Local treatment for hepatocellular carcinoma (HCC) has been widely used in clinical practice due to its minimal invasiveness and high rate of cure. Percutaneous radiofrequency ablation (RFA) is widely used because its treatment effectiveness. However, some serious complications can arise from percutaneous RFA. We present here a rare case of hemorrhagic cardiac tamponade secondary to an anterior cardiac vein (right marginal vein) injury during RFA for treatment of HCC.
Carcinoma, Hepatocellular/radiography/*surgery ; Cardiac Tamponade/*etiology ; *Catheter Ablation ; Fatal Outcome ; Hemorrhage/*etiology ; Humans ; Iatrogenic Disease ; Intraoperative Complications/*etiology ; Liver Neoplasms/radiography/*surgery ; Male ; Middle Aged ; Radiography, Interventional ; Tomography, X-Ray Computed

PURPOSE: During carotid angioplasty and stenting (CAS), hemodynamic instability (HDI) can occur, possibly causing post-procedural ischemic complications. The goal of this study was to investigate the risk factors of HDI focusing on characteristics of plaque. MATERIALS AND METHODS: Thirty nine CAS patients were retrospectively evaluated for HDI. Prolonged HDI that lasted over 30 minutes was analyzed in relation to characteristics of calcified plaque. RESULTS: Nineteen (48.7%) patients had HDI. Ten of the 19 had both bradycardia and hypotension, and nine had only bradycardia. All bradycardia was treated well with a transcutaneous temporary cardiac pacemaker. But eight patients presented with prolonged hypotension in spite of recovery of bradycardia. Calcified plaque was a related factor associated with HDI (odds ratio, 8.571; 95% confidence interval, 1.321-55.62; p=0.024). Extensive and eccentric type calcified plaques were associated with prolonged hypotension (p=0.04, and p=0.028, respectively). CONCLUSION: The calcification of plaque is a predictable factor of HDI during CAS, and its extensive and eccentric calcified plaques may be related to prolonged HDI.
Aged ; Angioplasty/*adverse effects ; Bradycardia/complications ; Carotid Arteries/*surgery ; Carotid Stenosis/*physiopathology ; Female ; *Hemodynamics ; Humans ; Hypotension/complications ; Intraoperative Complications/*etiology/radiography ; Intraoperative Period ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Stents ; Tomography, X-Ray Computed