• Title/Summary/Keyword: Transcatheter

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Lobaplatin Combined Floxuridine/Pirarubicin-based Transcatheter Hepatic Arterial Chemoembolization for Unresectable Primary Hepatocellular Carcinoma

  • Zhao, Chang;Wang, Xu-Jie;Wang, Song;Feng, Wei-Hua;Shi, Lei;Yu, Chun-Peng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2057-2060
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    • 2014
  • Purpose: To assess the effect and safety of lobaplatin combinated floxuridine /pirarubicin in transcatheter hepatic arterial chemoembolization(TACE) of unresectable primary liver cancer. Patients and Methods: TACE combined with the chemotherapy regimen was used to treat 34 unresectable primary liver cancer patients. DSA/MRI/CT/blood routine examinations were used to evaluate short term activity and toxicity after 4-5 weeks, the process being repeated if necessary. Results: Among the 34 cases, 1 (2.9%) showed a complete response, 21 (61.7%) a partial response, 8 (23.5%) stable disease, and 4 progressive disease, with a total effective rate of 67.6%. The content of alpha fetoprotein dropped by over 50% in 20 cases (58.8%). The rate of recovery was hepatalgia (88.2%), ascites (47.1%), appetite (55.9%), Performance Status(30.4%). The median follow-up time (MFT) was 281 days (63-558 days), and median progression-free survival was 118.5 days (95%, CI:88.8-148.2days). Adverse reactions (III-IV grade) were not common, with only 4 cases of vomiting and 2 cases of thrombocytopenia (III grade). Conclusions: Lobaplatin-based TACE is an effective and safe treatment for primary liver cancer.

Internal Mammary Artery Injury Caused by Blunt Chest Trauma Treated with Transcatheter Arterial Embolization (흉부 둔상에 의해 발생한 내흉동맥 손상의 카테터경유 혈관색전술 치료 경험)

  • Choi, Seok Jin;Jeong, Tae Oh;Lee, Jae Baek;Yoon, Jae Chol
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.296-299
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    • 2012
  • The aorta is the most common major thoracic artery injured by blunt chest trauma. Injuries to major aortic arch branch arteries can also occur but are much less common than aortic injuries in the setting of blunt trauma. Although internal mammary artery (IMA) injury is uncommon and rarely diagnosed in cases of blunt chest trauma, it is one of the important sources of bleeding in chest trauma. IMA bleeding can cause ongoing blood loss and may lead to serious conditions such as extensive hemothorax, anterior mediastinal hematoma or its catastrophic complication, cardiac tamponade. However such arotic and branch artery injuries are not easily detected by plain radiograph, and are detected indirectly because of associated mediastinal hematoma. Herein, we report a case of IMA injury caused by blunt chest trauma secondary to pedestrian traffic accident. The injured patient was successfully treated by transcatheter arterial embolization (TAE).

Recurrent Post-Traumatic Adrenal Bleeding after Transcatheter Arterial Embolization: A Case Report (외상성 부신 손상에 대한 경카테터 동맥 색전술 후 재발성 출혈: 증례 보고)

  • Hyojoo Kim;Sang Hyun Seo;Hyun Seok Jung
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1408-1413
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    • 2023
  • Adrenal gland trauma is uncommon and is diagnosed at an increasing frequency using CT scans. However, owing to the rarity of this injury and its diverse clinical presentations and prognoses, there is no consensus on its management. In this case report, a 73-year-old male patient experienced recurrent bleeding in the right adrenal gland due to an in-car traffic accident, which was treated with repeated transcatheter arterial embolization.

Transcatheter Arterial Embolization for Hemoptysis (객혈환자에서 동맥 색전술의 효과)

  • Yoo, Byung-Su;Ryu, Jeong-Seon;Lee, Won-Yeon;Song, Kwang-Seon;Ahn, Kang-Hyun;Yong, Suk-Joong;Shin, Kye-Chul;Kim, Young-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.50-57
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    • 1995
  • Background: Transcather arterial embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function such as postpneumonectomy patients and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization and analysed the correlation of the clinical and angiographic characteristics and investigated the clinical course and outcome after arterial embolization in the patients with significant hemoptysis. Method: 58 patients with massive or recurrent hemoptysis underwent transcatheter arterial embolization for the treatment of hemoptysis from April 1992 to Sept. 1993. Results: Most common cause of hemoptysis was pulmonary tuberculosis(34 cases, 58.3%). Embolized vessels responsible for hemoptysis were 56 bronchial arteries and 32 nonbronchial systemic arteries. Initial most common angiographic findings were hypervascularity and shunt. Initial success rate of hemoptysis control revealed 81.1%. However, 15 of 58 patients(25.9%) showed recurrence of hemoptysis after transcatheter arterial embolization. The complications(18 cases, 31%) such as chest pain, fever, voiding difficulty, atelectasis, paralytic ileus and unwanted embolization were occured. Conclusion: Transcatheter arterial embolization is useful and relatively safe treatment modality for immediate bleeding control of patients with massive hemoptysis or inoperable cases. The further evaluation of the long term results according to the embolized material and underlying pulmonary disease will be required.

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Impact of Low Versus Conventional Doses of Chemotherapy During Transcatheter Arterial Chemo-embolization on Serum Fibrosis Indicators and Survival of Liver Cancer Patients

  • Kong, Wei-Dong;Cao, Jian-Ming;Xu, Jian;Chen, Bo;Yang, Tao;Xu, Tan-Tan;Lu, Guang-Ming;Li, Jun;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4757-4761
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    • 2012
  • Objectives: To explore the impact of low- vs conventional-dose chemotherapy via transcatheter arterial chemo-embolization (TACE) on serum fibrosis indicators and treatment efficacy of hepatocellular cancer patients (HCC). Materials and Methods: Patients fulfilling the eligibility criteria were assigned to TACE in Group A (with low-dose chemotherapy) or Group B (conventional-dose chemotherapy). Four serum fibrosis related indicators, hyaluronic acid(HA), human pro-collagen type-III (hPC-III), laminin (LN), and collagen type-IV(IV-C) before TACE were compared with the values 7 days after TACE. The response rate and survival time were also compared between the two groups. Results: Fifty patients with HCC were enrolled in this study, including 25 in Group A and 25 in Group B. No significant differences were detected between the two groups in the four indicators before TACE. After TACE, the value of the four serum indicators increased significantly in Group B. However, no significant differences regarding these four indicators were found in Group A after TACE. Significant differences were demonstrated between the two groups after TACE, but median survival time and 1 or 2 year overall survival rates did not differ (P>0.05). Conclusions: Low-, compared with conventional-dose chemotherapy exerts the same impact on the variation of fibrosis related indicators and has no influence on median survival time and survival rate after TACE in HCC patients.

Patent Ductus Arteriosus Occlusion with an $Amplatz^{(R)}$ Canine Duct Occluder in a Dog (개에서 $Amplatz^{(R)}$ Canine Duct Occluder를 이용한 동맥관개존증의 폐쇄 증례)

  • Kang, Min-Hee;Kim, Seung-Gon;Hahn, Tae-Yeon;Park, Hyun-Ah;Min, Sa-Hee;Park, Ji-Hwan;Kim, Tae-Woo;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.498-501
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    • 2012
  • A 10-month-old intact male Maltese dog (body weight, 1.6 kg) presented with intermittent cough and abnormal heart sounds. The dog was diagnosed with a left-to-right patent ductus arteriosus (PDA) on the basis of the results of transthoracic echocardiography, color flow Doppler examination, and angiography. Transcatheter occlusion of the PDA was performed using the $Amplatz^{(R)}$ Canine Duct Occluder (ACDO) via the femoral artery. The device was placed under fluoroscopic guidance and successfully occluded the PDA. The continuous heart murmur disappeared immediately after the correction and no residual flow was detected. The dog was discharged the following day and regularly examined for complications and safety. This is the first report demonstrating the clinical application of ACDO for the transcatheter closure of PDA via the femoral artery in a small-breed dog in Korea.

Comparison of the Outcomes between Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Replacement in Patients Aged above 80

  • Lee, Jeong-Woo;Kim, Jihoon;Jung, Sung-Ho;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.255-262
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    • 2017
  • Background: Transcatheter aortic valve replacement (TAVR) has been suggested as a less invasive treatment for high-risk patients with aortic valve disease. I n this study, we compared the outcomes of conventional surgical aortic valve replacement (AVR) and TAVR in elderly patients aged over 80. Methods: A total of 108 patients aged 80 years or older who underwent isolated AVR (n=35) or TAVR (n=73) from 2010 through 2015 at Asan Medical Center were identified. Early and late clinical outcomes, including echocardiographic findings, were evaluated in both groups. The mean follow-up duration was $766.4{\pm}528.7days$ in the AVR group and $755.2{\pm}546.6days$ in the TAVR group, and the average timing of the last follow-up echocardiography was at $492.6{\pm}512.5days$ in the AVR group and $515.7{\pm}526.8days$ in the TAVR group. Results: The overall early mortality was 2.8% (0 of 35, 0% in the AVR group vs. 3 of 73, 4.1% in the TAVR group). Permanent pacemaker insertion was significantly more common in the TAVR group (p=0.010). Renal failure requiring dialysis and new-onset atrial fibrillation was more frequent and the length of hospital stay was longer in the AVR group; however, this difference did not reach statistical significance. In the TAVR group, 14 patients (19.2%) were rehospitalized due to cardiac problems, and 13 patients (17.8%) had developed significant paravalvular leakage by the time of the last follow-up echocardiography. Conclusion: TAVR could be a good alternative to conventional surgical AVR in elderly patients. However, TAVR has several shortcomings, such as frequent significant paravalvular leakage or readmission, which should be considered in decision-making.

Transcatheter arterial chemoembolization and radiation therapy for treatment-na$\ddot{i}$ve patients with locally advanced hepatocellular carcinoma

  • Kim, Sang Won;Oh, Dongryul;Park, Hee Chul;Lim, Do Hoon;Shin, Sung Wook;Cho, Sung Ki;Gwak, Geum-Youn;Choi, Moon Seok;Paik, Yong Han;Paik, Seung Woon
    • Radiation Oncology Journal
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    • v.32 no.1
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    • pp.14-22
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    • 2014
  • Purpose: To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) followed by radiotherapy (RT) in treatment-na$\ddot{i}$ve patients with locally advanced hepatocellular carcinoma (HCC). Materials and Methods: Eligibility criteria were as follows: newly diagnosed with HCC, the Barcelona Clinic Liver Cancer stage C, Child-Pugh class A or B, and no prior treatment for HCC. Patients with extrahepatic spread were excluded. A total of 59 patients were retrospectively enrolled. All patients were treated with TACE followed by RT. The time interval between TACE and RT was 2 weeks as per protocol. A median RT dose was 47.25 $Gy_{10}$ as the biologically effective dose using the ${\alpha}/{\beta}$ = 10 (range, 39 to 65.25 $Gy_{10}$). Results: At 1 month, complete response was obtained in 3 patients (5%), partial response in 27 patients (46%), stable disease in 13 patients (22%), and progressive disease in 16 patients (27%). The actuarial one- and two-year OS rates were 60.1% and 47.2%, respectively. The median OS was 17 months (95% confidence interval, 5.6 to 28.4 months). The median time to progression was 4 months (range, 1 to 35 months). Grade 3 or greater liver enzyme elevation occurred in only two patients (3%) after RT. Grade 3 gastroduodenal toxicity developed in two patients (3%). Conclusion: The combination treatment of TACE followed by RT with two-week interval was safe and it showed favorable outcomes in treatment-na$\ddot{i}$ve patients with locally advanced HCC. A prospective randomized trial is needed to validate these results.

Efficacy of Prophylactic Entecavir for Hepatitis B Virus-Related Hepatocellular Carcinoma Receiving Transcatheter Arterial Chemoembolization

  • Li, Xing;Zhong, Xiang;Chen, Zhan-Hong;Wang, Tian-Tian;Ma, Xiao-Kun;Xing, Yan-Fang;Wu, Dong-Hao;Dong, Min;Chen, Jie;Ruan, Dan-Yun;Lin, Ze-Xiao;Wen, Jing-Yun;Wei, Li;Wu, Xiang-Yuan;Lin, Qu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8665-8670
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    • 2016
  • Background and Aims: Hepatitis B virus (HBV) reactivation was reported to be induced by transcatheter arterial chemoembolization (TACE) in HBV-related hepatocellular carcinonma (HCC) patients with a high incidence. The effective strategy to reduce hepatitis flares due to HBV reactivation in this specific group of patients was limited to lamivudine. This retrospective study was aimed to investigate the efficacy of prophylactic entecavir in HCC patients receiving TACE. Methods: A consecutive series of 191 HBV-related HCC patients receiving TACE were analyzed including 44 patients received prophylactic entecavir. Virologic events, defined as an increase in serum HBV DNA level to more than 1 log10 copies/ml higher than nadir the level, and hepatitis flares due to HBV reactivation were the main endpoints. Results: Patients with or without prophylactic were similar in host factors and the majorities of characteristics regarding to tumor factors, HBV status, liver function and LMR. Notably, cycles of TACE were parallel between the groups. Ten (22.7%) patients receiving prophylactic entecavir reached virologic response. The patients receiving prophylactic entecavir presented significantly reduced virologic events (6.8% vs 54.4%, p=0.000) and hepatitis flares due to HBV reactivation (0.0% vs 11.6%, p=0.039) compared with patients without prophylaxis. Kaplan-Meier analysis illustrated that the patients in the entecavir group presented significantly improved virologic events free survival (p=0.000) and hepatitis flare free survival (p=0.017). Female and Eastern Cooperative Oncology Group (ECOG) performance status 2 was the only significant predictors for virological events in patients without prophylactic antiviral. Rescue antiviral therapy did not reduce the incidence of hepatitis flares due to HBV reactivation. Conclusion: Prophylactic entecavir presented promising efficacy in HBV-related cancer patients receiving TACE. Lower performance status and female gender might be the predictors for HBV reactivation in these patients.

Comparative Study on Transcatheter Arterial Chemoembolization, Portal Vein Embolization and High Intensity Focused Ultrasound Sequential Therapy for Patients

  • Cui, Lin;Liu, Xing-Xiang;Jiang, Yong;Wu, Xing-Jun;Liu, Jian-Jun;Zhou, Xiang-Rong;He, Xue-Jun;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6257-6261
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    • 2012
  • Objective: To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE), combined with portal vein embolization (PVE), and high intensity focused ultrasound (HIFU) sequential therapy in treating patients with hepatocellular carcinoma (HCC). Methods: Patients with inoperative HCC were treated by two methods: in the study group with TACE first, then PVE a week later, and then TACE+PVE every two months as a cycle, after 2~3 cycles finally HIFU was given; in the control group only TACE+PVE was given. Response (CR+PR), and disease control rate (CR+PR+SD), side effects, overall survival and time to progress were calculated. Results: Main side effects of both groups were nausea and vomiting. No treatment related death occurred. In the study group, 32 patients received TACE for overall 67 times, PVE 64 times, and HIFU 99 times; on average 2.1, 2 and 3.1 times for each patient, respectively. In the control group, 36 patients were given TACE 78 times and PVE 74 times, averaging 2.2 and 2.1 times per patient. Effective rate: 25.0% in study group and 8.3% in control group (p>0.05). Disease control rates were 71.9% and 44.4%, respectively (p<0.05). In patients with portal vein tumor thrombus, the rate reduced over 1/2 after treatment was 69.2%(9/13) in the study and 21.4%(3/14) in the control group (p<0.05). Rate of AFP reversion or decrease over 1/2 was 66.7%(16/24) in study and 37%(10/27) (p<0.05) in control group. Median survival time: 16 months in study and 10 months in control group. PFS was 7months in study and 3 months in control group. Log-rank test suggested that statistically significant difference exists between two groups (p=0.024). 1-, 2- and 3-year survival rates were 56.3%, 18.8% and 9.3% in study, while 30.6%, 5.6% and 0 in control group, respectively, with statistically significant difference between two groups (by Log-rank, p = 0.014). Conclusions: The treatment of TACE+PVE+HIFU sequential therapy for HCC increases response rate, prolong survival, and could thus be a safe and effective treatment for advanced cases.