding due to vascular abnormality caused by D and E : doppler sonography for diagnosis and transcatheter arterial embolization for treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Jo; Heo, Chan; Jung, Tae Gun; Kim, Gi Sung; Kwon, Hyeok Po; Lee, Sang Kwon; Kwon, Jung Hyeok [Dongkang Hospital, Ulsan (Korea, Republic of); Lee, Yeong Hwan [Taegu Catholic Univ. School of Medicine, Taegu (Korea, Republic of)

    1996-06-01

    We attempted to evaluate the usefulness of Doppler sonography in the diagnosis of uterine vascular abnormality caused by previous D and E, and to report that transarterial embolization is an excellent treatment modality. We analyzed gray-scale US, color/duplex Doppler US and angiographic findings in seven patients with radiologically proven uterine vascular abnormality. Two of the seven cases were pseudoaneurysms and five of the seven cases were AVMs. n one of the AVMS, two small pseudoaneurysms were combined. In all cases, transarterial embolizations using 3 mm coil or/and gelfoam particles were performed. Follow-up US studies, including color Doppler US, were performed. on color/duplex Doppler sonography, two cases of pseudoaneurysm showed blood pools with turbulent arterial flow, and five cases of AVM showed asymmetrically increased cascularity, with vailable high velocities composed of the pulsatile arterial flow, with a high diastolic component. on angiography, the former showed pseudoaneruysmal sacs, and the latter densely opacified vascular tangles. No more abnormal uterine bleeding was shown following transarterial embolization in all cases. Color/duplex Doppler sonography was valuable in the diagnosis or treatment of abnormal uterine bleeding caused by uterine vascular abnormality such as acquired AVM or pseudoaneruysm.

  3. Abnormal uterine bleeding due to vascular abnormality caused by D and E : doppler sonography for diagnosis and transcatheter arterial embolization for treatment

    International Nuclear Information System (INIS)

    Kim, Yong Jo; Heo, Chan; Jung, Tae Gun; Kim, Gi Sung; Kwon, Hyeok Po; Lee, Sang Kwon; Kwon, Jung Hyeok; Lee, Yeong Hwan

    1996-01-01

    We attempted to evaluate the usefulness of Doppler sonography in the diagnosis of uterine vascular abnormality caused by previous D and E, and to report that transarterial embolization is an excellent treatment modality. We analyzed gray-scale US, color/duplex Doppler US and angiographic findings in seven patients with radiologically proven uterine vascular abnormality. Two of the seven cases were pseudoaneurysms and five of the seven cases were AVMs. n one of the AVMS, two small pseudoaneurysms were combined. In all cases, transarterial embolizations using 3 mm coil or/and gelfoam particles were performed. Follow-up US studies, including color Doppler US, were performed. on color/duplex Doppler sonography, two cases of pseudoaneurysm showed blood pools with turbulent arterial flow, and five cases of AVM showed asymmetrically increased cascularity, with vailable high velocities composed of the pulsatile arterial flow, with a high diastolic component. on angiography, the former showed pseudoaneruysmal sacs, and the latter densely opacified vascular tangles. No more abnormal uterine bleeding was shown following transarterial embolization in all cases. Color/duplex Doppler sonography was valuable in the diagnosis or treatment of abnormal uterine bleeding caused by uterine vascular abnormality such as acquired AVM or pseudoaneruysm

  4. Infusion Extractor

    Science.gov (United States)

    Chang-Diaz, Franklin R.

    1988-01-01

    Apparatus and method of removing desirable constituents from an infusible material by infusion extraction, where a piston operating in a first chamber draws a solvent into the first chamber where it may be heated, and then moves the heated solvent into a second chamber containing the infusible material, and where infusion extraction takes place. The piston then moves the solvent containing the extract through a filter into the first chamber, leaving the extraction residue in the second chamber.

  5. Endovascular uterine artery interventions

    Directory of Open Access Journals (Sweden)

    Chandan J Das

    2017-01-01

    Full Text Available Percutaneous vascular embolization plays an important role in the management of various gynecologic and obstetric abnormalities. Transcatheter embolization is a minimally invasive alternative procedure to surgery with reduced morbidity and mortality, and preserves the patient's future fertility potential. The clinical indications for transcatheter embolization are much broader and include many benign gynecologic conditions, such as fibroid, adenomyosis, and arteriovenous malformations (AVMs, as well as intractable bleeding due to inoperable advanced-stage malignancies. The most well-known and well-studied indication is uterine fibroid embolization. Uterine artery embolization (UAE may be performed to prevent or treat bleeding associated with various obstetric conditions, including postpartum hemorrhage (PPH, placental implantation abnormality, and ectopic pregnancy. Embolization of the uterine artery or the internal iliac artery also may be performed to control pelvic bleeding due to coagulopathy or iatrogenic injury. This article discusses these gynecologic and obstetric indications for transcatheter embolization and reviews procedural techniques and outcomes.

  6. Hepatic parenchymal changes following transcatheter embolization and chemoembolization in a rabbit tumor model.

    Directory of Open Access Journals (Sweden)

    Yong Wang

    Full Text Available OBJECTIVE: To compare the effects of transcatheter arterial chemoembolization (TACE with transcatheter arterial embolization (TAE on liver function, hepatic damage, and hepatic fibrogenesis in a rabbit tumor model. MATERIALS AND METHODS: Thirty-nine New Zealand white rabbits implanted with VX2 tumors in the left liver lobes were randomly divided into three groups: TAE, TACE, and control group. In the TAE group (n = 15, polyvinyl alcohol particles (PVAs were used for left hepatic artery embolization. In the TACE group (n = 15, the tumors were treated with left hepatic arterial infusions of a suspension of 10-hydroxycamptothecin and lipiodol, followed by embolization with PVAs. In the control group (n = 9, the animals received sham treatment with distilled water. Serum and liver samples were collected at 6 hours, 3 days and 7 days after treatment. Liver damage was measured using a liver function test and histological analyses. Liver fibrogenesis and hepatic stellate cell (HSC activation were evaluated using Sirius Red and anti-alpha-smooth muscle actin (α-SMA immunohistochemical stains. RESULTS: TACE caused liver injury with greater increases in serum alanine aminotransferase and aspartate aminotransferase levels on day 3 (P<0.05. Histological analyses revealed increased hepatic necrosis in adjacent non-tumorous liver tissue from day 3 compared to the TAE group (Suzuki score of 2.33±1.29 versus 1.13±1.18, P = 0.001. HSC activation and proliferation were significantly increased in the TACE group compared to the control group at 3 and 7 days after treatment (0.074±0.014 vs. 0.010±0.006, and 0.088±0.023 vs. 0.017±0.009, P<0.05. Sirius Red staining demonstrated a statistically significant increase in collagen deposition in the livers in the TACE group 7 days after embolization compared to the control group (0.118±0.012 vs. 0.060±0.017, P = 0.05. CONCLUSION: The results of this animal study revealed that TACE induced

  7. Transcatheter embolization of pseudoaneurysms complicating acute severe pancreatitis

    International Nuclear Information System (INIS)

    Wu Hanping; Liang Huimin; Zheng Chuansheng; Feng Gansheng

    2005-01-01

    Objective: To evaluate the therapeutic roles of transcatheter embolization in patients with pseudoaneurysms complicating acute severe pancreatitis. Methods: Seven patients who suffered from pseudoaneurysms complicating acute severe pancreatitis received abdominal angiography and were treated with transcatheter embolization. The angiographic findings, complications related to the procedure and post- embolization, and rebleeding were observed. Results: The pseudoaneurysms developed at the splenic artery (n=5), right gastroepiploic artery (n=1), and left gastric artery (n=1), respectively. Findings of active bleeding were observed in 3 patients. Six of them were embolized with coils, and the bleedings were stopped immediately. Rebleeding occurred 14-60 days after the embolization in 3 patients, and in one of them, another pseudo aneurysm was observed in repeated angiography and was successfully treated by repeated embolization. No causes of bleeding were found in repeated angiography in the other 2 patients, who died from severe hemorrhage. One pseudo aneurysm was embolized with gelfoam granule. The gastrointestinal bleeding was not controlled and the patient died 3 days later. Procedure related complications occurred in 2 patients. One was celiac trunk rupture during angiography, the other was intima dissecting in splenic artery. Severe post procedure complications occurred in none of the patients. Conclusion: Transcatheter embolization is safe and relatively effective in the management of pseudoaneurysms complicating acute severe pancreatitis. (authors)

  8. Infusion cisternography

    International Nuclear Information System (INIS)

    Magnaes, B.; Rootwelt, K.; Sjaastad, O.

    1976-01-01

    A source of error in cerebrospinal fluid (CSF) infusion tests is leakage at the dural puncture site. The addition of a bolus of radionuclide to the infusion fluid was helpful in detecting the existence of leakage as shown by increased infusion pressure in six of eight patients studied with and without scintigraphic evidence of leakage. Comparison of CSF dynamics in 26 patients studied by infusion cisternography and conventional cisternography showed similar patterns, suggesting no alteration of CSF dynamics by the artificial CSF infusion. Combining the two tests, therefore, resulted in simple identification of the leakage and saved the patient time and discomfort

  9. A clinical examination of antibiotics in continuous regional arterial infusion (CRAI) therapy for severe acute pancreatitis (SAP). A prospective randomized controlled trial of BIPM and IPM/CS

    International Nuclear Information System (INIS)

    Yamasaki, Shigemichi; Ishikura, Hiroyasu; Kamitani, Takanori

    2011-01-01

    Continuous regional arterial infusion (CRAI) therapy using both protease inhibitors and antibiotics are one of the specific therapeutic methods for severe acute pancreatitis (SAP). As for the administered antibiotics, imipenem/cilastatin sodium (IPM/CS) is generally chosen as a first step, but there are only a few reports comparing IPM/CS with other antibiotics. Therefore, we performed a prospective randomized controlled trial between biapenem (BIPM) and IPM/CS as CRAI antibiotics. Twelve patients with SAP were admitted to our institution during April, 2009 since August, 2006, and were randomized into two groups. They were treated with 120 mg/day of nafamostat mesilate and either 1.2 g/day of BIPM (n=6) or 2.0 g/day of IPM/CS (n=6) for CRAI therapy within 48 hours after the administration. The clinical data, inflammatory markers (WBC, CRP), serum pancreatic enzymes (lipase, tripsin, phospholipase A2, elastase 1 and pancreatic secretory trypsin inhibitor (PSTI) and contrast-enhanced abdominal Computed Tomography findings were compared between the two groups and the adverse effects were monitored. CRAI therapy was performed for seven days. The curative effect of this therapy was evaluated at the beginning of the treatment, the day 7 and the day 14. Our results suggested that BIPM was a non-recessive antibiotic which had an equal effect in CRAI therapy in comparison with IPM/CS. (author)

  10. Combined Arterial Infusion and Stent Implantation Compared with Metal Stent Alone in Treatment of Malignant Gastroduodenal Obstruction

    International Nuclear Information System (INIS)

    Wang Zhongmin; Chen Kemin; Gong Ju; Zheng Yunfeng; Wang Tianxiang

    2009-01-01

    Many patients with malignant gastroduodenal obstruction have an unresectable primary lesion and distant metastases, which may prompt palliative management to allow the patient to eat and to improve the quality of life. Intraluminal metallic stent implantation (MSI) under fluoroscopic guidance has been reported to be an effective option for symptomatic relief in these patients, with a good safety record. An alternative, dual interventional therapy (DIT), has been used during the last decade, in which prosthesis insertion is followed by intra-arterial chemotherapy via the tumor-feeding arteries. The aim of this study was to compare success rates, complication rates, and survival time between MSI and DIT in patients who presented with gastroduodenal obstruction from advanced upper gastrointestinal tract cancer. All consecutive patients with malignant gastroduodenal obstruction seen at our center between October 2002 and August 2007 were retrospectively studied. Patients were treated palliatively by either MSI or DIT by the patient's or the next of kin's decision. Outcomes included technical and clinical success, complication rates, and survival. Of the 164 patients with malignant gastric and duodenal outlet obstructions, 80 (49%) underwent stent insertion as the primary therapy, while the remaining 84 (51%) received DIT. Clinical characteristics were similar between the two groups. In the MSI cohort initial stent implantation was successful in 73 patients (91%), two stents were used in 5 patients, and delayed additional stent insertion for stent obstruction related to tumor overgrowth was required in 3 patients during follow-up. In the DIT cohort the technical success rate was 94%, 3 patients required two stents, and stent obstruction occurred in 2 patients after initial stent placement. Early postprocedural clinical success, indicated by average dysphagia score, improved significantly in both groups: MSI group, from 4.56 to 1.51 (P < 0.01); and DIT group, from 4

  11. Carboplatin selective intra-arterial infusion chemotherapy with concurrent radiotherapy on cervical lymph node metastasis in squamous cell carcinoma in the oral region

    International Nuclear Information System (INIS)

    Kuang, Hai; Sunakawa, Hajime; Arasaki, Akira; Arakaki, Keiichi; Nakasone, Toshiyuki; Ueda, Gosei; Gibo, Masaki

    2005-01-01

    In this retrospective study, we evaluated the effect of carboplatin (CBDCA) selective intra-arterial infusion chemotherapy with concurrent radiotherapy (SIACR) on cervical lymph node metastasis in patients with squamous cell carcinoma in the oral region, and determined the factors related to this effect. Twenty seven patients were enrolled with biopsy-proven squamous cell carcinoma of the oral region. They received CBDCA SIACR for cervical lymph node metastasis and underwent neck dissection. For all patients, 38 metastatic lymph nodes were diagnosed using a number of criteria. The short-axis diameters of lymph nodes were measured on CT images before and after SIACR. All metastatic lymph nodes were histologically classified into complete, good, or poor responses according to their histological features. Level I metastatic lymph nodes were classified as proximal or distal according to the position of the tip of the microcatheter in the feeding artery. In 9 of 27 patients, computed tomography angiography (CTA) was performed to evaluate the vascularity and extent of the primary tumor and metastatic lymph nodes. The reduction percentage of lymph node short-axis diameters was 0%-58.3% with a mean of 26%. Complete response nodes (36%±12%) showed a significant reduction in short-axis diameters compared with good (24%±15%) and poor (27%±11%) response nodes (P<0.05). In the proximal group, 0, 5 (63%) and 3 (37%) lymph nodes exhibited complete, good and poor responses. In the distal group, 4 (44%), 5 (56%) and 0 lymph nodes exhibited complete, good and poor responses. The difference between the proximal and distal groups' histological response was statistically significant (P<0.05). No lymph nodes identified by CTA exhibited a poor response. A correlation between reduction in short-axis diameters of lymph nodes and histological responses was demonstrated in which reduction rates increased with histological response. Findings indicated that histological response was greater

  12. [A case report-advanced pancreas cancer with liver and lung metastases well controlled over one year by combination therapy with systemic chemotherapy, radiation and hepatic arterial infusion in an outpatient setting].

    Science.gov (United States)

    Hasuike, Yasunori; Tanigawa, Takahiko; Yamada, Masaharu; Minami, Yukiko; Ezumi, Koji; Kashiwazaki, Masaki; Fujimoto, Takayoshi

    2008-11-01

    We report a case of advanced pancreatic cancer with liver and lung metastases that was well controlled over one year by combination therapy with systemic chemotherapy, radiation and hepatic arterial infusion in an outpatient setting. The patient was a 74-year-old woman. Chief complaints were back pain and anorexia. She was diagnosed with pancreas cancer with liver and lung metastases at the time of first visit. We started systemic chemotherapy with gemcitabine 1 g/body and 5-FU 1 g/body alternately every other week on an outpatient basis. At 1.5 months (M) after initiation of chemotherapy, we started radiation therapy to the main tumor at a total dose of 40 Gy. After radiation, chemotherapy was resumed. As a result, the size of the main tumor decreased but metastatic liver tumors got larger. Then we changed to combination therapy with systemic chemotherapy (gemcitabine and 5-FU) and hepatic arterial infusion (5-FU weekly). Liver metastases almost disappeared after 7.5 M. Despite all these treatments, however, the number of metastatic lung tumors increased. The patient was hospitalized for 15 M and died after 17 M. We focused on and succeeded in the prolongation of lifetime and maintenance of QOL by combination therapy with systemic chemotherapy, radiation and hepatic arterial infusion therapy.

  13. Early pulmonary response is critical for extra-pulmonary carbon nanoparticle mediated effects: comparison of inhalation versus intra-arterial infusion exposures in mice.

    Science.gov (United States)

    Ganguly, Koustav; Ettehadieh, Dariusch; Upadhyay, Swapna; Takenaka, Shinji; Adler, Thure; Karg, Erwin; Krombach, Fritz; Kreyling, Wolfgang G; Schulz, Holger; Schmid, Otmar; Stoeger, Tobias

    2017-06-20

    The death toll associated with inhaled ambient particulate matter (PM) is attributed mainly to cardio-vascular rather than pulmonary effects. However, it is unclear whether the key event for cardiovascular impairment is particle translocation from lung to circulation (direct effect) or indirect effects due to pulmonary particle-cell interactions. In this work, we addressed this issue by exposing healthy mice via inhalation and intra-arterial infusion (IAI) to carbon nanoparticles (CNP) as surrogate for soot, a major constituent of (ultrafine) urban PM. Equivalent surface area CNP doses in the blood (30mm 2 per animal) were applied by IAI or inhalation (lung-deposited dose 10,000mm 2 ; accounting for 0.3% of lung-to-blood CNP translocation). Mice were analyzed for changes in hematology and molecular markers of endothelial/epithelial dysfunction, pro-inflammatory reactions, oxidative stress, and coagulation in lungs and extra-pulmonary organs after CNP inhalation (4 h and 24 h) and CNP infusion (4 h). For methodological reasons, we used two different CNP types (spark-discharge and Printex90), with very similar physicochemical properties [≥98 and ≥95% elemental carbon; 10 and 14 nm primary particle diameter; and 800 and 300 m 2 /g specific surface area] for inhalation and IAI respectively. Mild pulmonary inflammatory responses and significant systemic effects were observed following 4 h and 24 h CNP inhalation. Increased retention of activated leukocytes, secondary thrombocytosis, and pro-inflammatory responses in secondary organs were detected following 4 h and 24 h of CNP inhalation only. Interestingly, among the investigated extra-pulmonary tissues (i.e. aorta, heart, and liver); aorta revealed as the most susceptible extra-pulmonary target following inhalation exposure. Bypassing the lungs by IAI however did not induce any extra-pulmonary effects at 4 h as compared to inhalation. Our findings indicate that extra-pulmonary effects due to CNP

  14. Randomized phase II study of 5-fluorouracil hepatic arterial infusion with or without antineoplastons as an adjuvant therapy after hepatectomy for liver metastases from colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Yutaka Ogata

    Full Text Available Antineoplastons are naturally occurring peptides and amino acid derivatives found in human blood and urine. Antineoplaston A10 and AS2-1 reportedly control neoplastic growth and do not significantly inhibit normal cell growth. Antineoplastons contain 3-phenylacetylamino-2, 6-piperidinedione (A10, phenylacetylglutamine plus phenylacetylisoglutamine (A10-I, and phenylacetylglutamine plus phenylacetate (AS2-1. This open label, non- blinded randomized phase II study compared the efficacy of hepatic arterial infusion (HAI with 5-fluorouracil,with or without antineoplastons as a postoperative therapy for colorectal metastasis to the liver.Sixty-five patients with histologically confirmed metastatic colon adenocarcinoma in liver, who had undergone hepatectomy, and/or thermal ablation for liver metastases were enrolled between 1998- 2004 in Kurume University Hospital. Patients were randomly assigned to receive systemic antineoplastons (A10-I infusion followed by per-oral AS2-1 plus HAI (AN arm or HAI alone (control arm based on the number of metastases and presence/ absence of extra-hepatic metastasis at the time of surgery. Primary endpoint was cancer-specific survival (CSS; secondary endpoints were relapse-free survival (RFS, status and extent of recurrence, salvage surgery (rate and toxicity.Overall survival was not statistically improved (p=0.105 in the AN arm (n=32. RFS was not significant (p=0.343. Nevertheless, the CSS rate was significantly higher in the AN arm versus the control arm (n=33 with a median survival time 67 months (95%CI 43-not calculated versus 39 months (95%CI 28-47 (p=0.037 and 5 year CSS rate 60% versus 32% respectively. Cancer recurred more often in a single organ than in multiple organs in the AN arm versus the control arm. The limited extent of recurrent tumours in the AN arm meant more patients remained eligible for salvage surgery. Major adverse effects of antineoplastons were fullness of the stomach and phlebitis. No

  15. Multiple small pseudoaneurysms complicating pancreatitis: angiographic diagnosis and transcatheter embolization

    International Nuclear Information System (INIS)

    Maleux, G.; Stockx, L.; Vanbeckevoort, D.; Wilms, G.; Marchal, G.; Steenbergen, W. van

    2000-01-01

    We report a case of retroperitoneal hemorrhage due to multiple, small pseudoaneurysms complicating a chronic alcoholic pancreatitis. Cross-sectional imaging with CT and US could not clearly depict these vascular lesions. Selective arteriography of the superior mesenteric and gastroduodenal arteries clearly showed the small pseudoaneurysms and definitive treatment was performed by transcatheter embolization using coils. Eight months after successful embolization, the patient is asymptomatic without any recurrent bleeding. (orig.)

  16. Pharmacogenetic determinants of outcomes on triplet hepatic artery infusion and intravenous cetuximab for liver metastases from colorectal cancer (European trial OPTILIV, NCT00852228).

    Science.gov (United States)

    Lévi, Francis; Karaboué, Abdoulaye; Saffroy, Raphaël; Desterke, Christophe; Boige, Valerie; Smith, Denis; Hebbar, Mohamed; Innominato, Pasquale; Taieb, Julien; Carvalho, Carlos; Guimbaud, Rosine; Focan, Christian; Bouchahda, Mohamed; Adam, René; Ducreux, Michel; Milano, Gérard; Lemoine, Antoinette

    2017-09-26

    The hepatic artery infusion (HAI) of irinotecan, oxaliplatin and 5-fluorouracil with intravenous cetuximab achieved outstanding efficacy in previously treated patients with initially unresectable liver metastases from colorectal cancer. This planned study aimed at the identification of pharmacogenetic predictors of outcomes. Circulating mononuclear cells were analysed for 207 single-nucleotide polymorphisms (SNPs) from 34 pharmacology genes. Single-nucleotide polymorphisms passing stringent Hardy-Weinberg equilibrium test were tested for their association with outcomes in 52 patients (male/female, 36/16; WHO PS, 0-1). VKORC1 SNPs (rs9923231 and rs9934438) were associated with early and objective responses, and survival. For rs9923231, T/T achieved more early responses than C/T (50% vs 5%, P=0.029) and greatest 4-year survival (46% vs 0%, P=0.006). N-acetyltransferase-2 (rs1041983 and rs1801280) were associated with up to seven-fold more macroscopically complete hepatectomies. Progression-free survival was largest in ABCB1 rs1045642 T/T (P=0.026) and rs2032582 T/T (P=0.035). Associations were found between toxicities and gene variants (P<0.05), including neutropenia with ABCB1 (rs1045642) and SLC0B3 (rs4149117 and rs7311358); and diarrhoea with CYP2C9 (rs1057910), CYP2C19 (rs3758581), UGT1A6 (rs4124874) and SLC22A1 (rs72552763). VKORC1, NAT2 and ABCB1 variants predicted for HAI efficacy. Pharmacogenetics could guide the personalisation of liver-targeted medico-surgical therapies.

  17. Superselective intra-arterial infusion of high-dose cisplatin combined with radiation therapy for head and neck carcinoma. Experience of Yamagata University Hospital

    International Nuclear Information System (INIS)

    Hamamoto, Yasushi; Niino, Keiji; Ishiyama, Hiromichi; Koike, Shuji; Hosoya, Takaaki; Aoyagi, Masaru

    2003-01-01

    Local effectiveness and complication of superselective intra-arterial infusion of high-dose cisdiamminedichloroplatinum (CDDP) (SIC) combined with radiation therapy (RT) were investigated. Between 1998 and 2000, 18 head and neck carcinomas including 10 maxillary carcinomas (T3; 1, T4; 9), 3 oral cavity carcinomas (T2; 1, T4; 2), and 5 oropharyngeal carcinomas (T2; 2, T4; 3) were treated with SIC and RT with or without surgery. CDDP of 100-150 mg/body was administered weekly in principle for 2-9 weeks (mean: 4.9) with the simultaneous administration of sodium thiosulfate. Radiation doses ranged from 40 Gy to 70 Gy (mean: 56.8 Gy). Complete response was obtained in 7 of 10 maxillary carcinomas, 2 of 3 oral-cavity carcinomas, and 2 of 5 oropharyngeal carcinomas, respectively. When surgical intervention was performed if necessary, 2-year local control rates for maxillary carcinoma, and other carcinoma including oral-cavity carcinoma and oropharyngeal carcinoma were 80% and 63% respectively. Two-year local control rates for T4 maxillary carcinoma, and other T4 carcinoma including oral-cavity carcinoma and oropharyngeal carcinoma were 78% and 40% respectively. Two-year overall survival rates for all cases, maxillary carcinoma, and oral-cavity/oropharyngeal carcinoma were 88%, 90% and 86% respectively. All local recurrences occurred within 6 months from the initiation of treatment. The systemic toxicity of weekly SIC was comparatively mild; however, a total CDDP dose of 1,000 mg or more and/or RT of 70 Gy induced complications of local soft tissue such as mucosal ulcer and fistula. SIC combined with RT is useful to improve the local control/survival rates and to avoid the aggressive surgery for locally advanced head and neck carcinoma. A high total dose of CDDP and/or RT of a comparatively high dose may be risk factors for local soft tissue complications. (author)

  18. Transcatheter closure of patent ductus arteriosus and interruption of inferior vena cava with azygous continuation using an Amplatzer duct occluder II

    Directory of Open Access Journals (Sweden)

    Koh Ghee

    2009-01-01

    Full Text Available We report a case of transcatheter closure of patent ductus arteriosus using the new Amplatzer duct occluder II in an adult patient with interrupted inferior vena cava with azygous continuation via the femoral artery approach.

  19. Effect of time duration of ruminal urea infusions on ruminal ammonia concentrations and portal-drained visceral extraction of arterial urea-N in lactating Holstein cows

    DEFF Research Database (Denmark)

    Røjen, Betina Amdisen; Kristensen, Niels Bastian

    2012-01-01

    investigated. Three Danish Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in major splanchnic blood vessels were randomly allocated to a 3 × 3 Latin square design with 21-d periods. Treatments were ventral ruminal infusion of water for 24h (water INF), 24-h infusion of 15g...

  20. Thallium-201 infusion imaging

    International Nuclear Information System (INIS)

    Alazraki, N.; Kralios, A.; Wooten, W.W.

    1988-01-01

    To test the accuracy of Thallium-201 coronary artery infusion imaging of the earth during rapid changes in blood flow through a major coronary artery, the author performed a study in dogs correlating electromagnetic flow probe recordings with 201 Tl scintillation camera acquisitions. Hyperemic vascular response was produced experimentally in a major coronary artery by occlusion and release interventions which altered flow from baseline to zero during occlusion (20 seconds), followed by rapid flow increases approaching three times baseline immediately upon release of the occlusion. Flow returned to the baseline level within 60 seconds following release. Flow was also altered in a controlled fashion by other interventions. Recordings of Thallium uptake in the myocardium were displayed as a time histogram (counts per second squared vs time) which correlated very closely with electromagnetic flow probe recordings of flow (R=o.82-0.97). These experiments demonstrate a high degree of accuracy in Thallium infusion imaging to detect rapid changes in flow through a major coronary artery

  1. Transcatheter embolization in a haemophiliac with post-traumatic renal haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Klamut, M; Szczerbo-Trojanowska, M; Kowalewski, J; Nowakowski, A [Akademia Medyczna, Lublin (Poland)

    1979-01-01

    Percutaneous transcatheter arterial embolization was performed in a case of severe haemophilia A to control haemorrhage secondary to renal trauma. The treatment proved to be life-saving. Eighteen months follow-up revealed no evidence of hypertension, renal failure or infection.

  2. Transcatheter shunt embolotherapy in multiple myeloma with high output heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Ho [Wonkwang University School of Medicine, Iksan (Korea, Republic of); Ko, Gi Young; Yoon, Hyun Ki; Sung, Kyu Bo [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2002-12-01

    High-output heart failure may be fairly common in patients with multiple myeloma and is associated with severe bone involvement. In this report, we describe the case of a 67-year-old man with multiple myeloma who presented with high output heart failure subsequently treated by transcatheter arterial embolization.

  3. Transcatheter shunt embolotherapy in multiple myeloma with high output heart failure

    International Nuclear Information System (INIS)

    Kim, Jeong Ho; Ko, Gi Young; Yoon, Hyun Ki; Sung, Kyu Bo

    2002-01-01

    High-output heart failure may be fairly common in patients with multiple myeloma and is associated with severe bone involvement. In this report, we describe the case of a 67-year-old man with multiple myeloma who presented with high output heart failure subsequently treated by transcatheter arterial embolization

  4. The preventive effect of granisetron on digestive tract symptoms induced by arterial infusion of anticancer and hypertensive agents in combination with radiotherapy. A study of forty patients with bladder cancer

    International Nuclear Information System (INIS)

    Hayashida, Shigeaki; Hirasawa, Teruyuki; Uchiyama, Kouichi; Mitsui, Hiroshi; Nasu, Takahito; Shinohara, Youichi

    1995-01-01

    Forty patients with bladder cancer who underwent radiotherapy with angiotensin II, a hypertensor, and two cycles of arterial infusion of anticancer chemotherapies, including cisplatin 100 mg/body, were randomly assigned to a granisetron group and a non-granisetron group for comparative study of its prophylactic effect on nausea, vomiting and anorexia. Granisetron proved significantly effective in preventing nausea, as 75% of granisetron-administered patients experienced either only slight nausea or none at all, against only 22.5% in the non-granisetron group. The number of vomiting episodes was zero during the three-day observation period in 28 out of 40 (70%) granisetron-administered patients compared with 6 patients (15%) in the non-granisetron group. A significant difference in prophylactic effect on anorexia was demonstrated between the granisetron and non-granisetron group, indicating that control of alimentary symptoms such as nausea and vomiting influences the severity of anorexia. As to the safety, nausea was lengthened and deteriorated in one patient. Though the physician in charge judged it to be an adverse event too minor to question the safety of granisetron. Thus, granisetron proved to be highly effective and safe in preventing nausea, vomiting and anorexia in patients under concomitant administration of radiotherapy with hypertensor and arterial infusion of anticancer chemotherapies. (author)

  5. The preventive effect of granisetron on digestive tract symptoms induced by arterial infusion of anticancer and hypertensive agents in combination with radiotherapy. A study of forty patients with bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hayashida, Shigeaki; Hirasawa, Teruyuki; Uchiyama, Kouichi; Mitsui, Hiroshi; Nasu, Takahito; Shinohara, Youichi [Tokuyama Central Hospital (Japan)

    1995-04-01

    Forty patients with bladder cancer who underwent radiotherapy with angiotensin II, a hypertensor, and two cycles of arterial infusion of anticancer chemotherapies, including cisplatin 100 mg/body, were randomly assigned to a granisetron group and a non-granisetron group for comparative study of its prophylactic effect on nausea, vomiting and anorexia. Granisetron proved significantly effective in preventing nausea, as 75% of granisetron-administered patients experienced either only slight nausea or none at all, against only 22.5% in the non-granisetron group. The number of vomiting episodes was zero during the three-day observation period in 28 out of 40 (70%) granisetron-administered patients compared with 6 patients (15%) in the non-granisetron group. A significant difference in prophylactic effect on anorexia was demonstrated between the granisetron and non-granisetron group, indicating that control of alimentary symptoms such as nausea and vomiting influences the severity of anorexia. As to the safety, nausea was lengthened and deteriorated in one patient. Though the physician in charge judged it to be an adverse event too minor to question the safety of granisetron. Thus, granisetron proved to be highly effective and safe in preventing nausea, vomiting and anorexia in patients under concomitant administration of radiotherapy with hypertensor and arterial infusion of anticancer chemotherapies. (author).

  6. Side Effects of Long-Term Continuous Intra-arterial Nimodipine Infusion in Patients with Severe Refractory Cerebral Vasospasm after Subarachnoid Hemorrhage.

    Science.gov (United States)

    Kieninger, Martin; Flessa, Julia; Lindenberg, Nicole; Bele, Sylvia; Redel, Andreas; Schneiker, André; Schuierer, Gerhard; Wendl, Christina; Graf, Bernhard; Silbereisen, Vera

    2018-02-01

    Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects. All patients treated with CIAN therapy for at least 5 days between May 2011 and December 2015 were included. We retrospectively extracted data from the patient data management system regarding the period between 2 days before the beginning and 5 days after the termination of CIAN therapy to analyze the course of ventilation parameters and pulmonary gas exchange, hemodynamic support, renal and liver function, integrity of the gastrointestinal tract, and the occurrence of infectious complications. In addition, we recorded the mean daily values of intracranial pressure (ICP) and intracerebral problems associated with CIAN therapy. Data from 28 patients meeting inclusion criteria were analyzed. The mean duration of long-term CIAN therapy was 10.5 ± 4.5 days. Seventeen patients (60.7%) reached a good outcome level (Glasgow Outcome Scale [GOS] 4-5) 6 months after SAH. An impairment of the pulmonary gas exchange occurred only at the very beginning of CIAN therapy. The required vasopressor support with norepinephrine was significantly higher on all days during and the first day after CIAN therapy compared to the situation before starting CIAN therapy. Two patients required short-time resuscitation due to cardiac arrest during CIAN therapy. Acute kidney injury was observed in four patients, and one of them required renal replacement therapy with sustained low-efficiency daily dialysis. During CIAN therapy, 23 patients (82.1%) needed the escalation

  7. Preoperative computer tomography evaluation in transcatheter aortic valve replacement (TAVI)

    International Nuclear Information System (INIS)

    Groudeva, V.; Stoynova, V.; Trendafilova, D.; Dzhorgova, Y.; Nachev, G.

    2014-01-01

    Transcatheter aortic valve replacement is rapidly emerging technique alternative to surgery in high risk patients. Imaging and especially computer tomography is important in preoperative assessment of the aortic ring and the prosthetic valve choice. The aim of this study is to share authors initial experience in CT assessment of the aortic ring prior to Transcatheter aortic valve replacement. 49 patients (mean age 76,55) underwent 320 rows MDCT (Acquilon One) prior TAVI. Protocol involved scanning from thoracic inlet to common femoral arteries. Aortic root size, aortic diameter at the level of coronary sinuses and the sinotubular junction and distance to coronary ostia were evaluated on a Vitrea work station. MDCT established maximal aortic ring diameter from 18 to 31 mm mean 25,04 mm while the lesser rate was from 16 to 21 mm. Accordingly positioned prostheses were in 34,75% No. 23, in 49% - No. 26 and in16,3% - No. 29. MDCT is crucial in aortic valve assessment prior to TAVI in experienced hands and multidisciplinary team. (authors) Key words: TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVI). MDCT AORTIC VALVE ASSESSMENT

  8. Creation of transcatheter aortopulmonary and cavopulmonary shunts using magnetic catheters: feasibility study in swine.

    Science.gov (United States)

    Levi, Daniel S; Danon, Saar; Gordon, Brent; Virdone, Nicky; Vinuela, Fernando; Shah, Sanjay; Carman, Greg; Moore, John W

    2009-05-01

    Surgical shunts are the basic form of palliation for many types of congenital heart disease. The Glenn shunt (superior cavopulmonary connection) and central shunt (aortopulmonary connection) represent surgical interventions that could potentially be accomplished by transcatheter techniques. We sought to investigate the efficacy of using neodymium iron boron (NdFeB) magnetic catheters to create transcatheter cavopulmonary and aortopulmonary shunts. NdFeB magnets were machined and integrated into catheters. "Target" catheters were placed in the pulmonary arteries (PAs), and radiofrequency "perforation" catheters were placed in either the descending aorta (DAo) for central shunts or the superior vena cava (SVC) for Glenn shunts. The magnet technique or "balloon target" method was used to pass wires from the DAo or the SVC into the PA. Aortopulmonary and cavopulmonary connections were then created using Atrium iCAST covered stents. Magnet catheters were used to perforate the left pulmonary artery from the DAo, thereby establishing a transcatheter central shunt. Given the orientation of the vasculature, magnetic catheters could not be used for SVC-to-PA connections; however, perforation from the SVC to the right pulmonary artery was accomplished with a trans-septal needle and balloon target. Transcatheter Glenn or central shunts were successfully created in four swine.

  9. Selective arterial thrombolysis with urokinase

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Park, Kil Sun; Chung, Jin Wook; Han, Joon Koo; Kim, Sang Joon [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Young [Choong Buk University College of Medicine, Jeonju (Korea, Republic of)

    1991-07-15

    Seven patients with thrombotic occlusions of the peripheral arteries or grafts were treated with urokinase by direct intraarterial selective infusion. During the infusion, simultaneous heparin infusion was used to reduce the frequency of thrombus formation on the infusion catheter or recurrent thrombosis. In 4 patients in whom a complete thrombolysis occurred, urokinase was infused by a high-dose transthrombus bolus technique followed by continuous infusion. There other patients, in whom thrombolysis was partially accomplished and then surgical thrombectomy was performed, were treated only by continuous urokinase infusion. Small hematomas developed at the infusion catheter entry site in 2 patients, but transfusion or operation was not required. Other significant complications were not found. Our results suggest that selective arterial infusion of urokinase with a transthrombus bolus technique can accomplish a complete arterial thrombolysis without any significant complications.

  10. Selective arterial thrombolysis with urokinase

    International Nuclear Information System (INIS)

    Park, Jae Hyung; Park, Kil Sun; Chung, Jin Wook; Han, Joon Koo; Kim, Sang Joon; Kim, Dae Young

    1991-01-01

    Seven patients with thrombotic occlusions of the peripheral arteries or grafts were treated with urokinase by direct intraarterial selective infusion. During the infusion, simultaneous heparin infusion was used to reduce the frequency of thrombus formation on the infusion catheter or recurrent thrombosis. In 4 patients in whom a complete thrombolysis occurred, urokinase was infused by a high-dose transthrombus bolus technique followed by continuous infusion. There other patients, in whom thrombolysis was partially accomplished and then surgical thrombectomy was performed, were treated only by continuous urokinase infusion. Small hematomas developed at the infusion catheter entry site in 2 patients, but transfusion or operation was not required. Other significant complications were not found. Our results suggest that selective arterial infusion of urokinase with a transthrombus bolus technique can accomplish a complete arterial thrombolysis without any significant complications

  11. Endovascular treatment of nonvariceal acute arterial upper gastrointestinal bleeding

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Duvnjak, Stevo

    2010-01-01

    Transcatheter arterial embolization as treatment of upper nonvariceal gastrointestinal bleeding is increasingly being used after failed primary endoscopic treatment. The results after embolization have become better and surgery still has a high mortality. Embolization is a safe and effective...... procedure, but its use is has been limited because of relatively high rates of rebleeding and high mortality, both of which are associated with gastrointestinal bleeding and non-gastrointestinal related mortality causes. Transcatheter arterial embolization is a valuable minimal invasive method...

  12. A Retrospective Study of 1,526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus.

    Science.gov (United States)

    Jin, Mei; Liang, Yong-Mei; Wang, Xiao-Fang; Guo, Bao-Jing; Zheng, Ke; Gu, Yan; Lyu, Zhen-Yu

    2015-09-05

    Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices. One thousand five hundred and twenty-six patients (537 boys, 989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications. Median age and median weight were 4.0 years (range: 0.3-52.0 years old) and 15.3 kg (range: 4.5-91.0 kg), respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 mm, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I (ADO I, 1280, 85.8%), Cook detachable coils (116, 7.8%), ADO II (ADO II, 68, 4.6%), muscular VSD occluder (12, 0.8%), and Amplatzer vascular plug (16, 1.0%). Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently.

  13. Arterial oxygen tension and pulmonary ventilation in horses placed in the Anderson Sling suspension system after a period of lateral recumbency and anaesthetised with constant rate infusions of romifidine and ketamine.

    Science.gov (United States)

    François, I; Lalèyê, F-X; Micat, M; Benredouane, K; Portier, K

    2014-09-01

    Some controversy exists over whether or not horses' recovery and cardiopulmonary function are affected by suspension in slings. To measure arterial oxygen tension and pulmonary ventilation in anaesthetised horses placed in a standing position in an Anderson Sling (AS) after a period of right lateral recumbency (RLR). Randomised crossover experimental study. Six Standardbred horses were anaesthetised twice. Catheters were inserted into the right jugular vein and the left carotid artery. After premedication with romifidine, anaesthesia was induced with diazepam and ketamine. Following 50 min in RLR, horses were maintained in either RLR or AS for an additional 60 min through to recovery. Anaesthesia was maintained i.v. with a constant rate infusion of romifidine and ketamine. Heart rate, respiratory rate, mean arterial pressure, expiratory tidal volume, minute volumes and end tidal CO2 were monitored continuously. Venous and arterial bloods were sampled for lactate concentration, creatine kinase activity and blood gas analysis before premedication, after induction, every 20 min for 100 min, as soon as the horse was standing (TR), and 24 h later. The data were averaged within 2 anaesthetic periods: P1, 0-20 min; and P2, 40-100 min. During P2, horses in the RLR group had lower arterial oxygen tension (P = 0.001), higher alveolar-arterial oxygen tension gradient (P = 0.005), higher respiratory rate (P = 0.04) and higher minute volumes (P = 0.04) than horses in the AS group. Arterial CO2 tension and mean arterial pressure increased in the AS group during P2 (P = 0.01 and 0.02 respectively). The recoveries were judged better in the AS group than in the RLR group (P = 0.01). During TR, lactate were higher in the RLR group than in the AS group (P = 0.007). Creatine kinase activities were higher in the AS group at 24 h vs. TR (P = 0.02). Anderson Sling suspension after a period of recumbency improves cardiopulmonary function and recovery quality in horses and

  14. Pressão arterial, respostas metabólicas e autonômicas à insulina e infusão de intralipid® em pacientes chagásicos Presión arterial, respuestas metabólicas y autonómicas a la insulina e infusión de intralipid® en pacientes chagásicos Blood pressure, metabolic and autonomic responses to insulin and intralipid® infusion in chagasic patients

    Directory of Open Access Journals (Sweden)

    Claudia Cristina Soares Silva

    2012-03-01

    Full Text Available FUNDAMENTO: Infusão de intralipid e heparina resulta em aumento da pressão arterial e também em anormalidades autonômicas em indivíduos normais e hipertensos. OBJETIVO: Avaliar a sensibilidade a insulina e o impacto da infusão de intralipid e de heparina (ILH sobre a resposta hemodinâmica, metabólica e autonômica em pacientes com a forma indeterminada da doença de Chagas. MÉTODOS: Doze pacientes com a forma indeterminada da doença de Chagas e 12 voluntários saudáveis foram avaliados. RESULTADOS: A pressão arterial basal e a frequência cardíaca foram semelhantes nos dois grupos. Os níveis plasmáticos de noradrenalina encontravam-se ligeiramente aumentados no grupo de pacientes chagásicos. Após o Teste de Tolerância a Insulina (TTI, houve um declínio significativo na glicose dos dois grupos. A Infusão de ILH resultou em aumento da pressão arterial em ambos os grupos, mas não houve nenhuma mudança significativa na noradrenalina plasmática. O componente de Baixa Frequência (BF mostrou-se semelhante e aumentou de forma semelhante em ambos os grupos. O componente de Alta Frequência (AF apresentou-se menor no grupo chagásico. CONCLUSÃO: Pacientes com forma indeterminada da doença de Chagas apresentaram aumento da atividade simpática no momento basal e uma resposta inadequada à insulina. Eles também tiveram um menor componente de alta frequência e sensibilidade barorreflexa prejudicada no momento basal e durante a infusão de intralipid e heparina.FUNDAMENTO: La Infusión de intralipid® y de heparina trae como resultado un aumento de la presión arterial y también de las anormalidades autonómicas en los individuos normales e hipertensos. OBJETIVO: Evaluar la sensibilidad a la insulina y el impacto de la infusión de intralipid® y de heparina (ILH sobre la respuesta hemodinámica, metabólica y autonómica en pacientes con la forma indefinida de la Enfermedad de Chagas. MÉTODOS: Fueron evaluados doce pacientes

  15. Long-term results of interventional treatment of large unresectable hepatocellular carcinoma (HCC): significant survival benefit from combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) compared to TACE monotherapy; Langzeitergebnisse der interventionellen Therapie von grossen, inoperablen hepatozellulaeren Karzinomen (HCC): signifikanter Ueberlebensvorteil von transarterieller Chemoembolisation (TACE) und perkutaner Ethanolinjektion (PEI) gegenueber der TACE-Monotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Lubienski, A.; Bitsch, R.G.; Grenacher, L.; Kauffmann, G.W. [Radiologische Universitaetsklinik Heidelberg, Abt. Radiodiagnostik, Heidelberg (Germany); Schemmer, P. [Chirurgische Universitaetsklinik Heidelberg (Germany); Duex, M. [Radiologisches Zentralinstitut Krankenhaus Nordwest Frankfurt (Germany)

    2004-12-01

    Purpose: A retrospective analysis of long-term efficacy of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) and TACE monotherapy was conducted in patients with large, non-resectable hepatocellular carcinoma (HCC). Methods and Materials: Fifty patients with large, unresectable HCC lesions underwent selective TACE. Liver cirrhosis was present in 42 patients, due to alcohol abuse (n = 22) and viral infection (n = 17). In three patients, the underlying cause for liver cirrhosis remained unclear. Child A cirrhosis was found in 22 and Child B cirrhosis in 20 patients. Repeated and combined TACE and PEI were performed in 22 patients and repeated TACE monotherapy was performed in 28 patients. Survival and complication rates were determined and compared. Results: The 6-, 12-, 24- and 36-month survival rates were 61%, 21%, 4%, and 4% for TACE monotherapy and 77%, 55%, 39% and 22% for combined TACE and PEI (Kaplan-Meier method). The kind of treatment significantly affected the survival rate (p=0.002 log-rank test). Severe side effects were present in two patients of the monotherapy group and in three patients of the combination therapy group. (orig.)

  16. Imaging anatomy of dorsal pancreatic artery in patients with diabetes: a comparative study between CTA and DSA

    International Nuclear Information System (INIS)

    Lin Yuning; Li Hui; Yang Xizhang; Chen Ziqian; Tan Jianming; Zhong Qun; Yang Li; Wu Zhixian; Li Huimin; Huang Yisheng

    2011-01-01

    Objective: To investigate the clinical value of 64-section CT angiography (CTA) in detecting the origin of dorsal pancreatic artery (DPA). Methods: Ninety-seven consecutive patients with diabetes received transcatheter infusion of autologous bone marrow-derived stem cell transplantation into DPA. Abdominal CTA was performed in 42 patients before angiography. Celiac trunk, splenic, common hepatic and superior mesenteric arteries were reconstructed in order to locate the origin and traveling course of DPA. A routine angiography of both celiac and superior mesenteric arteries was performed for the demonstration of DPA. Further angiography of splenic and gastroduodenal arteries was carried out if necessary. Taking DSA images as the reference standard, the sensitivity, specificity and accuracy of CTA for DPA detection were calculated. Results: DPA was the main supply artery of pancreas in 85.7% patients (36/42). CTA demonstrated the origin of DPA in 35 cases, although one of which was confirmed to be misjudged (false positive). In seven cases CTA could not demonstrate DPA, and DSA proved that 2 of them was misjudged (false negative). The sensitivity,specificity and accuracy of CTA for DPA detection were 94.4%, 83.3% and 92.9%, respectively. Conclusion: 64-section CTA can accurately detect the origin of main supply artery of pancreas, which is of great value in guiding the interventional procedure for pancreatic diseases. (authors)

  17. Anatomical challenges for transcatheter mitral valve intervention

    DEFF Research Database (Denmark)

    De Backer, Ole; Luk, Ngai H V; Søndergaard, Lars

    2016-01-01

    Following the success of transcatheter aortic and pulmonary valve implantation, there is a large interest in transcatheter mitral valve interventions to treat severe mitral regurgitation (MR). With the exception for the MitraClipTM (Abbott, Abbott Park, IL, USA) edge-to-edge leaflet plication...

  18. Transcatheter Aortic Valve Replacement in Europe

    DEFF Research Database (Denmark)

    Mylotte, Darren; Osnabrugge, Ruben L J; Windecker, Stephan

    2013-01-01

    The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy.......The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy....

  19. The future of transcatheter mitral valve interventions

    DEFF Research Database (Denmark)

    Maisano, Francesco; Alfieri, Ottavio; Banai, Shmuel

    2015-01-01

    of transcatheter mitral valve interventions will be. The purpose of the present report is to review the current state-of-the-art of mitral valve intervention, and to identify the potential future scenarios, which might benefit most from the transcatheter repair and replacement devices under development....

  20. Transcatheter embolization for treatment of acute lower gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Uflacker, R.

    1987-01-01

    Treatment of lower gastrointestinal bleeding was attempted in 13 patients by selective embolization of branches of the mesenteric arteries with Gelfoam. Bleeding was adequately controlled in 11 patients with active bleeding during the examination. One patient improved after embolization but bleeding recurred within 24 hours and in another patient the catheterization was unsuccessful. Five patients with diverticular hemorrhage were embolized in the right colic artery four times, and once in the middle colic artery. Three patients had embolization of the ileocolic artery because of hemorrhage from cecal angiodysplasia, post appendectomy, and leukemia infiltration. Three patients had the superior hemorrhoidal artery embolized because of bleeding from unspecific proctitis, infiltration of the rectum from a carcinoma of the bladder, and transendoscopic polypectomy. One patient was septic and bled from jejunal ulcers. Ischemic changes with infarction of the large bowel developed in two patients and were treated by partial semi-elective colectomy, three and four days after embolization. Four other patients developed pain and fever after embolization. Transcatheter embolization of branches of mesenteric arteries in an effective way to control acute lower gastrointestinal bleeding, but still has a significant rate of complications that must be seriously weighed against the advantages of operation. (orig.)

  1. Applicable study of patient-controlled epidural analgesia in peri-interventional uterine arterial embolization for uterine myomata

    International Nuclear Information System (INIS)

    Wang Miao; She Shouzhang; Chen Chunlin; Xu Xuebing; Xie Xiaoqing

    2006-01-01

    Objective: To study the effectiveness and safety of epidural patient-controlled analgesia (PCEA) for post-operative pain relief and adverse reactions after uterine arterial embolization (UAE). Methods: 100 patients (ASA I-II grade) undergoing transcatheter UAE of uterine myomata were randomly divided into five groups. All patients except group V used PCEA; including group I ( n=20) for epidural infusion with 0.2% ropivacaine plus 0.004% morphine, group II (n=20) with epidural infusion of 0.2% ropivacaine and 0.004% morphine plus 0.005% droperidol, group III (n=20) with epidural infusion of 0.2% ropivacaine and 0.004% morphine plus 0.01% droperidol, group IV (n=20) of epidural infusion of 0.2% ropivacaine plus 0.01% morphine, group V (n=20) served as the control with either traditional oral drugs of micronized nimesulide, or intramuscular injection (plus analgesic of rotundin or pethidine hydrochloride), or both. Results The quality of pain relief in the group I, group II, group III and group IV was obviously superior to that of group V. The PCEA application group recovered faster than that of group V after the procedure (P<0.01). Conclusions: During or after UEA, PCEA could effectively relieve pain by providing less side effects, faster recovery and high safety to the patient. The best analgetic methods of PCEA are coincident with the use of 0.2% ropivacaine plus 0.01% morphine. (authors)

  2. Transcatheter Embolization for Delayed Hemorrhage Caused by Blunt Splenic Trauma

    International Nuclear Information System (INIS)

    Krohmer, Steven J.; Hoffer, Eric K.; Burchard, Kenneth W.

    2010-01-01

    Although the exact benefit of adjunctive splenic artery embolization (SAE) in the nonoperative management (NOM) of patients with blunt splenic trauma has been debated, the role of transcatheter embolization in delayed splenic hemorrhage is rarely addressed. The purpose of this study was to evaluate the effectiveness of SAE in the management of patients who presented at least 3 days after initial splenic trauma with delayed hemorrhage. During a 24-month period 4 patients (all male; ages 19-49 years) presented with acute onset of pain 5-70 days after blunt trauma to the left upper quadrant. Two had known splenic injuries that had been managed nonoperatively. All had computed axial tomography evidence of active splenic hemorrhage or false aneurysm on representation. All underwent successful SAE. Follow-up ranged from 28 to 370 days. These cases and a review of the literature indicate that SAE is safe and effective for NOM failure caused by delayed manifestations of splenic arterial injury.

  3. [Selection of patients for transcatheter aortic valve implantation].

    Science.gov (United States)

    Tron, Christophe; Godin, Matthieu; Litzler, Pierre-Yves; Bauer, Fabrice; Caudron, Jérome; Dacher, Jean-Nicolas; Borz, Bogdan; Canville, Alexandre; Kurtz, Baptiste; Bessou, Jean-Paul; Cribier, Alain; Eltchaninoff, Hélène

    2012-06-01

    A good selection of patients is a crucial step before transcatheter aortic valve implantation (TAVI) in order to select the good indications and choose the access route. TAVI should be considered only in patients with symptomatic severe aortic stenosis and either contraindication or high surgical risk. Indication for TAVI should be discussed in a multidisciplinary team meeting. Echocardiography and/or CT scan are mandatory to evaluate the aortic annulus size and select the good prosthesis size. The possibility of transfemoral implantation is evaluated by angiography and CT scan, and based on the arterial diameters, but also on the presence of tortuosities and arterial calcifications. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  4. Intraarterial infusion chemotherapy for the treatment of metastatic liver cancer

    International Nuclear Information System (INIS)

    Arai, Yasuaki; Kido, Choichiro

    1987-01-01

    Some techniques of the most recent interventional radiology are very useful for the treatment of metastatic liver cancer and changing the style of hepatic infusion chemotherapy. This report shows our latest results and methods of hepatic infusion chemotherapy for metastatic liver cancer. 1. For the catheter placement, a new catheterization route via the left subclavian artery into the hepatic artery was developed and performed in 132 cases. Superselective catheterization succeeded in 123 cases (93.2 %). This procedure is less invasive than laparotomy and less troublesome than other percutaneous routes. 2. For useful infusion system, an implantable injection port ''Reservoir'' was developed and it was used in 87 cases. This method makes arterial infusion chemotherapy easy, and imploves their quality of life. 3. To acquire adequate drug delivery, arterial redistribution by steel coils was done, and 109 arteries in 80 cases were occluded. This method is very useful to make multiple hepatic artery single and it is important to avoid gasroduodenal complications. 4. Now, using these techniques, the phase II study of 5FU, ADM, MMC combined hepatic infusion in patients with non-resectable metastatic liver cancer is done. Up to this time, such a phase study on arterial infusion chemotherapy was difficult because of technical problems, but these new techniques make it possible. In conclusion, these new methods change the style and conception of hepatic infusion, and these make much progress on the treatment of patients with metastatic liver cancer. (author)

  5. Hemobilia: transcatheter embolotherapy

    International Nuclear Information System (INIS)

    Souza, V.C. de; Uflacker, R.

    1989-01-01

    Hemobilia is a rare bleeding phenomenon that is becoming more common since the advent of liver percutaneous drainage procedures; however, trauma is still a major cause of hemobilia. Eight patients presenting hemobilia were treated by percutaneous drainage procedures; however, trauma is still a major cause of hemobilia. Eight patients presenting hemobilia were treated by percutaneous embolization procedures. In four patients car accident trauma was the cause of pseudo aneurysm and bleeding. Surgical trauma was the cause of pseudo aneurysm in one. Aneurysm of the hepatic artery was the cause of bleeding in one patients and micotic aneurysm in one additional patient. Biliary drainage caused bleeding due to a pseudo aneurysm in the remaining patient. Gelfoam was used as an emboli material in four patients. Coils were used in two patients, in addition to Gelfoam in one of the patients. Blood clot, balloon catheter occlusion and Histoacryl were used in three patients respectively. Transvascular catheterization was used in all cases except one in which a direct percutaneous puncture of the pseudo aneurysm was performed. The procedure was successful in all patients with a follow up ranging from 9 months to 14 years. Embolization either intraarterial or by direct puncture is a simple, safe and effective method to treat hemobilia. (author)

  6. Krypton 81m infusion studies. Chapter 18

    International Nuclear Information System (INIS)

    Kaplan, E.; Mayron, L.W.; Friedman, A.M.; Gindler, J.E.

    1978-01-01

    A technique is described to give a continuous, constant-rate, intravascular infusion of 81 Krsup(m). Modifications of earlier generators included production of sodium-free 81 Rb, the use of a solution of commercial sterile isotonic non-ionic 5% dextrose-in-water as an eluant, the incorporation of a constant-rate infusion pump, and the miniaturization of the generator column and catheter system. Results are presented of studies of 81 Krsup(m) distribution in dogs, using both intravenous and intra-arterial infusion. (author)

  7. Evaluation of the angiographic findings for extrahepatic arterial supply to primary hepatic cancer and interventional therapy

    International Nuclear Information System (INIS)

    Wang Weiyu; Lv Weifu; Hou Changlong; Zhang Xingming; Zhang Zhengfeng; Lu Dong; Gao Zonggen

    2007-01-01

    Objective: To study the angiographic characteristics of extrahepatic arterial supply for primary hepatic cancer (PHC)and the significance of interventional therapy. Methods: 32 cases of primary. hepatic cancer were undertaken routine celiac arterial angiography and explored the extrahepatic arterial supply for the tumor, then followed by superselective transcatheter arterial chemoembolization (TACE). Results: 37 extrahepatic feeding arteries to hepatic cancers in 32 cases were found including 12 from superior mesenteric arteries(SMA), 9 right inferior phrenic arteries (RIPA), 1 left inferior phrenic arteries (LIPA), 2 pancreatic arterial arch, 1 right internal thoracic artery(RITA), 1 right intercostal artery(RICA), 6 left gastric arteries (LGA), 1 splenic artery, 2 omental arteries (OTA), 2 gastroduodenal arteries. The most common extrahepatic feeding arteries were originated from SMA and RIPA. The rest 33 were performed with superselective transcatheter arterial chemoembolization and the other 4 with only transcatheter arterial chemotherapeutic perfusion due to failure of superselective catheterization. Conclusion: The extrahepatic feeding artery is commonly seen with various kinds and also necessary for interventional treatment same as the primary ones for hepatic cancers. (authors)

  8. Thrombolytic treatment for acute ischemic cerebral stroke: intraarterial urokinase infusion vs. intravenous heparin and urokinase infusion

    International Nuclear Information System (INIS)

    Ko, Gi Young; Suh, Dae Chul; Lee, Jae Hong; Kim, Jun Hyoung; Choi, Choong Gon; Lee, Ho Kyu; Lee, Myoung Chong

    1996-01-01

    To evaluate the efficacy and limitation of intra-arterial urokinase (IAUK) infusion for treatment of acute cerebral stroke. Twenty-seven acute cerebral stroke patients treated with IAUK infusion within six hours of stroke onset were reviewed. All patients showed normal initial brain findings on CT. In 21 patients, urokinase(5-15 x 10 5 IU) was administered through a microcatheter placed into or proximal to occluded segment. Mechanical disruption of thrombus by guidewire was performed in 17 patients. Angiographic and clinical responses and complications after IAUK infusion, were evaluated and the results were compared with those of intravenous heparin(N=19) and urokinase infusion(N=19). Complete or partial angiographic recanalization of occluded segment was found in 18 patients (67%), and neurologic improvement was followed in 14 patients(52%). The degree of improvement on the stroke scale score after IAUK infusion was statistically more significant(p<0.05) than that shown after intravenous heparin and urokinase infusion. Complications after IAUK infusion were large(15%) and small amount intracerebral hemorrhage(15%), contrast leakage into brain parenchyma(11%), and gastrointestinal bleeding(4%). Between the IAVK and the intravenous urokinase infusion group, differences in extent and types of complications were statistically insignificant, but were significantly higher in those two groups than in the intravenous heparin infusion group. IAUK infusion may be effective for the treatment of acute cerebral stroke

  9. Platypnea-Orthodeoxia Syndrome after Transcatheter Aortic Valve Implantation

    Directory of Open Access Journals (Sweden)

    Andrew K. Roy

    2016-01-01

    Full Text Available Progressive dyspnea and hypoxaemia in the subacute phase after transcatheter aortic valve implantation (TAVI are uncommon and warrant immediate assessment of valve and prosthesis leaflet function to exclude thrombosis, as well as investigation for other causes related to the procedure, such as left ventricular dysfunction, pulmonary embolism, and respiratory sepsis. In this case, we report the observation of a patient presenting two weeks after TAVI with arterial hypoxaemia in an upright position, relieved by lying flat, and coupled with an intracardiac shunt detected on echocardiography in the absence of pulmonary hypertension, raising the suspicion of Platypnea-Orthodeoxia Syndrome (POS. Invasive intracardiac haemodynamic assessment showed a significant right-to-left shunt (Qp/Qs = 0.74, which confirmed the diagnosis, with subsequent closure of the intracardiac defect resulting in immediate relief of symptoms and hypoxaemia. To our knowledge, this is the first reported case of an interatrial defect and shunt causing Platypnea-Orthodeoxia Syndrome after transcatheter aortic valve implantation, resolved by percutaneous device closure.

  10. Sizing of patent ductus arteriosus in adults for transcatheter closure using the balloon pull-through technique.

    Science.gov (United States)

    Shafi, Nabil A; Singh, Gagan D; Smith, Thomas W; Rogers, Jason H

    2018-05-01

    To describe a novel balloon sizing technique used during adult transcatheter patent ductus arteriosus (PDA) closure. In addition, to determine the clinical and procedural outcomes in six patients who underwent PDA balloon sizing with subsequent deployment of a PDA occluder device. Transcatheter PDA closure in adults has excellent safety and procedural outcomes. However, PDA sizing in adults can be challenging due to variable defect size, high flow state, or anatomical complexity. We describe a series of six cases where the balloon- pull through technique was successfully performed for PDA sizing prior to transcatheter closure. Consecutive adult patients undergoing adult PDA closure at our institution were studied retrospectively. A partially inflated sizing balloon was pulled through the defect from the aorta into the pulmonary artery and the balloon waist diameter was measured. Procedural success and clinical outcomes were obtained. Six adult patients underwent successful balloon pull-through technique for PDA sizing during transcatheter PDA closure, since conventional angiography often gave suboptimal opacification of the defect. All PDAs were treated with closure devices based on balloon PDA sizing with complete closure and no complications. In three patients that underwent preprocedure computed tomography, the balloon size matched the CT derived measurements. The balloon pull-through technique for PDA sizing is a safe and accurate sizing modality in adults undergoing transcatheter PDA closure. © 2017 Wiley Periodicals, Inc.

  11. Delirium After Transcatheter Aortic Valve Replacement.

    Science.gov (United States)

    Giuseffi, Jennifer L; Borges, Nyal E; Boehm, Leanne M; Wang, Li; McPherson, John A; Fredi, Joseph L; Ahmad, Rashid M; Ely, E Wesley; Pandharipande, Pratik P

    2017-07-01

    Postoperative delirium is associated with increased mortality. Patients undergoing transcatheter aortic valve replacement are at risk for delirium because of comorbid conditions. To compare the incidence, odds, and mortality implications of delirium between patients undergoing transcatheter replacement and patients undergoing surgical replacement. The Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the Intensive Care Unit were used to assess arousal level and delirium prospectively in all patients with severe aortic stenosis who had transcatheter or surgical aortic valve replacement at an academic medical center. Multivariable logistic regression was used to determine the relationship between procedure type and occurrence of delirium. Cox regression was used to assess the association between postoperative delirium and 6-month mortality. A total of 105 patients had transcatheter replacement and 121 had surgical replacement. Patients in the transcatheter group were older (median age, 81 vs 68 years; P replacement. Delirium is less likely to develop in the transcatheter group but is associated with higher mortality in both groups. ©2017 American Association of Critical-Care Nurses.

  12. Uterine artery embolisation in the management of recurrent vaginal ...

    African Journals Online (AJOL)

    However, owing to extensive collateral circulation in the pelvis, the success rate of bilateral hypogastric artery ligation ranges from. 40% to 100%[5] and uterine artery ligation has been shown to have a success rate of 92%.[6] Both these techniques aim to leave the uterus intact and preserve fertility. In 1979, transcatheter ...

  13. Safety and Efficacy of Transcatheter Closure of Patent Ductus Arteriosus With Severe Mitral Regurgitation in Adults.

    Science.gov (United States)

    Wang, Zhongkai; Chen, Tao; Chen, Liang; Qin, Yongwen; Zhao, Xianxian

    2016-01-01

    Transcatheter closure is the usual treatment for patent ductus arteriosus (PDA), but its safety and efficacy have not been reported in adult PDA patients with severe mitral regurgitation. A retrospective study on 27 consecutive patients diagnosed with PDA and severe mitral regurgitation and treated using transcatheter closure between September 2010 and September 2012 at the Department of Cardiology of Changhai Hospital in Changhai, China. Left ventricular (LV) diastolic volume and function, pulmonary artery pressure, and instantaneous reverse-flow volume were examined by echocardiography before PDA closure, immediately after closure, and 1 year after closure. After the procedure, the LV diastolic volume (P.05). Pulmonary arterial systolic pressure was unchanged 1 year after closure (from 46.41 ± 19.92 mm Hg to 45.43 ± 13.64 mm Hg; P=.58). All procedures were uneventful and only mild complications occurred (hemolysis in 2 cases, subcutaneous hematoma in 4 cases, and fever in 2 cases). Transcatheter closure can decrease the LV volume and instantaneous reverse-flow volume in adult PDA patients with severe mitral regurgitation. This procedure is effective and has a good safety profile.

  14. Hepatocellular Carcinoma Supplied From the Short Gastric Artery: Treatment With Chemoembolization

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Ung Bae, E-mail: junwb73@pnuyh.co.kr; Lee, Jun Woo, E-mail: jwlee@pusan.ac.kr; Baik, Seung Kug, E-mail: skbaik9@gmail.com; Kim, Tae Un, E-mail: kimtaeun78@hanmail.net; Choo, Ki Seok, E-mail: kschoo0618@naver.com; Kim, Kun Il, E-mail: kikim@pusan.ac.kr; Kim, Yong-Woo, E-mail: kyw47914@yahoo.co.kr; Moon, Tae-Yong, E-mail: tymn@pusan.ac.kr [Pusan National University Yangsan Hospital, Department of Radiology (Korea, Republic of)

    2012-12-15

    We report a case of transcatheter arterial chemoembolization (TACE) to treat hepatocellular carcinoma (HCC) that was supplied by the short gastric artery. A 67-year-old woman with two nodular HCCs underwent repeated TACE. One of the nodules was supplied by the short gastric artery.

  15. Hepatocellular Carcinoma Supplied From the Short Gastric Artery: Treatment With Chemoembolization

    International Nuclear Information System (INIS)

    Jeon, Ung Bae; Lee, Jun Woo; Baik, Seung Kug; Kim, Tae Un; Choo, Ki Seok; Kim, Kun Il; Kim, Yong-Woo; Moon, Tae-Yong

    2012-01-01

    We report a case of transcatheter arterial chemoembolization (TACE) to treat hepatocellular carcinoma (HCC) that was supplied by the short gastric artery. A 67-year-old woman with two nodular HCCs underwent repeated TACE. One of the nodules was supplied by the short gastric artery.

  16. A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

    Science.gov (United States)

    Jin, Mei; Liang, Yong-Mei; Wang, Xiao-Fang; Guo, Bao-Jing; Zheng, Ke; Gu, Yan; Lyu, Zhen-Yu

    2015-01-01

    Background: Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices. Methods: One thousand five hundred and twenty-six patients (537 boys, 989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications. Results: Median age and median weight were 4.0 years (range: 0.3–52.0 years old) and 15.3 kg (range: 4.5–91.0 kg), respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 mm, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I (ADO I, 1280, 85.8%), Cook detachable coils (116, 7.8%), ADO II (ADO II, 68, 4.6%), muscular VSD occluder (12, 0.8%), and Amplatzer vascular plug (16, 1.0%). Conclusions: Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently. PMID:26315073

  17. Superselective transcather arterial embolization for hepatocellular carcinoma with a mixture of ethanol and lipiodol

    International Nuclear Information System (INIS)

    Park, Jae Hyung; Han, Joon Koon; Choi, Byung Ihn; Han, Man Chung

    1992-01-01

    To evaluate the effectiveness of superselective transcatheter arterial embolization (STAE) for hepatocellular carcinoma (HCC) with a mixture of ethanol and Lipiodol, STAE was done in 12 male patients with HCC. There were diagnosed clinically with angiographic findings and elevated alphafetprotein levels and three were recurrent tumors after surgery. Sono-guided aspiration biopsy proved the diagnosis of hepatocellular carcinoma in another six patients. The tumor was a small single nodule (2-5cm in diameter) in 11 patients. In one patient, two nodules were found. Superselective catheterization was done using 3F Tracker catheter (Target Therapeutics USA) coaxially through 6F catheter into the feeding hepatic artery, usually the third order branch. One to four cc of 75% ethanol mixed with Lipiodol was infused under fluoroscopy immediately after injection of 2% lidocaine. Immediate angiography and CT after 2 weeks were undertaken. Complete segmental or subsegmental devascularization including feeding arteries and tumor vascularities occurred in all patients. Follow-up angiography after 6 to 15 months revealed the tumor opacified by Lipiodol. The tumor decreased in 5 cases and recurrence was found in three patients. CT taken 2 weeks after STAE showed low density halo around the tumor in 5 cases. Subsequent segmentectomy in four patients revealed total or near total necrosis of the tumor and no evidence of damage in surrounding parenchyma. STAE for HCC with a mixture of ethanol and Lipiodol is an effective and safe measure for small HCC

  18. Transcatheter Pulmonary Valve Replacement for Right Ventricular Outflow Tract Conduit Dysfunction After the Ross Procedure

    DEFF Research Database (Denmark)

    Gillespie, Matthew J; McElhinney, Doff B; Kreutzer, Jacqueline

    2015-01-01

    BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review of databa......BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review....... Of these, 56 (84%) received a Melody valve; in 5 of the 11 patients who did not, the implant was aborted due to concern for coronary artery compression, and 1 implanted patient required emergent surgery for left coronary compression. The RVOT gradient decreased from a median 38 mm Hg to 13.5 mm Hg (p

  19. Simultaneous transcatheter closure of intralobar pulmonary sequestration and patent ductus arteriosus in a patient with infantile Scimitar syndrome.

    Science.gov (United States)

    Aslan, Eyüp; Tanıdır, İbrahim Cansaran; Saygı, Murat; Onan, Sertaç Hanedan; Güzeltaş, Alper

    2015-03-01

    Scimitar syndrome is a rare disease associated with a right lung sequestration vascularised by arteries arising from the abdominal aorta and abnormal venous drainage into the inferior vena cava. The infantile form is generally presented with severe heart failure, pulmonary hypertension and respiratory distress. It may be associated with various intracardiac defects, including atrial septal defects, ventricular septal defects, patent ductus arteriosus or more complicated structural congenital heart defects. Here, we present a 2-month-old girl with Scimitar syndrome whose pulmonary arterial pressure decreased after transcatheter patent ductus arteriosus closure and embolization of the anomalous systemic arterial supply.

  20. Transcatheter Embolization of Pseudoaneurysms Complicating Pancreatitis

    International Nuclear Information System (INIS)

    Golzarian, Jafar; Nicaise, Nicole; Deviere, Jacques; Ghysels, Marc; Wery, Didier; Dussaussois, Luc; Gansbeke, Daniel van; Struyven, Julien

    1997-01-01

    Purpose: To evaluate the therapeutic role of angiography in patients with pseudoaneurysms complicating pancreatitis. Methods: Thirteen symptomatic pseudoaneurysms were treated in nine patients with pancreatitis. Eight patients had chronic pancreatitis and pseudocyst and one had acute pancreatitis. Clinical presentation included gastrointestinal bleeding in seven patients and epigastric pain without bleeding in two. All patients underwent transcatheter embolization. Results: Transcatheter embolization resulted in symptomatic resolution in all patients. Rebleeding occurred in two patients, 18 and 28 days after embolization respectively, and was successfully treated by repeated emnbolization. One patient with severe pancreatitis died from sepsis 28 days after embolization. Follow-up was then available for eight patients with no relapse of bleeding after a mean follow-up of 32 months (range 9-48 months). Conclusion: Transcatheter embolization is safe and effective in the management of pseudoaneurysms complicating pancreatitis

  1. Transcatheter Mitral Valve Devices - Functional Mechanical Designs.

    Science.gov (United States)

    Kliger, Chad

    2014-03-01

    Mitral regurgitation is a complex disorder involving a multitude of components of the mitral apparatus. With the desire for less invasive treatment approaches, transcatheter mitral valve therapies (TMVT) are directed at these components and available at varying stages of development. Therapeutic advancements and the potential to combine technologies may further improve their efficacy and safety. Transcatheter mitral valve replacement, while preserving the mitral apparatus, may emerge as an alternative or even a more suitable treatment option. In addition, early data on transcatheter mitral valve-in-valve and valve-in-ring implantation are encouraging and this approach may be an alternative to reoperation in the high-risk patient. This review details the expanding functional mechanical designs of current active TMVT.

  2. Systemic, pulmonary and renal haemodynamic and renal morphologic effects of intravenously infused iodixanol

    International Nuclear Information System (INIS)

    Sunnegaardh, O.; Hietala, S.O.; Holtz, E.; Nycomed A/S, Oslo

    1990-01-01

    The systemic, pulmonary and renal haemodynamic effects following an intravenous infusion (1 ml/s, 4 ml/kg) of a non-ionic isoosmolar contrast medium (iodixanol) were investigated in 8 pigs. Histopathologic changes occurring after infusion of iodixanol were studied by repeated renal biopsies. Iodixanol caused a significant increase of cardiac output, mean right atrial pressure, mean pulmonary arterial pressure, mean pulmonary arterial occlusion pressure and mean arterial pressure. There was a decrease of the systemic and pulmonary vascular resistances. Most renal biopsies showed no pathologic findings after infusion of iodixanol but in 3 specimens proteinaceous content was observed 15 min after infusion. (orig.)

  3. Blood-brain barrier opening by isotonic saline infusion in normotensive and hypertensive animals

    International Nuclear Information System (INIS)

    Rapoport, S.I.

    1978-01-01

    The blood-brain barrier to intravascular Evans blue-albumin was opened in monkeys and rabbits by infusing isotonic saline for 15 s into the common carotid artery, when the external carotid was clamped temporarily and the lingual was catheterized for measuring pressure. Barrier opening correlated better with infusion pressure than with infusion rate, and occurred at carotid artery pressures above 170 mmHg. Systematic hypertension induced by Aramine increased barrier vulnerability by causing a higher net carotid artery pressure to be attained at a given infusion rate. (Auth.)

  4. Blood-brain barrier opening by isotonic saline infusion in normotensive and hypertensive animals

    Energy Technology Data Exchange (ETDEWEB)

    Rapoport, S I [Baltimore City Hospitals, MD (USA)

    1978-01-01

    The blood-brain barrier to intravascular Evans blue-albumin was opened in monkeys and rabbits by infusing isotonic saline for 15 s into the common carotid artery, when the external carotid was clamped temporarily and the lingual was catheterized for measuring pressure. Barrier opening correlated better with infusion pressure than with infusion rate, and occurred at carotid artery pressures above 170 mmHg. Systematic hypertension induced by Aramine increased barrier vulnerability by causing a higher net carotid artery pressure to be attained at a given infusion rate.

  5. Percutaneous transcatheter sclerotherapy of oophoritic cysts

    International Nuclear Information System (INIS)

    Huang Youhua; Xu Qiang; Sun Jun; Shen Tao; Shi Hongjian; Tang Qingfang; Chen Qiying; Zhou Mingxia; Li Hongyao

    2005-01-01

    Objective: To evaluate the clinical value of percutaneous transcatheter sclerotherapy in oophoritic cysts. Methods: Seventy six oophoritic cysts incluoling 48 simple and 28 chocolate cysts of 64 patients were treated with percutaneous transcatheter sclerotherapy under CT guidance. 4F multisideholes pigtail catheter was introduced into cyst using absolute alcohol as sclerosing agents. Results: The successful rate of percutaneous oophoritc cyst puncture was 100% in all 64 patients. Among them 58 were cured (90.6%), 6 improved significantly (9.4%). The total effective rate reached 100% with no serious complications. Conclusions: Catheterization sclerotherapy for oophoritic cyst is a simple, complete, safe and effective method. (authors)

  6. Tolerance and diagnostic accuracy of an abbreviated adenosine infusion for myocardial scintigraphy: a randomized, prospective study.

    Science.gov (United States)

    Treuth, M G; Reyes, G A; He, Z X; Cwajg, E; Mahmarian, J J; Verani, M S

    2001-01-01

    The objectives of this study were 2-fold: (1) to determine the tolerance of adenosine perfusion tomography with the use of an abbreviated (3-minute) infusion in comparison to the standard (6-minute) infusion, and (2) to assess the relative diagnostic accuracy of a 3-minute adenosine infusion in patients referred for arteriography. An abbreviated adenosine infusion may decrease the frequency and duration of side effects and be a more cost-effective alternative. We prospectively randomized 599 patients undergoing adenosine myocardial perfusion tomography to either a 3-minute or 6-minute adenosine infusion at 140 microg/kg per minute. Among the 599 enrolled patients, 142 subsequently underwent coronary angiography. Patients randomized to the 3-minute adenosine infusion tolerated the procedure better than those randomized to the standard infusion (P <.01). Flushing, headache, neck pain, and atrioventricular block were all significantly less frequent (P <.01) with the abbreviated infusion. Moreover, patients receiving the abbreviated infusion had less hypotension and tachycardia (P <.05). The sensitivity of the test for detection of coronary artery disease was 88% for both the 3- and 6-minute infusions. In patients with abnormal scan results, perfusion defect size was slightly larger in those receiving a 6-minute infusion versus those receiving a 3-minute infusion (P =.05). An abbreviated 3-minute adenosine infusion, in combination with perfusion tomography, has similar sensitivity for detection of coronary artery disease and is better tolerated than the standard 6-minute infusion.

  7. MDCT angiography and transcatheter embolization in management ...

    African Journals Online (AJOL)

    Hassan Abdelsalam

    2015-12-18

    Dec 18, 2015 ... 14 patients did not have a MDCT and proceeded straight to angiography;. 6 of them showed active bleeding on angiography. Conclusion: MDCT is an excellent technique before angiography and embolization in cases with acute gastrointestinal bleeding. Transcatheter embolization is an effective tool for ...

  8. Autopsy after transcatheter aortic valve implantation

    NARCIS (Netherlands)

    van Kesteren, F.; Wiegerinck, E. M. A.; Rizzo, S.; Baan, J.; Planken, R. N.; von der Thüsen, J. H.; Niessen, H. W. M.; van Oosterhout, M. F. M.; Pucci, A.; Thiene, G.; Basso, C.; Sheppard, M. N.; Wassilew, K.; van der Wal, A. C.

    2017-01-01

    Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview of

  9. Percutaneous Transcatheter PDA Device Closure in Infancy

    International Nuclear Information System (INIS)

    Ullah, M.; Sultan, M.; Akhtar, K.; Sadiq, N.; Akbar, H.

    2014-01-01

    Objective: To evaluate the results and complications associated with transcatheter closure of patent ductus arteriosus (PDA) in infants. Study Design: Quasi-experimental study. Place and Duration of Study: Paediatric Cardiology Department of Armed Forces Institute of Cardiology / National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from December 2010 to June 2012. Methodology: Infants undergoing transcatheter device closure of PDA were included. All patients were evaluated by experienced Paediatric Cardiologists with 2-D echocardiography and Doppler before the procedure. Success of closure and complications were recorded. Results: The age of patients varied from 05 - 12 months and 31 (56.4%) were females. Out of the 55 infants, 3 (5.4%) were not offered device closure after aortogram (two large tubular type ducts and one tiny duct, considered unsuitable for device closure); while in 50 (96.1%) patients out of remaining 52, the duct was successfully closed with transcatheter PDA device or coil. In one infant, device deployment resulted in acquired coarctation, necessitating device retrieval by Snare followed by surgical duct interruption and another patient had non-fatal cardiac arrest during device deployment leading to abandonment of procedure and subsequent successful surgical interruption. Local vascular complications occurred in 12 (21.8%) of cases and all were satisfactorily treated. Conclusion: Transcatheter device closure of PDA in infants was an effective procedure in the majority of cases; however, here were considerable number of local access site vascular complications. (author)

  10. Subclavian artery dissection during catheterization in a patient after irradiation

    International Nuclear Information System (INIS)

    Kanazawa, Susumu; Hiraki, Yoshio; Fujie, Shunji; Sato, Nobuo.

    1997-01-01

    A 47-year-old woman with right breast cancer underwent partial mastectomy and had irradiations to the primary and metastatic sites, including the left supraclavicular region. During catheterization of the left internal mammary artery for arterial infusion therapy, the patient developed an iatrogenic dissection and subsequent occlusion of the left subclavian artery. Arterial infusion of tissue plasminogen activator into the artery resulted in recanalization and improvement of clinical signs and symptoms. (author)

  11. Transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium.

    Science.gov (United States)

    Luciano, Debora; Laux, Daniela; Boudjemline, Younes; Hascoët, Sébastien; Lusson, Jean-René; Sorensen, Clio; Ovaert, Caroline; Kreitmann, Bernard; Van Praagh, Richard; Fraisse, Alain

    2013-12-10

    A persistent anastomosis between the pulmonary veins that connect with the left atrium and the systemic vein that drains into the right atrium has occasionally been reported. We report characteristics and transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium. We retrospectively studied such patients in 5 institutions. Ten patients (6 girls) presented at a median age of 8 (0.1 to 54) years with 2 anatomic types: 8 vertical vein types with drainage of the left upper lobe to the innominate vein via a large vertical vein (left superior cardinal vein) and to the left atrium via the left upper pulmonary vein; and 2 scimitar vein (SV) types with drainage of the right middle and lower pulmonary veins into the inferior vena cava and to the left atrium via an anomalous connecting vein. Associated malformations were aortic coarctation (n=2) and secundum atrial septal defects (n=3). Two patients of the vertical vein type were operated. Transcatheter occlusion of the abnormal pulmonary venous return was performed in 7 cases, associated with occlusion of systemic arterial supply (n=2), secundum atrial septal closure (n=2), left upper pulmonary vein stenosis stenting (n=1), and coarctation stenting (n=1). Including previously published cases, 18 patients (13 vertical veins and 5 scimitar veins) underwent transcatheter repair. Patients over 40 years of age tend to be symptomatic at presentation (p=0.056). In partially abnormal pulmonary venous return with dual drainage, transcatheter therapy can be offered in the majority of patients. © 2013.

  12. Clinical assessment of transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention using Amplatzer occluder

    Energy Technology Data Exchange (ETDEWEB)

    Xiumin, Han; Xianyang, Zhu; Yuwei, Zhang; Yan, Jin; Dong' an, Deng; Chanju, Hou; Wei, Quan [Shenyang General Hospital, PLA, Shenyang (China)

    2004-04-01

    Objective: To evaluate the application of transcatheter closure of patent ductus arteriosus (PDA) with severe pulmonary hypertention using the Amplatzer occluder device. Methods: Fifty-one cases of PDA with severe pulmonary hypertention were treated by transcatheter closure with Amplatzer occluder. Patients mean age was 9.4 years (ranging 3 months to 60 years) and the mean weight was (18.7 {+-} 13.8) kg (ranging 5.0 to 65.0 kg). The mean PDA diameter at its narrowest segment was (7.0 {+-} 2.4) (ranging 3.0 to 15.0) mm. The achievement of permanent transcatheter closure was decided according to the change of the pulmonary arterial pressure, aortic pressure and oxygen saturation. Results: The devices were successfully placed in all patients except one failure owing to the resistance of pulmonary hypertention. The systolic pulmonary pressure decreased from (84.7 {+-} 13.5) (range 70 to 137) to mmHg to (46.1 {+-} 14.9) (24 to 109) mmHg, and the mean pulmonary pressure decreased from (65.0 {+-} 11.5) (42 to 97) mmHg to (31.3 {+-} 11.6) (14 to 69) mmHg. Complete angiographic closure was seen 10 minutes after the device deployment in 30 out of 50 patients (60%), while trivial to small leak was present in 20 (40%). Complete echocardiographic closure was demonstrated in 49 out of 50 patients (98%) at 10 min, and 100% at 6-month follow-up in all patients. There were no PDA recanalization and migration of devices after the complete occlusion during following up. Conclusion: Transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention by using the Amplatzer occluder is a safe and effective interventional method with excellent short-term and middle-term results. (authors)

  13. Clinical assessment of transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention using Amplatzer occluder

    International Nuclear Information System (INIS)

    Han Xiumin; Zhu Xianyang; Zhang Yuwei; Jin Yan; Deng Dong'an; Hou Chanju; Quan Wei

    2004-01-01

    Objective: To evaluate the application of transcatheter closure of patent ductus arteriosus (PDA) with severe pulmonary hypertention using the Amplatzer occluder device. Methods: Fifty-one cases of PDA with severe pulmonary hypertention were treated by transcatheter closure with Amplatzer occluder. Patients mean age was 9.4 years (ranging 3 months to 60 years) and the mean weight was (18.7 ± 13.8) kg (ranging 5.0 to 65.0 kg). The mean PDA diameter at its narrowest segment was (7.0 ± 2.4) (ranging 3.0 to 15.0) mm. The achievement of permanent transcatheter closure was decided according to the change of the pulmonary arterial pressure, aortic pressure and oxygen saturation. Results: The devices were successfully placed in all patients except one failure owing to the resistance of pulmonary hypertention. The systolic pulmonary pressure decreased from (84.7 ± 13.5) (range 70 to 137) to mmHg to (46.1 ± 14.9) (24 to 109) mmHg, and the mean pulmonary pressure decreased from (65.0 ± 11.5) (42 to 97) mmHg to (31.3 ± 11.6) (14 to 69) mmHg. Complete angiographic closure was seen 10 minutes after the device deployment in 30 out of 50 patients (60%), while trivial to small leak was present in 20 (40%). Complete echocardiographic closure was demonstrated in 49 out of 50 patients (98%) at 10 min, and 100% at 6-month follow-up in all patients. There were no PDA recanalization and migration of devices after the complete occlusion during following up. Conclusion: Transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention by using the Amplatzer occluder is a safe and effective interventional method with excellent short-term and middle-term results. (authors)

  14. Expanding TAVI options: elective rotational atherectomy during trans-catheter aortic valve implantation

    International Nuclear Information System (INIS)

    Piccoli, Anna; Lunardi, Mattia; Ariotti, Sara; Ferrero, Valeria; Vassanelli, Corrado; Ribichini, Flavio

    2015-01-01

    Summary: Aortic valve stenosis (AVS) in the elderly is frequently associated to coronary artery disease (CAD). In patients with significant coronary stenosis surgical valve replacement is associated to coronary bypass grafting, but whether coronary angioplasty is needed in patients receiving trans-catheter aortic valve implantation (TAVI) is unknown. Given the frequent complexity of CAD in the elderly with calcific AVS, rotational atherectomy (RA) may be needed in some cases. No data are available about feasibility and safety of RA during TAVI. The need for myocardial revascularization in TAVI candidates is discussed, and a series of RA cases performed during TAVI is described

  15. Transcatheter valve-in-valve implantation due to severe aortic regurgitation in a degenerated aortic homograft

    DEFF Research Database (Denmark)

    Olsen, Lene Kjaer; Engstrøm, Thomas; Søndergaard, Lars

    2009-01-01

    Transcatheter aortic valve implantation (TAVI) in severe aortic stenosis has proven to be a feasible and effective treatment modality for inoperable patients. Until now, neither aortic regurgitation nor degenerated bioprostheses has been an indication for TAVI. However, this article reports...... a successful valve-in-valve implantation of a CoreValve aortic valve prosthesis through the right subclavian artery in a case of severe aortic regurgitation within a degenerated aortic homograft. The case exemplifies the possibilities of expanding the indications for TAVI, as well as other vascular access...

  16. Transcatheter occlusion of secundum atrial septal defect in elderly patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Hu Jian; Zhang Qi; Ding Fenghua; Yang Zhenkun; Zhang Ruiyan; Zhang Jiansheng; Shen Weifeng

    2008-01-01

    Objective: To evaluate the effect and safety of transcatheter occlusion for secundum atrial septal defect (ASD)in elderly patients with pulmonary hypertension. Methods: Thirty four patients underwent transcatheter occlusion of ASD from January 2002 to December 2006. Fifteen of them aged over 65 and accompanied with pulmonary hypertension (pulmonary hypertension group). All patients received thoracic cardiodynamic ultrasonography and 12 leads ECG before and 1 d, 1 mon, 3 mon, 6 mon, 12 mon after the procedure. Under the guidance of fluoroscopy and transthoracic cardio-ultrasonography, Amplatzer occluders was implanted for the atrial septal defect. Results: The successful rate of placement of the Amplatzer occluder was 100% and no complication was found during the procedure and follow-up period. There were significant differences between pulmonary hypertension group and non-pulmonary hypertension group in age (66.7 ± 5.0y vs 24.1 ± 9.0 y, P<0.001), classification of heart function (NYHA) (2.8 ± 0.7 vs 1.7 ± 0.7, P<0.001), diameter of ASD(30.5 ± 3.2 mm vs 14.2 ± 4.0 mm, P<0.001), size of Amplatzer occluder(35.3 ± 4.5 mm vs 18.2 ± 4.4 mm, P<0.001), systolic pulmonary artery pressure(65.2 ± 11.2 mmHg vs 29.5 ± 3.3 mmHg, P<0.001)and mean pulmonary artery pressure (31.5 ± 4.6 mmHg vs 17.9 ± 1.1 mmHg, P<0.001). After transcatheter closure of ASD, the parameters the systolic pulmonary artery pressure (36.6 ± 11.4 mmHg)and mean pulmonary artery pressure (21.6 ± 4.3 mmHg)decreased significantly in pulmonary hypertension group compared with those before procedure, and the classification of heart function (NYHA)improved (from 2.8 ± 0.7 to 1.8 ± 0.8, P<0.001). Conclusion: Transcatheter occlusion of secundum ASD in elderly patients with pulmonary hypertension is safe and effective. (authors)

  17. Expanding TAVI options: elective rotational atherectomy during trans-catheter aortic valve implantation

    Energy Technology Data Exchange (ETDEWEB)

    Piccoli, Anna; Lunardi, Mattia; Ariotti, Sara; Ferrero, Valeria; Vassanelli, Corrado; Ribichini, Flavio, E-mail: flavio.ribichini@univr.it

    2015-01-15

    Summary: Aortic valve stenosis (AVS) in the elderly is frequently associated to coronary artery disease (CAD). In patients with significant coronary stenosis surgical valve replacement is associated to coronary bypass grafting, but whether coronary angioplasty is needed in patients receiving trans-catheter aortic valve implantation (TAVI) is unknown. Given the frequent complexity of CAD in the elderly with calcific AVS, rotational atherectomy (RA) may be needed in some cases. No data are available about feasibility and safety of RA during TAVI. The need for myocardial revascularization in TAVI candidates is discussed, and a series of RA cases performed during TAVI is described.

  18. Embolization of gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis: a case report

    International Nuclear Information System (INIS)

    Kim, Se Jong; Ko, Kang Seok; Park, Byung Lan; Kim, Byong Geun; Kim, Jae Kyu

    1993-01-01

    Pseudoaneurysm due to chronic pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality associated with the pseudoaneurysm, early detection and treatment is essential. Surgical ligation or resection of the aneurysm has a high mortality and therefore, transcatheter embolization is preferably carried out. We report a case in which gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis was successfully treated by transcatheter embolization using Gelfoam and Gianturco spring coils

  19. Embolization of gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Se Jong; Ko, Kang Seok; Park, Byung Lan; Kim, Byong Geun [Kwangju Christian Hospital, Gwangju (Korea, Republic of); Kim, Jae Kyu [College of Medicine, Chonnam National Univrsity, Gwangju (Korea, Republic of)

    1993-01-15

    Pseudoaneurysm due to chronic pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality associated with the pseudoaneurysm, early detection and treatment is essential. Surgical ligation or resection of the aneurysm has a high mortality and therefore, transcatheter embolization is preferably carried out. We report a case in which gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis was successfully treated by