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Prevention of gastric complications in hepatic arterial chemoembolization. Balloon catheter occlusion technique
H Nakamura1, T Hashimoto, H Oi
1Department of Radiology, Osaka University, Osaka Teishin Hospital, Japan.
Insights
Transcatheter arterial chemoembolization can cause gastric issues. A new balloon occlusion method redirects blood flow, preventing complications by blocking agent entry into gastric arteries.
Area of Science:
- Interventional Radiology
- Hepatobiliary Oncology
Background:
- Gastric complications are a risk in transcatheter arterial chemoembolization (TACE).
- Anatomical variations of gastric arteries (right gastric artery, accessory left gastric artery) can lead to inadvertent agent delivery.
- These variations pose challenges for safe and effective TACE procedures.
Purpose of the Study:
- To describe a novel technique for preventing gastric complications during TACE.
- To evaluate the efficacy of temporary proper hepatic artery occlusion in redirecting gastric artery blood flow.
- To mitigate risks associated with chemoembolic agent delivery in TACE.
Main Methods:
- A balloon catheter was used to occlude the proper hepatic artery.
- This occlusion temporarily redirected blood flow within gastric artery branches towards the liver.
- Chemoembolic agents were then delivered proximally to these gastric branches.
Main Results:
- The procedure successfully prevented chemoembolic agents from entering gastric artery branches.
- Gastric complications were effectively avoided, even with proximal agent injection.
- The technique demonstrated safety and efficacy in managing anatomical variations during TACE.
Conclusions:
- Temporary proper hepatic artery occlusion is a viable strategy to prevent gastric complications in TACE.
- This method offers protection against chemoembolic agent-induced gastric injury.
- It enhances the safety profile of TACE, particularly in patients with variant gastric artery anatomy.
Abstract:
Gastric complications may be a problem in transcatheter arterial chemoembolization, if the right gastric artery branches distally from the proper hepatic artery or its branch, or the accessory left gastric artery arises from the left hepatic artery. We occluded the proper hepatic artery with a balloon catheter to redirect blood flow in these gastric branches toward the liver. This procedure prevented chemoembolic agents from flowing into the gastric branches, and accordingly protected against gastric complications even when chemoembolization was performed by injecting the agents proximally to the gastric branches.