Palmaz-Schatz stent for hepatic artery stenosis during hepatic arterial infusion chemotherapy
T Ogata1, K Okuda, J Nagashima
1Department of Surgery, Kurume University Hospital, Fukuoka, Japan.
Insights
A Palmaz-Schatz stent successfully treated severe common hepatic artery stenosis caused by catheterization in a hepatocellular carcinoma patient. This intervention improved blood flow and demonstrated the stent
Area of Science:
- Interventional Radiology
- Oncology
- Vascular Surgery
Background:
- Advanced hepatocellular carcinoma (HCC) treatment often involves hepatic arterial infusion chemotherapy (HAIC).
- Implantable port systems facilitate continuous chemotherapy delivery via the common hepatic artery (CHA).
Observation:
- During catheterization for HAIC, intimal dissection of the CHA occurred, leading to severe stenosis.
- Percutaneous transluminal angioplasty (PTA) followed by Palmaz-Schatz stent placement was performed 55 days post-dissection.
Findings:
- Post-stent placement, Digital Subtraction Angiography (DSA) and Doppler ultrasound confirmed improved CHA blood flow.
- The patient showed a partial response to treatment.
- DSA confirmed adequate stent patency 6 months post-procedure.
Implications:
- This case highlights the Palmaz-Schatz stent as a viable option for managing severe CHA stenosis resulting from catheterization techniques.
- Successful stenting may improve treatment delivery and outcomes in complex HCC cases.
- This represents the first report on Palmaz-Schatz stent utility in this specific clinical scenario.
Abstract:
Hepatic arterial infusion chemotherapy using an implantable port system was performed on a 40 year-old man with advanced hepatocellular carcinoma. When the in-dwelling catheter was inserted into the common hepatic artery (CHA), intimal dissection occurred as a result of the catheterization causing severe stenosis. On day 55 after intimal dissection, an in-dwelling Palmaz-Schatz stent was inserted after percutaneous transluminal angioplasty (PTA). CHA blood flow was shown to have improved on Digital subtraction angiography (DSA) and Doppler ultrasound after the in-dwelling Palmaz-Schatz stent. Thus a partial response was shown. The DSA from the implantable port system showed adequate patency 6 months after. This is the first report describing the usefulness of a Palmaz-Schatz stent for the severe stenosis of the CHA caused by the technique of catheterization.
