Abstract: Introduction: the review is devoted to clinical results of the use of radiological and endovascular interventionsin intrahepatic cholangiocarcinoma: chemoinfusion, chemo- and radioembolization of the hepatic artery, preoperative embolization of right branch of portal vein. Aim: was to evaluate and compare the effectiveness of methods of intravascular therapy for intrahepatic cholangiocarcinoma. Materials and methods: article presents an analysis of 50 scientific literature sources in leading domestic and foreign scientific journals. Results: it was found that intra-arterial treatment methods have approximately the same clinical efficacy. Chemoinfusion is a technically simple and effective method of treatment, prospects of which are associated with the creation of new chemotherapy drugs and therapeutic regimens. Chemoembolization is most effective for hypervascular cholangiocarcinoma. The question of its use in a neoadjuvant mode requires study, even in resectable cases, it helps to reduce the biological activity of the tumor. Radioembolization (RE) effectively slows down the growth of cholangiocarcinoma and is well tolerated by patients, but long-term results are little bit worse to those of infusion and embolization. The procedure seems to be technically difficult and requires expensive logistics. When solving these problems, ER can become one of the most important methods of treating cholangiocarcinoma, especially when the tumor is resistant to other methods of therapy. Preoperative portal vein embolization is routinely used in clinical practice. However, operations performed after this procedure account for only 3-6% of all liver resections. The wider application of this technically simple and safe technique seems logical. 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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.
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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). 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Gastroduodenal artery embolization during endovascular interventions in cirrhosis and tumors of the liver. Vestnik Khirugii. 1988; 140(1): 83- 85 [In Russ]. 18. Lopez-Benitez R, Hallscheidt P, Kratochwil C et al. Protective embolization of the gastroduodenal artery with a one HydroCoil technique in radioembolization procedures. Cardiovascular and Interventional Radiology. 2013; 36(1): 105-110. 19. Enriquez J, Javadi S, Murthy R et al. Gastroduodenal artery recanalization after transcatheter fibered coil embolization for prevention of hepatoenteric flow: incidence and predisposing technical factors in 142 patients. Acta Radiologica. 2013; 54(7): 790-794. 20. Kubota H, Nimura X Hayakawa N, Shionoya S. Hepatic transcatheter arterial embolization with gastroduodenal artery blocking by finger compression. Radiology. 1989; 170(2): 562-563. 21. Tarazov PG, Pavlovskij AV, Granov DA. Oily chemoembolization of pancreatic head adenocarcinoma. Cardiovascular Interventional Radiology. 2001; 24(6): 424-426. 22. Karimov Shi, Borovskiy SP, Khakimov MSh, Adylkhodzhaev AA. Regional chemotherapy in the treatment of unresectable pancreatic tumors. Annaly Khirurgicheskoy Gepatologii. 2010; 15(3): 105-109 [In Russ]. 23. Khayrutdinov ER, Tsurkan VA, Arablinskiy AV, Gromov DG. First experience in using transradial arterial approach in selective chemoembolization of malignant pancreatic tumor. Diagnosticheskaya i Intervenzionnaya Radiologiya. 2017; 11(4): 81-85 [In Russ].
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 1. Unger L, Stork T, Bucsics T, et al. The role of TIPS in the management of liver transplant candidates. United Eur. Gastroenterol. J. 2017; 5 (8): 1100-1107. 2. Garcia-Pagan JC, Caca K, Bureau C, et al. Early use of TIPS in patients with cirrhosis and variceal bleeding. N. Engl. J. Med. 2010; 362 (25): 2370-2379. 3. Bacalbasa N, Balescu I, Brasoveanu V. Celiac Trunk Stenosis Treated by Resection and Splenic Patch Reconstruction - A Case Report and Literature Review. In Vivo. 2018; 32 (3): 699-702. 4. Degheili J., Chediak A., Dergham M, et al. Pancreaticoduodenal Artery Aneurysm Associated with Celiac Trunk Stenosis: Case Illustration and Literature Review. Hindawi. Case reports in radiology. Volume 2017, Article ID 6989673,7 pages. 5. Uchida H, Sakamoto S, Matsunami M., et al. Hepatic artery reconstruction preserving the pancreaticoduodenal arcade in pediatric liver transplantation with celiac axis compression syndrome: report of a case. Pediatr. Transplant. 2014; 18 (7): 232-235. 6. Katsura M, Gushimiyagi M, Takara H, et al. True aneurysm of the pancreaticoduodenal arteries: a single institution experience. Journal of Gastrointestinal Surgery. 2010; 14 (9): 1409-1413. 7. Chiang K, Johnson C, McKusick M, et al. Management of inferior pancreaticoduodenal artery aneurysms: a 4-year, single centre experience. CardioVascular and Interventional Radiology. 1994; 17 (4): 217-221. 8. Koganemaru M, Abe T, Nonoshita M, et al. Follow-up of true visceral artery aneurysm after coil embolization by three-dimensional contrast-enhanced MR angiography. Diagnostic and Interventional Radiology. 2014; 20 (2): 129-135. 9. Bastante D, Raya M, Rabelo V., et al. Analysis of ischemic cholangiopathy after treatment of arterial thrombosis in liver transplantation in our series. Transplant Proc. 2018; 50 (2): 628-630. 10. Polikarpov AA, Tarazov PG, Granov DA, Polysalov VN. Arterial aneurysm of internal organs: the role of angiography and transcatheter embolization. Regional blood circulation and microcirculation. 2002; 1 (2): 30-36 [In Russ]. 11. Tien Y-W, Kao H-L, Wang H-P. Celiac artery stenting: a new strategy for patients with pancreaticoduodenal artery aneurysm associated with stenosis of the celiac artery. Journal of Gastroenterology. 2004; 39 (1): 81-85. 12. Granov AM, Granov DA, Zherebcov FK, Polysalov VN, Gerasimova OA et al. Experience of 100 liver transplantation in RSCRST. Herald of surgery I.I. Grekov. 2012; 171 (2): 74-77 [In Russ]. 13. Gautier SV, Moysuk YG, Homyakov SM. Organ donation and transplantation in Russian Federation in 2014. 7-th report of National Register. Russian Journal of Transplantology and Artificial Organs. 2015; 17 (2): 7-22 [In Russ]. 14. Tarazov PG, Granov DA, Polikarpov AA, Generalov MI. Orthotopic liver transplantation: The role of interventional radiology. Herald of transplantology and artificial organs. 2009; 3: 42-50 [In Russ].
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. Reference 1. Поликарпов А.А. Рентгеноэндоваскулярные вмешательства в лечении нерезектабельных злокачественных опухолей печени. Дис. д-ра мед. наук. С.-Пб. 2006; 161. 2. Таразов П.Г. Роль методов интервенционной радиологии в лечении больных с метастазами колоректального рака в печень. Практ. онкол. 2005; 6 (2):119-126. 3. Hashimoto M., Watanabe O., Takahashi S. et al. Efficacy and safety of hepatic artery infusion catheter placement without fixation in the right gastroepiploic artery.J. Vasc. Intervent. Radiol. 2005; 16 (4): 465-470. 4. Habbe T., McCowan T., Goertzen T. et al. Complicationsand technical limitations of hepatic arterial infusioncatheter placement for chemotherapy.J. Vasc. Interv. Radiol. 1998; 9 (2): 233-239. 5. Sullivan R. Continuous arterial infusion cancer chemotherapy. Surg. Clin. N.Amer. 1962; 42: 365-388. 6. Watkins E., Khazei A., Nahra K. Surgical basis for arterial infusion chemotherapy of disseminated carcinoma of the liver. Surg. Gynecol. Obstet. 1970; 130 (4): 581-605. 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 1. Таразов П.Г. Артериальная химиоинфузия в лечении нерезектабельных злокачественных опухолей печени (обзор литературы). Вопр. онкол. 2000; 46 (5): 521-528. 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. 6. Chuang V, Wallace S., Stroehlein J. et al. Hepatic artery infusion chemotherapy: Gastroduodenal complication. Am.]. Roentgenol. 1981; 137: 347-350. 7. Cohen A., Kemeny N., К hne C. et al. Is intra-arterial chemotherapy worthwhile in the treatment of patients with unresectable hepatic colorectal cancer metastases? Eur.J. Cancer. 1996; 32: 2195-2205. 8. Doria M., Doria L., Faintuch J., Levin B. Gastric mucosal injury after hepatic arterial infusion chemotherapy with floxuridine: A clinical and pathologic study. Cancer. 1994; 73 (8): 2042-2047. 9. Bledin A., Kantarjian H., Kim E. et al. 99mTc-labeled macroaggregated albumin in intrahepatic arterial chemotherapy. Am.]. Roentgenol. 1982; 139:711-715. 10. Kaplan W, Ensminger W, Come S. et al. Radionuclide angiography to predict patient response to hepatic artery chemotherapy. Cancer Treat. Rep. 1980; 64: 1217-1222. 11. Frye J., Venook A., Ostoff J. et al. Hepatic intra-arterial methylene blue injection during endoscopy: A method of detecting gastroduodenal misperfusion in patients re ceiving hepatic intra-arterial chemotherapy via implan ted pump. Gastrointestinal Endoscopy. 1992; 38 (1): 52-54. 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.
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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 1. Гранов А.М., Давыдов М.И. Интервенционная радиология в онкологии. С.-Пб.: «Фолиант». 2007; 344. 2. Chuang V.P., Wallace S. Hepatic arterial redistribution for intraarterial infusion of hepatic neoplasms. Radiology. 1980; 135 (2): 295-299. 3. Таразов П.Г., Рыжков В.К. Эмболизация гастродуоденальной артерии при рентгеноэндоваскулярных вмешательствах по поводу цирроза и опухолей печени. Вестник хирургии. 1988; 140 (1): 83-85. 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. 7. Woods D. et al. Gluteal artery occlusion. Intraarterial chemotherapy of pelvic neoplasms. Radiology. 1985; 155 (2): 341-343. 8. Корытова Л.И., Гранов А.М., Хазова Т.В. и др. Способ лечения инфильтративно-отечного рака молочной железы. 2177349, Б.И. 2001. 9. Таразов П.Г., Корытова Л.И., Шачинов Е.Г Внутриартериальная терапия рака молочной железы (обзор литературы). Вопросы онкологии. 2011; 57 (1): 126-131. 10. Doughty J.C. et al. Anatomical basis of intraarterial chemotherapy for patients with locally advanced breast cancer. Br. J. Surg. 1996; 83 (8): 1128-1130. 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.
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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.
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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 1. Хачатуров А.А., Капранов С.А., Кузнецова В.Ф. и др. Актуальные вопросы чреспече-ночного эндобилиарного стентирования при злокачественных блоках желчеотделения. Диагностическая и интервенционная радиология. 2008; 2 (3): 33-47. 2. Борисов А.Е., Борисова Н.А., Непомнящая С.Л. Диагностика и лечение гемобилии. Анн. хир. гепатологии. 2005; 10 (1): 40-45. 3. Savader S.J., Trerotola S.O., Merine D.S. et al. Hemobilia after percutaneous transhepatic billiary drainage. Treatment with transcathe-ter embolotherapy. J.Vasc. Intervent. Radiol. 1992; 3 (2): 345-352. 4. Winick A.B., Waybill P.N., Venbrux A.C. Complications of percutaneous transhepatic biliary interventions. Tech. Vasc. Intern Radiol. 2001; 4 (3): 200-206. 5. Fidelman N., Bloom A.I., Kerlan R.K. et al.Hepatic arterial injuries after percutaneous biliary interventions in the era of laparoscopic surgery and liver transplantation. Experience with 930 patients. Radiology. 2008; 247 (3):880-886. 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. 7. Green M.H., Duell R.M., Johnson C.D, Jamieson N.V. Haemobilia. Br. J. Surg. 2001; 88 (6):773-786. 8. Hsu K.L., Ko S.F., Chou F.F. et al. Massive hemo-bilia. Hepatogastroenterology. 2002; 49 (44): 306-310. 9. Долгушин Б.И., Виршке Э.Р., Черкасов В.А.и др. Селективная эмболизация печеночных артерий при геморрагических осложнениях чрескожной чреспеченочной холангиографии. Анн. хир. гепатологии. 2007; 12 (4): 63-68. 10. Eurvilaichit C. Iatrogenic hemobilia. Management with transarterial embolization using gelfoam articles. J. Med. Assoc. Thai. 1999; 82 (9): 931-937. 11. Park J.Y., Ryu H., Bang S. et al. Hepatic artery pseudoaneurysm associated with plastic biliary stent. Yonsei. Med. J. 2007; 48 (3): 546-548. 12. Hammer F.D., Goffette P.P., Mathurin P. Glue embolization of a ruptured pancreaticoduo-denal artery aneurysm. Case report. Eur. Radiol. 1996; (4): 514-517. 13. Merrell S.V., Gibberston J.J., Albo D. et al. Atraumatic hemobilia arising from cirrhotic liver. Surgery. 1989; 106 (1): 105-109. 14. Rai R., Rose J., Manas D. Potentially fatal hae-mobilia due to inappropriate use of an expanding biliary stent. World. J. Gastroenterol. 2003; 9 (10): 2377-2378. 15. Dousset B., Sauvanet A., Bardou M. et al. Selective surgical indications for iatro-genic hemobilia. Surgery. 1997; 121 (1): 37-41.
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 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. 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