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Yamashita H, Yagi K, Seto Y. How should we define the no. 3b lesser curvature lymph node? Gastric Cancer 2017; 20:558-559. [PMID: 27590750 DOI: 10.1007/s10120-016-0638-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 08/23/2016] [Indexed: 02/07/2023]
Affiliation(s)
- Hiroharu Yamashita
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Koichi Yagi
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Complications in hepatic arterial infusion chemotherapy: retrospective comparison of catheter tip placement in the right/left hepatic artery vs. the gastroduodenal artery. Surg Today 2017; 47:851-858. [PMID: 28188368 DOI: 10.1007/s00595-016-1465-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/28/2016] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare the complication rates associated with hepatic arterial infusion chemotherapy (HAIC) for unresectable hepatocellular carcinoma (HCC) using two different catheter tip locations, the right/left hepatic artery (group 1) and the gastroduodenal artery (group 2). METHODS Between April 2001 and March 2015, 88 patients (group 1, n = 36; group 2, n = 52) with unresectable HCC, underwent HAIC via a transfemorally placed infusion catheter. The incidence of complications related to catheter placement (including hepatic arterial occlusion, catheter dislocation, non-target embolization and port-catheter system infection) as well as catheter patency and patient survival were evaluated. RESULTS The technical success rate was 100%. The overall complication rate was 17% (15/88 patients). The specific complications were as follows: hepatic artery occlusion, n = 1 (group 2, n = 1), gastroduodenal ulcer, n = 6 (group 1, n = 2; group 2, n = 4); catheter dislocation, n = 1 (group 2, n = 1); port-catheter system infection, n = 3 (group 2, n = 3); and bleeding at the puncture site, n = 4 (group 1, n = 1; group 2, n = 3). CONCLUSIONS The complication rates in groups 1 and 2 did not differ to a statistically significant extent.
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Powerski MJ, Erxleben C, Scheurig-Münkler C, Geisel D, Hamm B, Gebauer B. Anatomic variants of arteries often coil-occluded prior to hepatic radioembolization. Acta Radiol 2015; 56:159-65. [PMID: 24477267 DOI: 10.1177/0284185114522148] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Prior to radioembolization (RE) treatment of malignant liver lesions, many interventionalists occlude the right gastric artery (RGA), the cystic artery (CA), and the gastroduodenal artery (GDA) to prevent radioactive microspheres from entering non-target vessels. PURPOSE To systematically analyze anatomic variants of arteries that are important to know for the interventional radiologist performing RE of the liver. MATERIAL AND METHODS The computed tomography (CT) angiographies and conventional angiographies of 166 patients evaluated for RE were retrospectively analyzed for the presence of anatomic variants of the RGA, GDA, and CA. RESULTS The RGA was found to arise from the left hepatic artery in 42% of cases, from the proper hepatic artery in 40%, from the GDA in 10%, from the right hepatic artery in 4%, and from the common hepatic artery in 3% of cases. The GDA originated in the common hepatic artery in 97% of cases, in the left hepatic artery in 2%, and in the celiac trunk in 1% of cases. The CA arose from the right hepatic artery in 96% of cases and from the GDA in 2% of cases; in 2% of our study population, the gallbladder was supplied by small branches from the liver parenchyma. CONCLUSION Variant anatomy of the RGA is common, while it is quite rare for the GDA and CA. Knowledge of the variations of liver supplying arteries helps the interventionalist to embolize necessary vessels prior to RE.
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Affiliation(s)
- Maciej J Powerski
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Erxleben
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Dominik Geisel
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Bernhard Gebauer
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Vesselle G, Petit I, Boucebci S, Rocher T, Velasco S, Tasu JP. Radioembolization with yttrium-90 microspheres work up: Practical approach and literature review. Diagn Interv Imaging 2014; 96:547-62. [PMID: 24776810 DOI: 10.1016/j.diii.2014.03.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Radioembolization (RE) is a selective internal radiotherapy technique in which yttrium-90 blended microspheres are infused through the hepatic arteries. It is based on the fact that primary and secondary hepatic tumors are vascularized mostly by arterial blood flow whereas healthy hepatocytes obtain their blood supply mostly from the portal network. This enables high radiation doses to be delivered, sparing the surrounding non-malignant liver parenchyma. Most of the complications are caused by unexpected particles passing into the gastrointestinal tract through branches originating from the main hepatic arterial supply. Knowledge of this hepatic arterial network and of its variations and the technical considerations this raises are required in preparation for treatment. This work describes the specific anatomical features and techniques for this anatomy through recent literature illustrated by cases from our own experience.
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Affiliation(s)
- G Vesselle
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France.
| | - I Petit
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
| | - S Boucebci
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
| | - T Rocher
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
| | - S Velasco
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
| | - J-P Tasu
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
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5
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Favelier S, Germain T, Genson PY, Cercueil JP, Denys A, Krausé D, Guiu B. Anatomy of liver arteries for interventional radiology. Diagn Interv Imaging 2014; 96:537-46. [PMID: 24534562 DOI: 10.1016/j.diii.2013.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The availability of intra-arterial hepatic therapies (radio and/or chemo-embolisation, intra-arterial hepatic chemotherapy) has convinced radiologists to perfect their knowledge of the anatomy of the liver arteries. These sometimes, complex procedures most often require selective arterial catheterization. Knowledge of the different arteries in the liver and the peripheral organs is therefore essential to optimize the procedure and avoid eventual complications. This paper aims to describe the anatomy of the liver arteries and the variants, applying it to angiography images, and to understand the implications of such variations in interventional radiological procedures.
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Affiliation(s)
- S Favelier
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France.
| | - T Germain
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - P-Y Genson
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - J-P Cercueil
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France; Unité Inserm U866, faculté de médecine, Dijon, France
| | - A Denys
- Département de radiologie interventionnelle, CHU Vaudois, Lausanne, Switzerland
| | - D Krausé
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - B Guiu
- Département de radiologie diagnostique et interventionnelle, unité digestif, thoracique et oncologique, CHU Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France; Unité Inserm U866, faculté de médecine, Dijon, France; Département de radiologie interventionnelle, CHU Vaudois, Lausanne, Switzerland
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Miyazaki M, Shibuya K, Tsushima Y, Endo K. Catheterization and embolization of a replaced left hepatic artery via the right gastric artery through the anastomosis: a case report. J Med Case Rep 2011; 5:346. [PMID: 21812957 PMCID: PMC3164626 DOI: 10.1186/1752-1947-5-346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 08/03/2011] [Indexed: 11/21/2022] Open
Abstract
Introduction Conversion of multiple hepatic arteries into a single vascular supply is a very important technique for repeat hepatic arterial infusion chemotherapy using an implanted port catheter system. Catheterization of a replaced left hepatic artery arising from a left gastric artery using a percutaneous catheter technique is sometimes difficult, despite the recent development of advanced interventional techniques. Case presentation We present a case of a 70-year-old Japanese man with multiple hepatocellular carcinomas in whom the replaced left hepatic artery arising from the left gastric artery needed to be embolized. After several failed procedures, the replaced left hepatic artery was successfully catheterized and embolized with a microcatheter and microcoils via the right gastric artery through the anastomosis. Conclusion A replaced left hepatic artery arising from a left gastric artery can be catheterized via a right gastric artery by using the appropriate microcatheter and microguidewires, and multiple hepatic arteries can be converted into a single supply.
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Yamagami T, Terayama K, Yoshimatsu R, Matsumoto T, Miura H, Nishimura T. Embolisation of the right gastric artery in patients undergoing hepatic arterial infusion chemotherapy using two possible approach routes. Br J Radiol 2010; 83:578-84. [PMID: 20442280 PMCID: PMC3473675 DOI: 10.1259/bjr/51736762] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 04/15/2009] [Accepted: 06/09/2009] [Indexed: 11/05/2022] Open
Abstract
We used a retrospective non-randomised study to investigate the clinical effect of selective embolisation of the right gastric artery before hepatic arterial infusion chemotherapy (HAIC) using a port-catheter system. We evaluated whether the hepatic artery or the left gastric artery is the better approach for selecting the right gastric artery. A total of 367 patients (244 men and 123 women; mean age, 64.1 years) with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system. In 294 of these patients, right gastric arterial embolisation with microcoils was attempted before placement of the port-catheter system to prevent gastric mucosal lesions. Approach was either through the hepatic artery (175 patients) or through the left gastric artery (119 patients), with success rates in catheterising the right gastric artery of 78.3% and 77.3%, respectively. If the attempt was unsuccessful, the catheter was redirected to the alternative approach, which increased the final success rate to 96.3%. Only seven patients experienced gastroduodenal mucosal lesions acutely after HAIC, as revealed by endoscopy. Embolisation of the right gastric artery is a feasible procedure that can reduce the incidence of gastric mucosal lesions associated with HAIC. Approach through either the hepatic artery or the left gastric artery is equally acceptable.
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Affiliation(s)
- T Yamagami
- Department of Radiology, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto 602-8566, Japan.
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