• Title/Summary/Keyword: 간동맥 색전술

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The Effect of Transarterial Chemoembolization(TAE) on Lung Metastasis of Hepatocellular Carcinoma (간동맥 색전술이 간세포함의 폐 전이에 미치는 영향)

  • Lee, Heon-Ju;Eun, Jong-Ryul;Song, Young-Doo;Park, Chan-Won
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.66-74
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    • 2000
  • Background: During the follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. Methods: From March 1991 to March 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic methods at Yeungnam University hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months and, divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated for age, sex, child-pugh score, liver cirrhosis, and level of AFP. Results: Pulmonary metastasis was found in 18.0% (26/144), of which 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of the patients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. There was more likelihood for lung metastasis after TAE. but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. Conclusions: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. Child-pugh class was the only related clinical preciptating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-ups may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.

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Incidence and Risk Factors of Acute Ischemic Cholecystitis after Transarterial Chemoembolization: Correlation with Cone Beam CT Findings (간동맥 화학 색전술 후 발생한 급성 담낭염의 발생률과 위험인자: Cone Beam CT 소견과의 상관관계)

  • Jong Yeong Kim;Jung Suk Oh;Ho Jong Chun;Su Ho Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.363-371
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    • 2024
  • Purpose Acute cholecystitis is a complication of transarterial chemoembolization (TACE) that occasionally requires surgical intervention. We aimed to analyze the incidence and risk factors of cholecystitis requiring surgical intervention in patients with embolic material uptake on cone beam CT (CBCT) performed immediately after various TACE procedures. Materials and Methods After a retrospective review of 2633 TACE procedures performed over a 6-year period, 120 patients with embolic material retention in the gallbladder wall on CBCT immediately after TACE were selected. We analyzed the incidence of and risk factors for acute cholecystitis. Results The overall incidence of acute cholecystitis requiring surgical intervention was 0.45% (12 of 2633 TACE procedures); however, it was present in 10% (12 of 120) of procedures that showed high-density embolic material retention in the gallbladder wall on CBCT performed immediately after TACE. Acute cholecystitis requiring surgical intervention occurred in eight patients (66.7%) who underwent direct cystic arterial embolization. Surgical intervention was performed 15 days (mean) after TACE. Conclusion Most unintended chemolipiodol deposits in the gallbladder wall resolved without intervention or surgery. However, superselective direct cystic arterial chemoembolization was associated with a high incidence of acute cholecystitis requiring surgery, and patients who undergo this procedure should be closely monitored.

Evaluation of Embolization Effect of Hepatocellular Carcinoma by Hepatic Arterial Flow Study with $^{99m}Tc$-MAA SPECT (간암에서 색전술의 효과를 평가하는데 있어서 $^{99m}Tc$-MAA SPECT를 이용한 간동맥 혈류 검사의 의의)

  • Lee, Byung-Hee;Yoo, Hyung-Sik;Lee, Jong-Doo;Chung, Jin-Ill;Park, Chang-Yun;Lee, Jong-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.62-68
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    • 1994
  • This study was aimed to compare the density of the functional microcirculation of hepatocellular carcinoma (HCC) with normal liver and to investigate the effect of hepatic-arterial oily chemoembolization (HAE) by radionuclide examination. Methods : Eight patients with HCC proven by biopsy in five, and clinically and radiologically in three were included. The mixture of 2 cc normal saline with three to four mCi of $^{99m}Tc$-MAA was infused through a hepatic-arterial catheter for a minute. Dynamic images were obtained at a rate of 4 sec per frame for a minute, and static images and SPECT were followed. Results : In three patients who underwent hepatic arterial angiography (HAA) alone, radioactivity was markedly increased in tumors compared to the adjacent liver immediately after infusion of $^{99m}Tc$-MAA. The ratios of tumoral and extratumoral up-take (T/E ratio) were above 6.5 (range; $6.5{\sim}l9$, mean; 12.5). In four of the five patients who under-went superselective HAE, T/E ratio were remark-ably decreased ($0.5{\sim}1.3$). The areas of embolization were better delineated in radionuclide study than in postembolization HAA. In the other one who was considered to be embolized completely on HAA, strong radiouptake in the tumor was disclosed (T/E ratio; 7.0). Conclusions : Therefore hepatic-arterial flow study with radionuclide imaging using $^{99m}Tc$-MAA can be a valuable method to assess the accurate embolization effect in HCC.

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Dose Comparison between Fast Low Dose C-arm CT and DSA (Fast Low Dose C-arm CT와 DSA의 선량 비교)

  • Kim, Chan-woo;Kim, Jae-Seok
    • Journal of the Korean Society of Radiology
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    • v.14 no.5
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    • pp.613-618
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    • 2020
  • The average dose of Fast Low Dose C-arm CT used during hepatic arterial chemoembolization was compared with the average dose of DSA, and the exposure dose was analyzed by analyzing the average dose for each test technique in the total accumulated dose. 50 patients were randomly selected at our clinic and compared with Fast Low Dose C-arm CT, DAP and Air Kerma of DSA, and the accumulation of four test techniques (DSA, Fast Low Dose C-arm CT, Roadmap, Fluoroscopy) The proportion of dose (DAP, Air Kerma) was analyzed. For statistical comparative analysis, the corresponding sample T test and ANOVA test (post hoc test: Tukey) were performed using the statistical program SPSS 20.0. Fast Low Dose C-arm CT showed statistically significantly lower average dose (DAP, Air Kerma) than DSA. Reducing the number of tests for DSA can reduce the patient's exposure to medical radiation.

A Case of Infantile Hemangioendothelioma of the Liver Treated with Hepatic Embolization and Lobectomy (간동맥 색전술과 간엽 절제술로 치료한 영아 간내 혈관내피종 1례)

  • Kim, Jae Seon;Moon, Soo Kyung;Yoon, Hye Seon;Lee, Tae Seok
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.660-664
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    • 2005
  • Infantile hemangioendothelioma(IHE) of the liver is the most common vascular tumor in infants before the age of 6 months. It is a histologically benign tumor with potentially life-threatening complications. The clinical manifestations are variable, ranging from asymptomatic forms to intractable high-output heart failure. In addition, abdominal mass, intraperitoneal hemorrhage due to rupture of mass, respiratory distress, hematologic abnormalities and jaundice can occur. Diagnostic work-up is through doppler ultrasound sonography, computed tomography scan, magnetic resonance imaging and angiography. Treatment consists of medical treatment, interventional therapy, surgical resection and liver transplantation. We experienced symptomatic IHE in a premature neonate who presented with high output heart failure and respiratory distress. Initial medical treatment and steroid therapy failed to improve his condition. Coil embolization of left hepatic artery resulted in improvement of respiratory symptoms. However, a left lobectomy was performed because the mass size was not decreased with development of collateral vessels. The infant was well, after a successful discharge from the hospital.

The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization (체위변경이 간동맥 화학색전술 환자의 요통, 불편감, 출혈 합병증에 미치는 효과)

  • Yun, Mi-Jeong;Min, Hye Sook
    • Korean Journal of Adult Nursing
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    • v.26 no.4
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    • pp.424-433
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    • 2014
  • Purpose: This study was to test the effects of the positional change on low back pain, discomfort, and bleeding complications during the period of bed rest following transarterial chemoembolization (TACE). Methods: The research design for this study was a non-equivalent control group quasi-experimental design. The participants were 23 patients for the experimental group, and 23 patients for the control group. The experimental group received positional change of taking the semi-Fowler's position and the 30-degree lateral position alternatively during the period of bed rest after TACE for 4 hours at one-hour intervals. The control group maintained the supine position continuously during the period of bed rest after TACE. Results: There were statistically significant differences in low back pain and discomfort between the experimental and the control group after intervention. And no significant difference was found in bleeding complication between two groups. Conclusion: The results of the study suggest that the positional change is an effective nursing intervention to reduce low back pain and discomfort without increasing the risk of bleeding after TACE.

Effect of Bed Side Exercising on Back Pain and Bleeding Complications after Transcatheter Arterial Chemoembolization (간동맥 화학색전술 후 절대안정기간 동안의 침상운동요법이 요통과 출혈합병증에 미치는 효과)

  • Nam, Sun Hee;Kim, Young-Ju
    • Korean Journal of Adult Nursing
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    • v.25 no.4
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    • pp.400-408
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    • 2013
  • Purpose: This study was conducted to examine the effects of bed side exercising on back pain and bleeding during absolute bed rest in patients who had received transcatheter arterial chemoembolization (TACE). Methods: A nonequivalent control group pretest-posttest design was used. A total 46 patients were sampled from a gastrointestinal unit of a urban general hospital in Seoul. The control group received 8 hours of bed rest and conservative care. The experimental group received 8 hours of bed rest and bed side exercising every one hour from the time having absolute bed rest for 3 hours after TACE. Results: The experimental group with bed side exercising experienced significantly less back pain compared to the control group. There was no significant difference in the incidence of bleeding complications between two groups. Conclusion: The results indicate that a bed side exercising is associated with a reduction of back pain and with no increased risk of bleeding complications in patients after TACE.