Right Gastric Artery Embolization to Prevent Acute Gastric Mucosal Lesions in Patients Undergoing Repeat Hepatic Arterial Infusion Chemotherapy
Section snippets
Patients
Between 1993 and 1997, 331 patients in our institution underwent HAIC with use of radiologically placed intraarterial infusion catheters for treatment of malignant hepatic tumors. Of these 331 patients, we attempted RGA embolization in 217 and excluded the patients on the following grounds: 49 for a history of radical gastrectomy, 39 whose right gastric arteries had been previously ligated at the time of resection of primary cancer, and 26 in whom the RGA could not be confirmed on celiac,
Technical Outcome
RGA embolization was technically successful in 201 of 217 patients (93%) (Figure 1, Figure 2). The embolization materials used in RGA embolization were microcoils in 83 patients, n-BCA and iodized oil in 63, coils and n-BCA/iodized oil in 48, and 0.035-inch steel coils in seven. The Technical success rate improved gradually during the 5-year study: 84% in 1993, 90% in 1994, 96% in 1995, 94% in 1996, and 96% in 1997. Microcoil use increased, steel coil use decreased, and use of n-BCA/ iodized
DISCUSSION
Systemic chemotherapy is not effective treatment of unresectable hepatic neoplasms in most cases. Therefore, HAIC, chemoembolization, and ablative procedures are usually considered for local management. Chemoembolization is usually effective for hypervascular lesions such as hepatocellular carcinoma. Ablative procedures are also effective according to the number, size, and location of the lesions (17). However, in cases with multiple or advanced lesions unsuitable for these procedures and
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Retrograde embolization technique of the right gastric artery during the implantation of port-catheter system for hepatic arterial infusion chemotherapy
2021, Journal of Interventional MedicineCitation Excerpt :Third, AGMT was mostly diagnosed clinically using signs and symptoms of gastroduodenal inflammation and ulceration and only 4 cases were confirmed using endoscopy. This bias is also present in the report of Inaba et al.20; therefore, the actual incidence of AGMT in patients undergoing HAIC may be even higher than that reported in previous studies. In conclusion, it is very crucial to embolize the RGA as much as possible during port-catheter implantation for HAIC to reduce gastroduodenal mucosal injury.
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