Abstract:

This case describes successful combined treatment of patient with large hepatocellular carcinoma BCLC «B», occupying the entire right lobe of the liver, extending to the fourth segment and occupying the right lateral flank till small pelvis. As the first stage, selective tumor chemoembolization, mechanical chemoembolization of right portal vein branches with the aim of vicarious hypertrophy of remaining liver segments were performed. One and half months after performed procedure, the volume of remnant parenchyma was 31% of the total volume. According to the test with indocyanine green, the plasma elimination rate (ICG-PDR) was 12,2%/min, and the residual concentration at 15 minutes was 16%. Subsequently, was performed surgical intervention: Starzl laparotomy, revision of abdominal organs, cholecystectomy, right-sided hemihepatectomy + SI, drainage of the common bile duct according to Vishnevsky, lymphadenectomy of the hepatoduodenal ligament, drainage of abdominal cavity. Postoperative period was complicated by formation of an external biliary fistula and hepatic failure, regarded as class «B» according to criteria of the International Research Group for Liver Surgery (ISGLS), which required medical correction of patient's condition without use of extracorporeal detoxification methods. Later, patient was diagnosed with foci of recurrence of disease in the remaining parenchyma of the liver, for which endovascular treatment was carried out. Currently, patient is alive (6 years after surgery) and is receiving systemic treatment for the extrahepatic spread of the underlying disease.

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18.   Granov DA, Polehin AS, Tarazov PG, et al. Khimioehmbolizatsiya pechenochnykh arterii u bol'nykh gepatotsellyulyarnym rakom na fone tsirroza pered transplantatsiei pecheni: prognosticheskoe znachenie kontsentratsii al'fafetoproteina. Russian Journal of Transplantology and Artificial Organs. 2020; 22(4): 52-57 [In Russ].

https://doi.org/10.15825/1995-1191-2020-4-52-57

Abstract:

Introduction: arterial complications after orthotopic liver transplantation are common cause of graft loss (10-40%).

Aim: was to estimate efficiency of endovascular interventions in correction of revealed arterial complications in patients after OLT.

Material and methods: for the period of 2015-2020, arterial complications after 104 OLT were revealed in 24(23%) pts and were divided into 4 groups: «steal»-syndrome (n=8), hepatic artery thrombosis (n=7), combination of hepatic artery stenosis and «steal» syndrome (n=6), hepatic artery stenosis (n=3). Endovascular interventios such as splenic artery embolization, direct thrombolysis, stenting and balloon plastic were performed for correction of these complications.

Results: using of endovascular treatment, we successfully identified and correct complications with saving of the graft in 14 pts (58%), 10 pts died because of biliary necrosis, sepsis and graft loss.

Conclusion: early detection and elimination of emerging arterial complications after OLT play a keyrole in saving of organs and patients’ life.

References

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18.   Strain D, Brady P, Matalon T, et al. Splenic artery embolization as treatment for splenic artery steal syndrome after liver transplantation. J. Vasc. Intervent. Radiol. 2013; 24(4): 159-160.

19.   G?m?n G, Gelley F, Doros A, et al. Biliary complications after orthotopic liver transplantation: The Hungarian Experience. Transplantation Proceedings. 2013; 45: 3695-3697.

20.   Lee IJ, Kim SH, Lee SD, et al. Feasibility and midterm results of endovascular treatment of hepatic artery occlusion within 24 hours after living-donor liver transplantation. J Vasc Interv Radiol. 2017; 28(2): 269-275.

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Abstract:

Aim: was to estimate efficacy of methods of permanent or temporary blocking of blood flow through the gastroduodenal artery (GDA) during arterial chemoinfusion/chemoembolization of hepatic and pancreatic malignancies.

Materials and methods: for the period of 5 years (2015-2019), GDA embolization with coils was performed in 90 patients. Of them, 39 patients with liver tumors underwent occlusion of proximal GDA. GDA embolization distally to pancreatic branches (commonly on the level of gastroepiploic artery) was done in 51 patients with pancreatic head adenocarcinoma. Alternatively, in 12 patients with liver and 23 patients with pancreatic cancer, hand compression of GDA was used.

Results: technical success was 98% (88/90 patients). During embolization, coil migration into the hepatic artery developed in two patients with liver tumors: in one case stenting of the common hepatic artery was performed, the other case was asymptomatic and the presence of coil did not complicate the following arterial therapy. There were no other complications. Patients received multiple repeated courses of arterial chemotherapy.

Conclusion: methods of blocking of GDA blood flow are relatively safe, effective, simple and inexpensive. Both, embolization and hand compression, help to prevent non-target chemoinfusion and embolization.

References

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Abstract:

A 57-year-old woman was on the waiting list of Orthotopic Liver Transplantation (OLT) due to cirrhosis of viral etiology MSCT with contrast enhancement showed two aneurysms of the splenic artery, stenosis of the celiac trunk with aneurysm of the pancreaticoduodenal artery Taking into account asymptomatic course, we decided to eradicate vascular changes during the forthcoming OLT OLT performed 6 month later, was technically difficult and complicated by massive blood loss and episodes of unstable hemodynamics, so surgical correction of aneurysms was not performed because of high risk. The patient was well and asymptomatic for 2 years after the OLT, but then she developed abdominal pain. MSCT showed progression of vascular changes. Successful endovascular treatment included celiac trunk stenting and embolization of aneurysms. 

References

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Abstract:

Aim: was to analyze the first experiment and estimate the tolerability of intra-arterial use of the Abraxane in oil chemoembolization in patients with pancreatic adenocarcinoma.

Material and methods: for the period January 2018 - August 2018 г on the basis of the FSCU RIS RHT named after academician A.M. Granov, 19 patients with histologically verified ductal adenocarcinoma of the pancreas received treatment: intra-arterial oil chemoembolization with the use of the Abraxane.

Results: in 14 (73.6%) patients appeared mild pain syndrome that was not accompanied by marked laboratory changes, against the background of standard conservative prophylaxy. In 5 (26.4%) cases, patients had clinical and laboratory signs of postembolization syndrome, which was regarded as adverse events of grade 3 antitumor therapy, manifested by clinical and laboratory signs of mild acute pancreatitis, treated in all cases conservatively

The treatment of the postembolization syndrome lasted up to 7 days, until complete laboratory markers normalization, consisting in reducing the activity of blood amylase and urinary diastase to normal values. In all cases, postembolization syndrome was stopped conservatively In described 5 (26.4%) patients, adverse events of intra-arterial oil chemoembolization were regarded as mild postembolization pancreatitis. After treatment, a decrease in the tumor marker CA 19-9 was observed in 9 (90%) patients.

At the next stage, all patients with localized forms of the tumor underwent surgical treatment in the volume of pylorus-preserving pancreatoduodenal resection (n = 13) from 7 to 15 days after intra- arterial oil chemoembolization.

Conclusion: the procedure of oil chemoembolization with Abraxane can be considered as safe if dosages of the oil radiopaque drug Lipiodol are adeqate. There was a tendency to a decrease in the level of the tumor marker CA 19-9 in the blood of patients after the procedure. 

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Abstract:

Between May 2005 and March 2007, catheter-port systems were placed in 20 pts for continuous hepatic artery infusion chemotherapy in the treatment of unresectable colorectal liver metastases. Carboplatin (or oxaliplatin) plus 5-fluorouracil and systemic leucovorin were administered. No complications occurred during the implantation procedures. The mean number of intrahepatic chemotherapy cycles per patient was 10 (4-25). The mean follow-up period was 412 (100-853) days. During the follow-up period, complications occurred in 9 patients (45%), but surgical or interventional radiological correction was successful in all but one case. At present, 14 patients are alive within 4 and 41 months and continue to receive intraarterial chemotherapy, while 6 patients died in 5 to 21 months from tumor progression. The common 1 -year survival is 90% (18 patients). Percutaneous implantation is potentially effective treatment for patients with CLM.

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7.     Балахнин П.В.,Таразов П.Г., Поликарпов А. А. и др.Варианты артериальной анатомии печени по данным 1511 ангиографий. Анналы хирургической гепатологии. 2004; 9 (2): 14-21.

8.     Curley S.A., Chase J.L., Pharm D. et al. Technical consideration and complications associated with the placement of 180 implantable hepatic arterial infusion devices. Surgery. 1993; 114 (5): 928-935.

9.     Hildebrandt B., Pech M., Nicolaou A. et al. Interventionally implanted port catheter systems for hepatic arterial infusion of chemotherapy in patients with colorectal livermetastases: A phase II-study and historical comparisonwith the surgical approach. BMC Cancer. 2007; 24 (7): 69.

10.   Allen P., Nissan A., Picon A. et al. Technical complications and durability of hepatic artery infusion pumpsfor unresectable colorectal liver metastases. An institutional experience of 544 consecutive cases. J. Am.Coll. Surg. 2005; 201 (1): 57-65.

11.   Zhu A., Liu L., Piao D. et al. Liver regional continuouschemotherapy: Use of femoral or subclavian artery for percutaneous implantation of catheter-port systems.World.J. Gastroenterol. 2004; 10 (11): 1659-1662.

12.   Tajima T., Yoshimitsu K., Kuroiwa T. et al. Percutaneous femoral catheter placement for long-term chemotherapy infusions: Preliminary technical results. Am. J.  Roentgenol. 2005; 184 (3): 906-914.IduchiT., Inaba Y., Arai Y. et al. Radiologic removal andreplacement of port-catheter system for hepatic arterial infusion chemotherapy. Am. J. Roentgenol. 2006;187 (6): 1579-1584.

13.   Yamagami T., Kato T., Iida S. et al. Interventional radiologic treatment for hepatic arterial occlusion afterrepeated hepatic arterial infusion chemotherapy viaimplanted port-catheter system. J. Vasc. Interv. Radiol.2004; 15 (6): 633-639.

14.   Herrmann K., Waggershauser T., Sittek H. et al. Liverintraarterial chemotherapy. Use of the femoral artery for percutaneous implantation of catheter-port systems.Radiology. 2000; 215 (1): 294-299.

15.   Grosso M., Zanon C., Mancini A. et al. Percutaneous implantation of a catheter with subcutaneous reservoir for intraarterial regional chemotherapy :Technique and preliminary results. Cardiovasc. Intervent. Radiol. 2000; 23 (3): 202-210.

16.   Oi H., Kishimoto H., Matsushita M. et al. Percutaneous implantation of hepatic artery infusion reservoir by sonographically guided left subclavian artery puncture. Am.J. Roentgenol. 1996; 166 (4): 821-822.

17.   Chen Y., He X., Chen W. et al. Percutaneous implantation of a port-catheter system using the left subclavian artery. Cardiovasc. Intervent. Radiol. 2000; 23 (1): 22-25.

18.   Proietti S., De BaereT., Bessoud B. et al. Intervetionalmenagement of gastroduodenal lesions complicating intra-arterial hepatic chemotherapy. Eur. Radiol. 2007;17 (8): 2160-2165.

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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2.     Балахнин П.В., Генералов М.И., Полысалов В.Н. и др. Применение чрескожных имплантируемых инфузионных систем для регионарной химиотерапии метастазов колоректального рака. Анн. хир. гепатол. 2006; 11 (2): 41-48.

3.     Таразов П.Г. Роль методов интервенционной радиологии в лечении больных с метастазами колоректального рака в печень. Практ. онкол. 2005; 6 (2): 119-126.

4.     Herrmann К., Waggershauser Т., Heinemann V, Reiser М. Interventional radiological procedures in impaired function of surgically implanted catheter-port systems. Cardiovasc. Intervent. Radiol. 2001; 24: 31-36.

5.     Venturini M., Angeli E., Salvioni M. et al. Complications after percutaneous transaxillary implantation of a catheter for intraarterial chemotherapy of liver tumors: Clinical relevance and management in 204 patients. Am. J. Roentgenol. 2004; 182: 1417-1426.

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12.   Tanaka Т., Arai Y, Inaba Y. et al. Radiologic placement of side-hole catheter with tip fixation for hepatic arterial infusion chemotherapy. J. Vase. Interv. Radiol. 2003; 14: 63-68.

13.   Yamagami Т., Kato Т., Iida S. et al. Value of transcatheter arterial embolization with coils and n-butyl cyanoacrylate for long-term hepatic arterial infusion chemotherapy. Radiology. 2004; 230: 792-802.

14.   Herrmann K., Waggershauser Т., Sittek H. et al. Liver intraarterial chemotherapy: Use of the femoral artery for percutaneous implantation of catheter-port systems. Radiology. 2000; 215: 294-299.

Abstract:

Aim. Was to evaluate technicalfeasibility and safety of the internalmammary artery redistribution embolization during intra-artena chemotherapy in breast cancer

Materials and methods. Between 2000 and 2010 years 42 patients with inflammatory form of local-spread breast cancer received 48 courses of combined treatment, including systemic and arterial chemotherapy plus radiotherapy In 6 patients, blood flow redistribution n the internal mammary artery was performed to avoid undesirable extra-breast perfusion with possible complications such as neuralgia necrosis of the skin, organ dysfunction. Coil embolization of the internal mammary artery was made distally from branches supplying breast tumor. After that, infusion of chemotherapeutic drug-in-iodized oil was performed

Results. Technicalsuccess rate was 100%.There was no complication of embolization and intra-arterialtherapy During further repeated researches, a giography showed persistent occlusion of the embolized branches and compensatory dilation of tumor-feeding arteries.Survivalrate of patients starts from 2-22 months,with continuation of combined treatment.

Conclusion. Redistribution of blood flow in the internal mammary artery is safe and may be used to avoid complications of ntra-arterial chemotherapy in breast cancer. 

References 

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4.    Таразов П.Г., Павловский А.В., Гранов Д.А. Химиоэмболизация при раке головки поджелудочной железы. Вопросы онкологии. 2001; 47 (4): 489-491.

5.    Таразов П.Г. Эмболизация печеночной артерии при нетипичных анатомических вариантах ее строения у больных злокачественными опухолями печени. Вестник рентгенологии. 1990; 2: 28-32.

6.    Salem R., Thurston K.G. Radioembolization with 90 Yttrium microspheresa. Aa state-of-the-art brachytherapy treatment for primary and secondary liver malignancies, technical and methodologic considerations. J. Vasc. Intervent. Radiol. 2006; 17 (8): 1251-1278.

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9.    Таразов П.Г., Корытова Л.И., Шачинов Е.Г Внутриартериальная терапия рака молочной железы (обзор литературы). Вопросы онкологии. 2011; 57 (1): 126-131.

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11.  McCarter D.H.A. et al. Angiographic embolization of the distal internal mammary artery as an adjunct to regional chemotherapy in inoperable breast carcinoma. J. Vasc. Intervent. Radiol. 1995; 6 (2): 249-251.

Abstract:

46-year old man with obstructive jaundice has a complication of hemobilia after performed earlier percutaneous transhepatic biliary drainage (PTBD). Angiography failed to localize the bleeding site, that is why selective therapeutic embolization was not done. We performed implantation of Gore stent-graft into biliary ducts, and hemobilia stopped immediately.

Article exists only in Russian.

Abstract:

Hemobilia is known as one of the most severe complications of percutaneous transhepatic biliary drainage. In the present case, the severe bleeding developed as a result of balloon dilatation and stenting of malignant stricture. Emergency transhepatic arterial embolization was performed with good results. We also discuss 7 cases of hemobilia in our hospital, 3 of which were successfully treated with transcatheter embolotherapy. We conclude that transhepatic arterial embolization appears to be effective and safe treatment for massive hemobilia.

References 

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2.         Борисов А.Е., Борисова Н.А., Непомнящая С.Л. Диагностика и лечение гемобилии. Анн. хир. гепатологии. 2005; 10 (1): 40-45.

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6.         Saad W.E., Davies M.G., Darcy M.D. Management of bleeding after percutaneous transhepatic cholangiography or transhepatic biliary drain placement. Tech. Vasc. Interv. Radiol. 2008; 11 (1): 60-71.

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Article exists only in Russian.

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. 

References

1.     Tarazov P.G. Arterial radioembolization of liver malignancies with ittrium-90 microspheres (review). Voprosy onkologii. 2013; 59(4): 428-434 [In Russ].

2.     Lewandowski R.J., Geschwind J.-F., Liapi E., Salem R. Transcatheter intraarterial therapies: Rationale and overview. Radiology. 2011; 259(3): 641-657.

3.     Powerski M.J., Scheurig-Muenkel C., Banzen J., Schnappauff D., Hamm B., Gebauer B. Clinical practice in radioembolization of hepatic malignancies: A survey among interventional centers in Europe. Eur. J. Radiol. 2012; 81(7): e804-e811.

4.     Seidensticker R., Seidensticker M., Damm R., Mohnike K., Schutte K., Malfwertheiner P., Van Buskirk M., Pech M., Amthauer H., Ricke J. Hepatic toxicity after radioembolization of the liver using 90Y-micro- spheres: Sequential lobar versus whole liver approach. Cardiovasc. Intervent. Radiol. 2012; 35(5): 1109-1118.

5.     Garin E. Radioembolisation of hepatocellular carcinoma patients using 90Y-labelled microspheres: Towards a diffusion of the technique? Eur. J. Nucl. Med. Mol. Imaging. 2011; 38(12): 2114-2116.

6.     Atassi B., Bangash A.K., Lewandowski R.J., Ibrahim, Kulik L., Mulcahy M.F., Ryu R.K., Sato K.T., Miller F.H., Omary R.A., Salem R. Biliary sequelae following radioembolization with Yttrium-90 microspheres. J. Vasc. Interv. Radiol. 2008; 19(5): 691-697.

7.     Jakobs T.F., Saleem S., Atassi B., Reda E., Lewandowski R.J., Yaghmai V., Miller F., Ryu R.K., Ibrahim

5.,    Sato K.T., Kulik L.M., Mulcahy M.F., Omary R., Murthy R., Reiser M.F., Salem R. Fibrosis, portal hypertension, and hepatic volume changes induced by intra-arterial radiotherapy with 90Yttrium microspheres. Dig. Dis. Sci. 2008; 53(9): 2556-2563.

8.     Naymagon S., Warner R.R.P., Patel K., Harpaz N., Machac J., Weintraub J.L., Kim M.K. Gastroduodenal ulceration associated with radioembolization for the treatment of hepatic tumors: An institutional experience and review of the literature. Dig. Dis. Sci. 2010; 55(9): 24502458.

9.     Salem R., Lewandowski R.J., Mulcahy M.F., Riaz A., Ryu R.K., Ibrahim S., Atassi B., Baker T., Gates V., Miller F.H., Sato K.T., Wang E., Gupta R., Benson A.B., Newman S.B., Omary R.A., Abecassis M., Kulik L. Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: A comprehensive report of long-term outcomes. Gastroenterology. 2010; 138(1): 52-64.

10.   Salem R., Gilbertsen M., Butt Z., Memon K., Vouche M., Hickey R., Baker T., Abecassis M.M., Atassi R., Riaz A., Cella D., Burns J.L., Ganger D., Benson A.B., Miulcahy M.F., Kulik L., Lewandowsi R. Increased quality of life among hepatocellular carcinoma patients treated with radioembolization, compared with chemoembolization. Clin. Gastroenterol. Hepatol. 2013; 11(10): 1358-1365.

11.   Kim YH., Kim D.Y Yttrium-90 radioembolization for hepatocellular carcinoma: What we know and what we need to know. Oncology. 2013; 84 (suppl.1): 34-39.

12.   Memon K., Kulik L., Lewandowski R.J., Mulcahy M.F., Benson A.B., Ganger D., Riaz A., Gupta R., Vouche M., Gates V.L., Miller F.H., Omary R.A., Salem R. Radioembolization for hepatocellular carcinoma with portal vein thrombosis: Impact of liver function on systemic treatment options at disease progression. J. Hepatol. 2013; 58(1): 73-80.

13.   Moreno-Luna L.E., Yang J.D., Sanchez W., Paz- Fumagalli R., Harnois D.M., Mettler T.A., Gansen D.N., de Groen P.C., Lazaridis K.N., Menon K.W.N., LaRusso M.F., Alberts S.R., Gores G.J., Fleming C.J., Slettedahl S.W.. Harmsen W.S., Therneau T.M., Wiseman G.A., Andrews J.C., Roberts L.R. Efficacy and safety of transarterial radioembolization versus chemoembolization in patients with hepatocellular carcinoma. Cardiovasc. Intervent. Radiol. 2013; 36(3): 714-723.

14.   Tsai A.L., Burke C.T., Kennedy A.S., Moore D.T., Mauro M.A., Dixon R.D., Stavas J.M., Bernard S.A., Khandani A.H., O’Neil B.H. Use of yttrium-90 mocrospheres in patients with advanced hepatocellular carcinoma and portal vein thrombosis. J. Vasc. Interv. Radiol. 2010; 21(9): 1377-1384.

15.   Mazzaferro V., Sposito C., Bhoori S., Romito R., Chiesa C., Morosi C., Maccauro M., Marchiano A., Bongini M., Lanocita R., Civelli E., Bombardien E., Camerini T., Spreafico C. Yttrium-90 radioembolization for intermediate-advanced hepatocellular carcinoma: A phase 2 study. Hepatology. 2013; 57(5): 1826-1837.

16.   Stubbs R.S., Wickremesekera S.K. Selective internal radiation therapy (SIRT): A new modality for treating patients with colorectal liver metastases (review). HPB. 2004; 6(3): 133-139.

17.   Bester L., Meteling B., Pocock N., Pavlakis N., Chua T.C., Saxena A., Morris D.L. Radioembolization versus standard care of hepatic metastases: Comparative retrospective cohort study of survival outcomes and adverse events in salvage patients. J. Vasc. Interv. Radiol. 2012; 23(1): 96-105.

18.   Mahnken A.H., Spreafico C., Maleux G.,Helmberger T., Jacobs T.F. Standards of practice in transarterial radioembolization. Cardiovasc. Intervent. Radiol. 2013; 36(3): 613-622.

19.   Brown R.E., Bower M.R., Metzger T.L., Scoggins C.R., McMaster K.M., Hall M.J., Tatum C., Martin R.C.G. Hepatectomy after hepatic arterial therapy with either yttrium-90 or drug-eluting bead chemotherapy: Is it safe? HPB. 2011; 13(2): 91-95.

20.   Ibrahim S.M., Kulik L., Baker T., Ryu R.K., Mulcahy M.F., Abecassis M., Salem R., Lewandowski R.J. Treating and downstaging hepatocellular carcinoma in the caudate lobe with yttrium-90 radioembolization. Cardiovasc. Intervent. Radiol. 2012; 35(5): 1094-1101.

21.   Tohme S., Sukato D., Chen H.-W., Amesur N., Zajko A.B., Humar A., Geller D.A., Marsh J.W., Tsung A. Yttrium- 90 radioembolization as a bridge to liver transplantation: A single-institution experience. J. Vasc. Interv. Radiol. 2013; 24(11): 1632-1638.

22.   Hoffmann R.-T., Jakobs T.F., Kubisch C.H., Stemmler H.J., Trumm C., Tatsch K., Helmberger T.K., Reiser M.F. Radiofrequency ablation after selective internal radiation therapy with yttrium 90 microspheres in metastatic liver disease - is it feasible? Eur. J. Radiol. 2010; 74(1): 199-205.

23.   Wasan H., Kennedy A., Coldwell D., Sangro B., Salem R. Integrating radioembolization with chemotherapy in the treatment paradigm for unresectable colorectal liver metastases (review). Am. J. Clin. Oncol. 2012; 35(3): 293-301.

24.   Edeline J., Lenoir L., Boudjama K., Rolland Y, Boulic A., Le Du F., Pracht M., Raoul J.-L., Clement B., Garin E., Boucher E. Volumetric changes after 90Y radioembolization for hepatocellular carcinoma in cirrhosis: An option to portal vein embolization in a preoperative setting? Ann. Surg. Oncol. 2013; 20(8): 2518-2525.

25.   Vouche M., Lewandowski R.J., Atassi R., Memon K., Gates V.L., Ryu R.K., Gaba R.C., Mulcahy M.F., Baker T., Sato K., Hickey R., Ganger D., Riaz A., Fryer J., Caicedo J.C., Abecassis M., Kulik L., Salem R. Radiation lobectomy: Time-dependent analysis of future liver remnant volume in unresectable liver cancer as a bridge to resection. J. Hepatol. 2013; 59(5): 1029-1036.

26.   Lam M.G.E.H., Louie J.D., Iagaru A.H., Goris M.L., Sze D.Y Safety of repeated yrrium-90 radioembolization. Cardiovasc. Intervent. Radiol. 2013; 36(5): 13201328.

27.   Fiore F., Cappelli A., Rodrigues M., Ettorre G.M., Saltarelli A., Geatti O., Ahmadzadehfar H., Haug A.R., Izzo F., Giampalma E., Sangro B., Pizzi G., Notarianni E., Vit A., Wilhelm K., Jacobs T.F., Lastoria S. Comparison of the survival and tolerability of radioembolization in elderly vs younger patients with unresectable hepatocellular carcinoma. J. Hepatol. 2013; 59(4): 753-761. 

Abstract:

Aim: was to estimate possibilities of optical coherence tomography (OCT) in diagnostics of pathology of bile ducts in combination with percutaneous transhepatic biliary drainage (PTBD).

Materials and methods: examined 5 patients with obstructive jaundice, suspected cancerous etiology OCT was performed during or 5-14 days after PTBD. For morphological confirmation of results we performed forceps intraductal biopsies.

Results: tomographic evidences of the malignant stricture were revealed in 4 (80%) patients anc in 1 patient benign stricture was determined. Diagnoses were confirmed histologically (80%) and clinically (20%). Sensitivity of the OCT was 100%.

Conclusion: percutaneous transhepatic OCT appeared to be a perspective method for differential diagnostics of biliary strictures. 

References

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7.     Zagajnova E.V. Diagnosticheskaja cennost' opticheskoj kogerentnoj tomografii v jendoskopii. [Diagnostic value of optical coherence tomography in endoscopy]Avtoreferat. Diss. dokt. med. nauk. N. Novgorod. 2007; S27 [In Russ].

8.     Arvanitakis M., Hookey L., Tessier G. et al. Intraductal optical coherence tomography during endoscopic retrograde cholangiopancreatography for investigation of biliary strictures. Endoscopy. 2009; 41: 696-701. [PMID: 19618343 D0I:10.1055/s-0029-1214950].

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Abstract:

Inflammatory breast cancer (BC) is a locally-spread unresectable primary diffuse form of tumor, occurring in 1- 6% of patients with breast cancer, and is one of the most malignant forms of cancer with a poor prognosis and a low survival rate.

The article describes the clinical case of successful experience in the application of repeated chemoembolization and one cycle of radical radiation therapy in patient with metastatic breast cancer (inflammatory form), resistant to conduct systemic chemotherapy (possibility to transfer tumor into operable condition).

Patient underwent three cycles of chemoembolization into right internal thoracic artery, followed by radical radiotherapy The combination of these techniques allowed to reach a complete response to treatment and subsequently perform a radical mastectomy. Postoperative follow-up period is 85 months of remission without specific therapy.

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