• Title/Summary/Keyword: 간동맥 화학색전술

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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.

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.

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.

Factors Influencing Quality of Life in Patients with Hepatocellular Carcinoma Receiving Transarterial Chemoembolization (간동맥 화학색전술을 받은 간세포암 환자의 삶의 질 영향요인)

  • Park, Hyoung-Sook;Lee, Hyun-Ju;Ha, Jae-Hyun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.1
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    • pp.69-78
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    • 2015
  • Purpose: The purpose of this study was to examine the relationship among family support, self-care and quality of life(QOL) in Patients with hepatocellular carcinoma receiving transarterial chemoembolization, including the effects of these variables on QOL. Methods: The research was a cross-sectional, descriptive design. Participants were 103 patients with hepatocellular carcinoma who were receiving transarterial chemoembolization. Data were analyzed using descriptive statistics, t-test, one way ANOVA, and hierachial multiple regression analysis with SPSS 18.0 program. Results: QOL had a significant correlation with family support(r=.60, p<.001) and self-care(r=.38, p<.001). Family support had a significant correlation with self-care(r=.41, p<.001). Hierarchial multiple regression analysis for QOL revealed that the most powerful predictor was family support followed by self-care. Family support, self-care, gender, and occupation explained 50% of the variance in quality of life. Conclusion: These results indicate that various factors are related to the quality of life of these patients. Further, nursing strategies to improve the family support and self-care of patients with hepatocellular carcinoma are needed.

Effect of Positioning on Back Pain and Comfort of Bed Rest Patients after Transhepatic Arterial Chemoembolization (체위변경이 간동맥 화학색전술 후 침상안정기 환자의 요통과 안위에 미치는 효과)

  • Park Han-Jong;Sohng Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.12 no.3
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    • pp.317-324
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    • 2005
  • Purpose: The study was done to investigate whether positioning relieves the back pain and enhances comfort during bed rest after transhepatic arterial chemoembolization(TACE). Methods: A quasi-experimental design with non-equivalent control group non-synchronized design was used. The experimental group was placed semi Fowler's position for the first 2 hours. The following 4 hours the position was rotated hourly between 30 degrees laterally inclined position and a semi Fowler's position. The control group was maintained in a supine position for the 6 hours. Data were analyzed using t-test, $x^2$-test, Fisher's exact test and repeated measures ANOVA. Results: 1) Back pain intensity significantly decreased in the experimental group compared to the control group. 2) Comfort level significantly decreased in both groups, but there was no significant difference between the two groups. 3) There were no hematoma and bleeding complication in either group. In addition, there was no significant difference in urinary retention between the two groups. 4) Analgesics were less frequently taken by the experimental group. Conclusion: These results suggest that positioning relieves back pain without causing an increased incidence of hematoma and bleeding formation after TACE and this nursing intervention might help patients be more comfortable during the treatment of TACE.

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Usefulness of Balloon-type Hemostatic Device After Transarterial Chemoembolization (간동맥 화학색전술 후 풍선형 지혈기구의 유용성)

  • Kim, Seung-Gi
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.181-186
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    • 2019
  • Transarterial chemoembolization is one of the most representative procedures for puncture of the femoral artery. In addition, the same procedure is often repeatedly performed many times, and Hepatocellular carcinoma patients due to cancer is significantly lowered blood tests, regardless of platelet counts are not good enough to stop bleeding. More importantly, hepatocellular carcinoma has a high degree of complication and disease severity, which makes it less likely that the condition of the body will be relatively inferior to other patients. In order to prevent delayed hemorrhage of the femoral artery puncture site after the procedure, it is advised to absolutely stabilize the limb so that it does not bend the limb for 3 hours after climbing in the ward. Therefore, I have been complaining about inconvenience. In addition, in order to prevent delayed hemorrhage after hemostasis, balloon type hemostatic device was used instead of sand bag which was placed on hemostatic site. The results of this study were compared with the results of actual application. The use of a balloon-type hemostatic device to increase the effectiveness of continuous hemostasis and to minimize the inconvenience during the time of patient's absolute bed rest, rather than raising the sandbag to prevent primary delayed hemorrhage by various methods in transarterial chemoembolization. It can be used as a substitute for existing sand bags because it can alleviate pain, increase satisfaction, and can be used as a disposable one.

The Effect of Position Change on Comfort and Bleeding after Transarterial Chemoembolization (간동맥 화학색전술 후 체위변경이 안위와 출혈합병증에 미치는 영향)

  • Kang, Jung Sun;Park, Seong Yeon;Kim, Eun Ok
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.1
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    • pp.5-15
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    • 2010
  • Purpose: The purpose of this study was to examine the effect of position change on the level of comfort and occurrence of bleeding after transarterial chemoembolization. Methods: This study was the nonequivalent control group non-synchronized design. The experimental group was positioned in supine with 15-30 degree Semi-folwer's position for 2 hours and then changed supine position alternatively to 30 degree lateral positioning in turn per hour for 2 hours. For the control group, 6 hour supine positions without any position change were applied. Results: The level of discomfort of the control group was scored higher level than that of the experimental group. There was no significant differences in back pain and the degrees of voiding difficulty. There were no significant differences in the incidence of bleeding complication between the two groups. Conclusion: The position change in patients after transarterial chemoembolization could be applied without any severe side effects such as bleeding complication, but it was revealed to be effective in reducing the level of discomfort.

A Case of Acute Lung Injury Complicated by Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma (간세포암의 간동맥 화학색전술 후 발생한 급성 폐손상 1예)

  • Cho, Se-Haeng;Kim, Joo-Hang;Kim, Byung-Soo;Jang, Joon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.781-786
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    • 1995
  • Transcatheter arterial chemoembolization(TACE) was performed in a 61 year old male patient with hepatocellular carcinoma with 10 cc of Lipiodol and 50 mg of doxorubicin. Three days later, he complained of dyspnea and dry cough. The arterial blood gas study revealed moderate hypoxemia and hypocarbia. The chest PA showed acute pulmonary edema with bilateral pleural effusion. To rule out the possibilities of acute respiratory failure caused by infection, pulmonary embolism or congestive heart failure, we performed several laboratory studies. The blood and sputum culture studies revealed negative results for bacterial growth. The echocardiogram was normal. The abdominal CT scan and MR imaging revealed no thrombus or mass lesion in the inferior vena cava. So we concluded pulmonary oil embolism induced by lipiodol as the cause of acute lung injury. Four weeks later, clinical symptoms and chest x-ray were markedly improved with conservative care. We report a case of acute lung injury after TACE with lipiodol and doxorubicin, with review of literatures.

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