Polyvinyl Alcohol Embolization Adjuvant to Oily Chemoembolization in Advanced Hepatocellular Carcinoma with Arterioportal Shunts.
- Author:
Yeo Ju KIM
1
;
Hae Giu LEE
;
Jeong Mi PARK
;
Yeon Soo LIM
;
Myung Hee CHUNG
;
Mi Sook SUNG
;
Won Jong YOO
;
Hyun Wook LIM
Author Information
- Publication Type:Original Article
- Keywords: Shunts, arterioportal; Hepatic arteries, chemotherapeutic embolization; Liver neoplasms, chemotherapeutic embolization
- MeSH: Adult; Aged; Aged, 80 and over; Antibiotics, Antineoplastic/administration & dosage; Arteriovenous Fistula/therapy; Carcinoma, Hepatocellular/mortality/*therapy; *Chemoembolization, Therapeutic; Contrast Media/administration & dosage; Feasibility Studies; Female; Humans; Iodized Oil/administration & dosage; Liver Circulation; Liver Neoplasms/mortality/*therapy; Male; Middle Aged; Mitomycin/administration & dosage; Polyvinyl Alcohol/*administration & dosage; Retrospective Studies; Treatment Outcome
- From:Korean Journal of Radiology 2007;8(4):311-319
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To assess the feasibility and safety of polyvinyl alcohol (PVA) embolization adjuvant to transarterial oily chemoembolization (P-TACE) in advanced hepatocellular carcinoma (HCC) with arterioportal shunts (APS). MATERIALS AND METHODS: Nineteen patients who underwent PVA embolization for APS before a routine chemoembolization (TACE) procedure were retrospectively reviewed. 10 of these 19 patients underwent follow-up TACE or P-TACE after P-TACE (Group A), but nine patients underwent only initial P-TACE because of progression of HCC and/or underlying liver cirrhosis (Group B). Hepatic function tests, APS grades, and portal flow directions were evaluated before and after P-TACE sessions. Complications after procedures and survival days were also evaluated. RESULTS: In group A, APS grade was improved in eight patients and five of six patients with hepatofugal flow showed restored hepatopetal flow postoperatively. No immediate complication was developed in either group. Transient hepatic insufficiency developed in eight (42.1%) of 19 patients after P-TACE, and seven (87.5%) of these eight recovered within two weeks under conservative care. The mean and median survival time all study subjects was 280 days and 162 days. CONCLUSION: P-TACE is feasible and safe in advanced HCC patients with APS.
