Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 4/2009

01.07.2009 | Review

Analysis of Nontarget Embolization Mechanisms During Embolization and Chemoembolization Procedures

verfasst von: Rubén López-Benítez, Götz M. Richter, Hans-Ulrich Kauczor, Sibylle Stampfl, Juliane Kladeck, Boris A. Radeleff, Martin Neukamm, Peter J. Hallscheidt

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 4/2009

Einloggen, um Zugang zu erhalten

Abstract

Complications of embolization and chemoembolization remain a problem even with the development of low-profile catheter material and the introduction of new embolization agents. In recent years many new embolization materials have become available for clinical use, so the possibilities and limitations of these new materials must be understood to allow safe and effective embolization. Although up to now some scientific work has been published reporting the basic risk of embolization procedures, the underlying pathomechanism remains the object of speculation. Besides complications like drug toxicity, allergic reactions, and bleeding of the puncture site, the characteristics of embolization materials must be known to understand the potential complications of nontarget embolization and reflux of embolization material. This article gives an overview of established and new embolization materials, their potential risks, and the underlying pathophysiology.
Literatur
1.
Zurück zum Zitat Liapi E, Geschwind JF (2007) Transcatheter and ablative therapeutic approaches for solid malignancies. J Clin Oncol 25:978–986PubMedCrossRef Liapi E, Geschwind JF (2007) Transcatheter and ablative therapeutic approaches for solid malignancies. J Clin Oncol 25:978–986PubMedCrossRef
2.
Zurück zum Zitat Lohle PN, Boekkooi FP, Smeets AJ et al (2006) Limited uterine artery embolization for leiomyomas with tris-acryl gelatin microspheres: 1-year follow-up. J Vasc Interv Radiol 17:283–287PubMed Lohle PN, Boekkooi FP, Smeets AJ et al (2006) Limited uterine artery embolization for leiomyomas with tris-acryl gelatin microspheres: 1-year follow-up. J Vasc Interv Radiol 17:283–287PubMed
3.
Zurück zum Zitat Sakamoto I, Aso N, Nagaoki K et al (1998) Complications associated with transcatheter arterial embolization for hepatic tumors. Radiographics 18:605–619PubMed Sakamoto I, Aso N, Nagaoki K et al (1998) Complications associated with transcatheter arterial embolization for hepatic tumors. Radiographics 18:605–619PubMed
4.
Zurück zum Zitat Lopez-Benitez R, Radeleff BA, Barragan-Campos HM et al (2007) Acute pancreatitis after embolization of liver tumors: frequency and associated risk factors. Pancreatology 7:53–62PubMedCrossRef Lopez-Benitez R, Radeleff BA, Barragan-Campos HM et al (2007) Acute pancreatitis after embolization of liver tumors: frequency and associated risk factors. Pancreatology 7:53–62PubMedCrossRef
5.
Zurück zum Zitat Malagari K, Chatzimichael K, Alexopoulou E et al (2008) Transarterial chemoembolization of unresectable hepatocellular carcinoma with drug eluting beads: results of an open-label study of 62 patients. Cardiovasc Interv Radiol 31:269–280CrossRef Malagari K, Chatzimichael K, Alexopoulou E et al (2008) Transarterial chemoembolization of unresectable hepatocellular carcinoma with drug eluting beads: results of an open-label study of 62 patients. Cardiovasc Interv Radiol 31:269–280CrossRef
6.
Zurück zum Zitat Leung DA, Goin JE, Sickles C, Raskay BJ, Soulen MC (2001) Determinants of postembolization syndrome after hepatic chemoembolization. J Vasc Interv Radiol 12:321–326PubMedCrossRef Leung DA, Goin JE, Sickles C, Raskay BJ, Soulen MC (2001) Determinants of postembolization syndrome after hepatic chemoembolization. J Vasc Interv Radiol 12:321–326PubMedCrossRef
7.
Zurück zum Zitat Sharara AI, Rockey DC (2001) Gastroesophageal variceal hemorrhage. N Engl J Med 345:669–681PubMedCrossRef Sharara AI, Rockey DC (2001) Gastroesophageal variceal hemorrhage. N Engl J Med 345:669–681PubMedCrossRef
8.
Zurück zum Zitat O’Rourke MF, Nichols WW (2007) Timing and amplitude of wave reflection. Hypertension 49:E3, author reply E4PubMedCrossRef O’Rourke MF, Nichols WW (2007) Timing and amplitude of wave reflection. Hypertension 49:E3, author reply E4PubMedCrossRef
9.
10.
Zurück zum Zitat O’Rourke MF, Nichols WW, Murgo JP (2007) Noninvasive input impedance of the human systemic circulation. Hypertension 50:e16, author reply e17PubMedCrossRef O’Rourke MF, Nichols WW, Murgo JP (2007) Noninvasive input impedance of the human systemic circulation. Hypertension 50:e16, author reply e17PubMedCrossRef
11.
Zurück zum Zitat Stampfl S, Stampfl U, Rehnitz C et al (2007) Experimental evaluation of early and long-term effects of microparticle embolization in two different mini-pig models. Part I: Kidney. Cardiovasc Interv Radiol 30:257–267CrossRef Stampfl S, Stampfl U, Rehnitz C et al (2007) Experimental evaluation of early and long-term effects of microparticle embolization in two different mini-pig models. Part I: Kidney. Cardiovasc Interv Radiol 30:257–267CrossRef
12.
Zurück zum Zitat Derdeyn CP, Graves VB, Salamat MS, Rappe A (1997) Collagen-coated acrylic microspheres for embolotherapy: in vivo and in vitro characteristics. Am J Neuroradiol 18:647–653PubMed Derdeyn CP, Graves VB, Salamat MS, Rappe A (1997) Collagen-coated acrylic microspheres for embolotherapy: in vivo and in vitro characteristics. Am J Neuroradiol 18:647–653PubMed
13.
Zurück zum Zitat Siskin GP, Dowling K, Virmani R, Jones R, Todd D (2003) Pathologic evaluation of a spherical polyvinyl alcohol embolic agent in a porcine renal model. J Vasc Interv Radiol 14:89–98PubMed Siskin GP, Dowling K, Virmani R, Jones R, Todd D (2003) Pathologic evaluation of a spherical polyvinyl alcohol embolic agent in a porcine renal model. J Vasc Interv Radiol 14:89–98PubMed
14.
Zurück zum Zitat Siskin GP, Englander M, Stainken BF, Ahn J, Dowling K, Dolen EG (2000) Embolic agents used for uterine fibroid embolization. AJR 175:767–773PubMed Siskin GP, Englander M, Stainken BF, Ahn J, Dowling K, Dolen EG (2000) Embolic agents used for uterine fibroid embolization. AJR 175:767–773PubMed
15.
Zurück zum Zitat Stampfl S, Stampfl U, Rehnitz C et al (2007) Experimental evaluation of early and long-term effects of microparticle embolization in two different mini-pig models. Part II: liver. Cardiovasc Interv Radiol 30:462–468CrossRef Stampfl S, Stampfl U, Rehnitz C et al (2007) Experimental evaluation of early and long-term effects of microparticle embolization in two different mini-pig models. Part II: liver. Cardiovasc Interv Radiol 30:462–468CrossRef
16.
Zurück zum Zitat Huo TI, Lui WY, Wu JC et al (2004) Deterioration of hepatic functional reserve in patients with hepatocellular carcinoma after resection: incidence, risk factors, and association with intrahepatic tumor recurrence. World J Surg 28:258–262PubMedCrossRef Huo TI, Lui WY, Wu JC et al (2004) Deterioration of hepatic functional reserve in patients with hepatocellular carcinoma after resection: incidence, risk factors, and association with intrahepatic tumor recurrence. World J Surg 28:258–262PubMedCrossRef
17.
Zurück zum Zitat Kothary N, Weintraub JL, Susman J, Rundback JH (2007) Transarterial chemoembolization for primary hepatocellular carcinoma in patients at high risk. J Vasc Interv Radiol 18:1517–1526PubMedCrossRef Kothary N, Weintraub JL, Susman J, Rundback JH (2007) Transarterial chemoembolization for primary hepatocellular carcinoma in patients at high risk. J Vasc Interv Radiol 18:1517–1526PubMedCrossRef
18.
Zurück zum Zitat Wu SC, Chen RJ, Yang AD, Tung CC, Lee KH (2008) Complications associated with embolization in the treatment of blunt splenic injury. World J Surg 32(3):476–482PubMedCrossRef Wu SC, Chen RJ, Yang AD, Tung CC, Lee KH (2008) Complications associated with embolization in the treatment of blunt splenic injury. World J Surg 32(3):476–482PubMedCrossRef
19.
Zurück zum Zitat Takayasu K, Moriyama N, Muramatsu Y et al (1984) Splenic infarction, a complication of transcatheter hepatic arterial embolization for liver malignancies. Radiology 151:371–375PubMed Takayasu K, Moriyama N, Muramatsu Y et al (1984) Splenic infarction, a complication of transcatheter hepatic arterial embolization for liver malignancies. Radiology 151:371–375PubMed
20.
Zurück zum Zitat Khankan AA, Osuga K, Hori S, Morii E, Murakami T, Nakamura H (2004) Embolic effects of superabsorbent polymer microspheres in rabbit renal model: comparison with tris-acryl gelatin microspheres and polyvinyl alcohol. Radiat Med 22:384–390PubMed Khankan AA, Osuga K, Hori S, Morii E, Murakami T, Nakamura H (2004) Embolic effects of superabsorbent polymer microspheres in rabbit renal model: comparison with tris-acryl gelatin microspheres and polyvinyl alcohol. Radiat Med 22:384–390PubMed
21.
Zurück zum Zitat Stampfl S, Bellemann N, Stampfl U et al (2008) Inflammation and recanalization of four different spherical embolization agents in the porcine kidney model. J Vasc Interv Radiol 19:577–586PubMedCrossRef Stampfl S, Bellemann N, Stampfl U et al (2008) Inflammation and recanalization of four different spherical embolization agents in the porcine kidney model. J Vasc Interv Radiol 19:577–586PubMedCrossRef
22.
Zurück zum Zitat Lewis AL, Adams C, Busby W et al (2006) Comparative in vitro evaluation of microspherical embolisation agents. J Mater Sci: Mater Med 17:1193–1204CrossRef Lewis AL, Adams C, Busby W et al (2006) Comparative in vitro evaluation of microspherical embolisation agents. J Mater Sci: Mater Med 17:1193–1204CrossRef
23.
Zurück zum Zitat Laurent A, Wassef M, Saint Maurice JP et al (2006) Arterial distribution of calibrated tris-acryl gelatin and polyvinyl alcohol microspheres in a sheep kidney model. Invest Radiol 41:8–14PubMedCrossRef Laurent A, Wassef M, Saint Maurice JP et al (2006) Arterial distribution of calibrated tris-acryl gelatin and polyvinyl alcohol microspheres in a sheep kidney model. Invest Radiol 41:8–14PubMedCrossRef
24.
Zurück zum Zitat Laurent A, Wassef M, Chapot R, Houdart E, Merland JJ (2004) Location of vessel occlusion of calibrated tris-acryl gelatin microspheres for tumor and arteriovenous malformation embolization. J Vasc Interv Radiol 15:491–496PubMed Laurent A, Wassef M, Chapot R, Houdart E, Merland JJ (2004) Location of vessel occlusion of calibrated tris-acryl gelatin microspheres for tumor and arteriovenous malformation embolization. J Vasc Interv Radiol 15:491–496PubMed
25.
Zurück zum Zitat Yang X (2007) Nano- and microparticle-based imaging of cardiovascular interventions: overview. Radiology 243:340–347PubMedCrossRef Yang X (2007) Nano- and microparticle-based imaging of cardiovascular interventions: overview. Radiology 243:340–347PubMedCrossRef
26.
Zurück zum Zitat Lewis AL, Gonzalez MV, Lloyd AW et al (2006) DC bead: in vitro characterization of a drug-delivery device for transarterial chemoembolization. J Vasc Interv Radiol 17:335–342PubMedCrossRef Lewis AL, Gonzalez MV, Lloyd AW et al (2006) DC bead: in vitro characterization of a drug-delivery device for transarterial chemoembolization. J Vasc Interv Radiol 17:335–342PubMedCrossRef
27.
Zurück zum Zitat Nakamura H, Hashimoto T, Oi H, Sawada S, Furui S (1991) Prevention of gastric complications in hepatic arterial chemoembolization. Balloon catheter occlusion technique. Acta Radiol 32:81–82PubMedCrossRef Nakamura H, Hashimoto T, Oi H, Sawada S, Furui S (1991) Prevention of gastric complications in hepatic arterial chemoembolization. Balloon catheter occlusion technique. Acta Radiol 32:81–82PubMedCrossRef
28.
Zurück zum Zitat Dai H, Ding H, Liu F et al (2007) Complications of chemoembolization for hepatic neoplasms. Saudi Med J 28:1208–1212PubMed Dai H, Ding H, Liu F et al (2007) Complications of chemoembolization for hepatic neoplasms. Saudi Med J 28:1208–1212PubMed
29.
Zurück zum Zitat Prollius A, du Plessis A, Nel M (2005) Uterine artery embolization in HIV positive patients. Int J Gynaecol Obstet 88:67–68PubMedCrossRef Prollius A, du Plessis A, Nel M (2005) Uterine artery embolization in HIV positive patients. Int J Gynaecol Obstet 88:67–68PubMedCrossRef
30.
Zurück zum Zitat Chung JW, Park JH, Han JK et al (1996) Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization. Radiology 198:33–40PubMed Chung JW, Park JH, Han JK et al (1996) Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization. Radiology 198:33–40PubMed
31.
Zurück zum Zitat Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire (1995) A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. N Engl J Med 332:1256–1261CrossRef Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire (1995) A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. N Engl J Med 332:1256–1261CrossRef
32.
33.
Zurück zum Zitat Varela M, Real MI, Burrel M et al (2007) Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol 46:474–481PubMedCrossRef Varela M, Real MI, Burrel M et al (2007) Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol 46:474–481PubMedCrossRef
34.
Zurück zum Zitat Llovet JM, Real MI, Montana X et al (2002) Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 359:1734–1739PubMedCrossRef Llovet JM, Real MI, Montana X et al (2002) Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 359:1734–1739PubMedCrossRef
35.
Zurück zum Zitat Roullet MH, Denys A, Sauvanet A, Farges O, Vilgrain V, Belghiti J (2002) Acute clinical pancreatitis following selective transcatheter arterial chemoembolization of hepatocellular carcinoma. Ann Chir 127:779–782PubMedCrossRef Roullet MH, Denys A, Sauvanet A, Farges O, Vilgrain V, Belghiti J (2002) Acute clinical pancreatitis following selective transcatheter arterial chemoembolization of hepatocellular carcinoma. Ann Chir 127:779–782PubMedCrossRef
36.
Zurück zum Zitat Xia J, Ren Z, Ye S et al (2006) Study of severe and rare complications of transarterial chemoembolization (TACE) for liver cancer. Eur J Radiol 59:407–412PubMedCrossRef Xia J, Ren Z, Ye S et al (2006) Study of severe and rare complications of transarterial chemoembolization (TACE) for liver cancer. Eur J Radiol 59:407–412PubMedCrossRef
37.
Zurück zum Zitat Kauffmann GW, Richter GM, Rohrbach R, Wenz W (1989) Prolonged survival following palliative renal tumor embolization by capillary occlusion. Cardiovasc Interv Radiol 12:22–28CrossRef Kauffmann GW, Richter GM, Rohrbach R, Wenz W (1989) Prolonged survival following palliative renal tumor embolization by capillary occlusion. Cardiovasc Interv Radiol 12:22–28CrossRef
Metadaten
Titel
Analysis of Nontarget Embolization Mechanisms During Embolization and Chemoembolization Procedures
verfasst von
Rubén López-Benítez
Götz M. Richter
Hans-Ulrich Kauczor
Sibylle Stampfl
Juliane Kladeck
Boris A. Radeleff
Martin Neukamm
Peter J. Hallscheidt
Publikationsdatum
01.07.2009
Verlag
Springer-Verlag
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 4/2009
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-009-9568-9

Weitere Artikel der Ausgabe 4/2009

CardioVascular and Interventional Radiology 4/2009 Zur Ausgabe

PET kann infarktgefährdete Koronararterien entdecken

04.06.2024 Koronare Herzerkrankung Nachrichten

Der Nachweis aktiver Plaques mittels 18F-Natriumfluorid-PET hilft nicht nur, infarktgefährdete Patienten, sondern auch infarktgefährdete Koronararterien zu erkennen. Von einer gezielten Behandlung vulnerabler Plaques ist man trotzdem weit entfernt.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.