Abstract:

To show possibilities to diagnose and treat toxic complications of continuous hepatic artery chemoinfusion using percutaneous implanted catheter-port system.

Materials and methods: Between May 2005 and March 2007, 20 patients (pts) underwent percutaneous transfemoral implantation of the catheter-port system for treatment of unresectable colorectal liver metastases. Toxic complications (gastritis, pancreatits or stomach ulcer) occurred in three pts (each in one). Endoscopy (after arterial injection of methylene blue) and scintigraphy (after arterial injection of technetium-99m macroaggregated albumin) showed abnormal liver perfusion. Visceral angiography was performed for verification and embolization of non-targeted vessels. Angiography with embolization of collateral arteries resulted in normalization of liver perfusion and resolution of complications. At present, all pts continue to receive intraarterial chemotherapy. Transcatheter coil embolization of non-targeted arteries is effective for the management of the catheter-port system misperfusion.

Reference 

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Abstract:

Aim: was to estimate first own results of arterial radioembolization (RE) in patients with primary or metastatic liver malignancy.

Materials and methods: in 2009, RE of the right (n=3) or left (n=1) hepatic artery using Yttrium-90 glass microspheres (Therasphere) was performed in 4 patients: 3 with hepatocellular carcinoma on cirrhosis complicated by portal vein branch thrombosis (contraindication for chemoembolization), and 1 patient with colorectal liver metastases.

Results: all RE procedures were technically successful. The radiation dose to the tumor was 1 20-150 Gy The post embolization syndrome was minimal and uncomplicated. After RE, partial tumor response and stabilization were noted in 2 patients each. Patients survived from 14 to 32 months.

Conclusion: RE is well-tolerated and safe procedure causing significant local damage of liver tumor. According to our first experience, RE is a very promising method for treatment of hepatic malignancies. 

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