Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 5/2013

01.10.2013 | Clinical Investigation

Downstream Hepatic Arterial Blood Pressure Changes Caused by Deployment of the Surefire AntiReflux Expandable Tip

verfasst von: Steven C. Rose, Steven G. Kikolski, James E. Chomas

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 5/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this work was to evaluate blood pressure changes caused by deployment of the Surefire antireflux expandable tip. The pressure measurements are relevant because they imply changes in hepatoenteric arterial blood flow within this liver compartment during hepatic artery delivery of cytotoxic agents.

Methods

After positioning the Surefire antireflux system in the targeted hepatic artery, blood pressure was obtained initially with the tip collapsed (or through a femoral artery sheath), then again after the tip was expanded before chemoembolization or yttrium 90 (90Y) radioembolization.

Results

Eighteen patients with liver malignancy underwent 29 procedures in 29 hepatic arteries (3 common hepatic, 22 lobar, 4 segmental). Systolic, diastolic, and mean blood pressure were all decreased by a mean of 29 mm Hg (p = 0.000004), 14 mm Hg (p = 0.0000004), and 22 mm Hg (p = 0.00000001), respectively.

Conclusion

When the Surefire expandable tip is deployed to prevent retrograde reflux of agents, it also results in a significant decrease in blood pressure in the antegrade distribution, potentially resulting in hepatopedal blood flow in vessels that are difficult to embolize, such as the supraduodenal arteries.
Literatur
1.
Zurück zum Zitat López-Benítez R, Richter GM, Kauczor H-U et al (2009) Analysis of nontarget embolization mechanisms during embolization and chemoembolization procedures. Cardiovasc Intervent Radiol 32:615–622PubMedCrossRef López-Benítez R, Richter GM, Kauczor H-U et al (2009) Analysis of nontarget embolization mechanisms during embolization and chemoembolization procedures. Cardiovasc Intervent Radiol 32:615–622PubMedCrossRef
2.
Zurück zum Zitat Murthy R, Brown DB, Salem R et al (2007) Gastrointestinal complications associated with hepatic arterial yttrium-90 microsphere therapy. J Vasc Interv Radiol 18:553–562PubMedCrossRef Murthy R, Brown DB, Salem R et al (2007) Gastrointestinal complications associated with hepatic arterial yttrium-90 microsphere therapy. J Vasc Interv Radiol 18:553–562PubMedCrossRef
3.
Zurück zum Zitat Riaz A, Lewandowski RJ, Kulik LM et al (2009) Complications following radioembolization with yttrium-90 microspheres: A comprehensive literature review. J Vasc Interv Radiol 20:1121–1130PubMedCrossRef Riaz A, Lewandowski RJ, Kulik LM et al (2009) Complications following radioembolization with yttrium-90 microspheres: A comprehensive literature review. J Vasc Interv Radiol 20:1121–1130PubMedCrossRef
4.
Zurück zum Zitat Kennedy AS, McNeillie P, Dezarn WA et al (2009) Treatment parameters and outcome in 680 treatments of internal radiation with resin 90Y-microspheres for unresectable hepatic tumors. Int J Radiation Oncology Biol Phys 74:1494–1500CrossRef Kennedy AS, McNeillie P, Dezarn WA et al (2009) Treatment parameters and outcome in 680 treatments of internal radiation with resin 90Y-microspheres for unresectable hepatic tumors. Int J Radiation Oncology Biol Phys 74:1494–1500CrossRef
5.
Zurück zum Zitat Salem R, Lewandowski RJ, Mulcahy MF et al (2010) Radioembolization for hepatocellular carcinoma using yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 138:52–64PubMedCrossRef Salem R, Lewandowski RJ, Mulcahy MF et al (2010) Radioembolization for hepatocellular carcinoma using yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 138:52–64PubMedCrossRef
6.
Zurück zum Zitat Sangro B, Carpanese L, Cianni R et al (2011) Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona Clinic Liver Cancer stages: A European evaluation. Hepatology 54:868–878PubMedCrossRef Sangro B, Carpanese L, Cianni R et al (2011) Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona Clinic Liver Cancer stages: A European evaluation. Hepatology 54:868–878PubMedCrossRef
7.
Zurück zum Zitat Bester L, Meteling B, Pavlakis N, Chua TC, Saxena A, Morris DL (2012) Radioembolization versus standard care of hepatic metastases: Comparative retrospective cohort study of survival outcomes and adverse events of salvage patients. J Vasc Interv Radiol 23:96–105PubMedCrossRef Bester L, Meteling B, Pavlakis N, Chua TC, Saxena A, Morris DL (2012) Radioembolization versus standard care of hepatic metastases: Comparative retrospective cohort study of survival outcomes and adverse events of salvage patients. J Vasc Interv Radiol 23:96–105PubMedCrossRef
8.
Zurück zum Zitat Liu DM, Salem R, Bui JT et al (2005) Angiographic considerations in patients undergoing liver-directed therapy. J Vasc Interv Radiol 16:911–935PubMedCrossRef Liu DM, Salem R, Bui JT et al (2005) Angiographic considerations in patients undergoing liver-directed therapy. J Vasc Interv Radiol 16:911–935PubMedCrossRef
9.
Zurück zum Zitat Lewandowski RJ, Sato KT, Atassi B et al (2007) Radioembolization with 90Y microspheres: angiographic and technical considerations. Cardiovasc Invervent Radiol 30:571–592CrossRef Lewandowski RJ, Sato KT, Atassi B et al (2007) Radioembolization with 90Y microspheres: angiographic and technical considerations. Cardiovasc Invervent Radiol 30:571–592CrossRef
10.
Zurück zum Zitat Hong K, Chomas J, Kraitchman D, Naglreiter B, Arepathy A (2011) Quantification and reduction of reflux during embolotherapy using Micro CT and Tantalum Beads with ex-vivo analysis. World Conference of Interventional Oncology, New York Hong K, Chomas J, Kraitchman D, Naglreiter B, Arepathy A (2011) Quantification and reduction of reflux during embolotherapy using Micro CT and Tantalum Beads with ex-vivo analysis. World Conference of Interventional Oncology, New York
11.
Zurück zum Zitat Rose SC, Lim GM, Arellano RS, Easter DB, Roberts AC (1998) Temporary splenic artery balloon occlusion for protection of nonsplenic vascular beds during splenic embolization. AJR Am J Roentgenol 170:1186–1188PubMedCrossRef Rose SC, Lim GM, Arellano RS, Easter DB, Roberts AC (1998) Temporary splenic artery balloon occlusion for protection of nonsplenic vascular beds during splenic embolization. AJR Am J Roentgenol 170:1186–1188PubMedCrossRef
12.
Zurück zum Zitat Rose SC, Kikolski SG, Nutting CW, Sze DY (2012) Relationship of aortoceliac angle and the ability to advance a Surefire® Guidecath into the targeted hepatic artery. [Abstract 550209]. Global Embolization Symposium and Therapy Annual Meeting, New York Rose SC, Kikolski SG, Nutting CW, Sze DY (2012) Relationship of aortoceliac angle and the ability to advance a Surefire® Guidecath into the targeted hepatic artery. [Abstract 550209]. Global Embolization Symposium and Therapy Annual Meeting, New York
13.
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
14.
Zurück zum Zitat Mahvash A, Zaer N, Shaw C, Chasen B, Avritscher R, Murthy R (2012) Temporary balloon occlusion of the common hepatic artery for administration of yttrium-90 resin microspheres in a patient with patent hepatoenteric collaterals. J Vasc Interv Radiol 23:277–280PubMedCrossRef Mahvash A, Zaer N, Shaw C, Chasen B, Avritscher R, Murthy R (2012) Temporary balloon occlusion of the common hepatic artery for administration of yttrium-90 resin microspheres in a patient with patent hepatoenteric collaterals. J Vasc Interv Radiol 23:277–280PubMedCrossRef
15.
Zurück zum Zitat Haydar AA, Wasan H, Wilson C, Tait P (2010) 90Y Radioembolization: Embolization of the gastroduodenal artery is not always appropriate. Cardiovasc Intervent Radiol 33:1069–1071PubMedCrossRef Haydar AA, Wasan H, Wilson C, Tait P (2010) 90Y Radioembolization: Embolization of the gastroduodenal artery is not always appropriate. Cardiovasc Intervent Radiol 33:1069–1071PubMedCrossRef
16.
Zurück zum Zitat Abdelmaksoud MHK, Hwang GL, Louie JD et al (2010) Development of new hepaticoenteric collateral pathways after hepatic arterial skeletonization in preparation for yttrium-90 radioembolization. J Vasc Interv Radiol 21:1385–1395PubMedCrossRef Abdelmaksoud MHK, Hwang GL, Louie JD et al (2010) Development of new hepaticoenteric collateral pathways after hepatic arterial skeletonization in preparation for yttrium-90 radioembolization. J Vasc Interv Radiol 21:1385–1395PubMedCrossRef
17.
Zurück zum Zitat Bilbao JI, Garrastachu P, Herráiz MJ et al (2010) Safety and efficacy assessment of flow redistribution by occlusion of intrahepatic vessels prior to radioembolization in the treatment of liver tumors. Cardiovasc Intervent Radiol 33:523–531PubMedCrossRef Bilbao JI, Garrastachu P, Herráiz MJ et al (2010) Safety and efficacy assessment of flow redistribution by occlusion of intrahepatic vessels prior to radioembolization in the treatment of liver tumors. Cardiovasc Intervent Radiol 33:523–531PubMedCrossRef
Metadaten
Titel
Downstream Hepatic Arterial Blood Pressure Changes Caused by Deployment of the Surefire AntiReflux Expandable Tip
verfasst von
Steven C. Rose
Steven G. Kikolski
James E. Chomas
Publikationsdatum
01.10.2013
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 5/2013
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-012-0538-2

Weitere Artikel der Ausgabe 5/2013

CardioVascular and Interventional Radiology 5/2013 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

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