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Sign Convention01:30

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When analyzing a beam subjected to various loads, it is crucial to understand the internal forces and moments generated within the structure. These internal forces can be broadly classified into normal forces, shear forces, and bending moments. To determine these forces and moments, we use the method of sections and apply a specific sign convention based on their direction and the side of the section being analyzed.
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Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
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Ultraselective conventional transarterial chemoembolization: When and how?

Shiro Miyayama1

  • 1Department of Diagnostic Radiology, Fukui-ken Saiseikai Hospital, Fukui, Japan.

Clinical and Molecular Hepatology
|April 27, 2019
PubMed
Summary
This summary is machine-generated.

Ultraselective conventional transarterial chemoembolization (cTACE) offers a new approach for treating small hepatocellular carcinoma (HCC). This technique achieves complete tumor necrosis and can replace traditional surgical methods in select cases.

Keywords:
Chemoembolization, TherapeuticConebeam computed tomographyGelatin sponge, AbsorbableHepatocellular carcinomaIodized oil

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Area of Science:

  • Interventional Radiology
  • Hepatobiliary Oncology
  • Vascular Interventions

Background:

  • Hepatocellular carcinoma (HCC) is a primary liver cancer with limited treatment options for small tumors.
  • Conventional transarterial chemoembolization (cTACE) is a standard treatment, but achieving optimal results for small HCCs remains a challenge.
  • Ultraselective cTACE targets the most distal hepatic artery branches for precise treatment delivery.

Purpose of the Study:

  • To evaluate the efficacy of ultraselective cTACE in achieving complete tumor necrosis in small HCC.
  • To explore the potential of ultraselective cTACE as an alternative to surgical resection and radiofrequency ablation.
  • To investigate the mechanism of action, including the role of iodized oil injection and gelatin sponge slurry embolization.

Main Methods:

  • Performing cTACE at the most distal subsubsegmental hepatic artery using microcatheter advancement.
  • Injecting a larger volume of iodized oil into the portal vein within a limited area under altered hemodynamics.
  • Adding gelatin sponge slurry embolization to occlude both hepatic artery and portal vein supply to the tumor.

Main Results:

  • Achieved complete tumor necrosis and massive peritumoral necrosis.
  • Successfully treated small HCCs, including those with less hypervascular portions.
  • Demonstrated the ability to block reversed portal flow into the tumor during embolization.

Conclusions:

  • Ultraselective cTACE is an effective method for achieving complete necrosis in small HCC.
  • This technique can potentially replace surgical resection and radiofrequency ablation for selected HCC patients.
  • The precise delivery and dual embolization contribute to superior treatment outcomes.