PURPOSE: The aim of this study was to assess the incidence, degree, and predictors of hepatic arterial damage (HAD) after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A total of 33 patients with unresectable HCC underwent TACE alone using a mixture of iodized oil, epirubicin, and gelatin sponge. A follow-up angiogram was available for 76 of 109 sessions, and HAD was evaluated at each subsegment of the hepatic artery using a three-grade scale (1, no or slight wall irregularity; 2, overt stenosis; 3, occlusion). Grades 2 and 3 were considered to indicate significant HAD. The predictors of HAD were analyzed by multivariate analysis. RESULTS: A total of 161 hepatic arteries were embolized from the lobar (n = 43), segmental (n = 40), subsegmental (n = 72), or more distal (n = 6) level. The follow-up period between the initial and last sessions ranged from 70 to 1505 days (median 497 days). Significant HAD occurred in 37 of 231 subsegmental hepatic arteries (16%) and in 16 of 33 patients (48%). The accumulated dose of epirubicin per artery (P = 0.001) and Child-Pugh score (P < 0.001) were significant predictors. CONCLUSION: TACE is more likely to induce HAD in cirrhotic patients with impaired liver function and when a high dose of the chemotherapeutic agent was used.
PURPOSE: The aim of this study was to assess the incidence, degree, and predictors of hepatic arterial damage (HAD) after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A total of 33 patients with unresectable HCC underwent TACE alone using a mixture of iodized oil, epirubicin, and gelatin sponge. A follow-up angiogram was available for 76 of 109 sessions, and HAD was evaluated at each subsegment of the hepatic artery using a three-grade scale (1, no or slight wall irregularity; 2, overt stenosis; 3, occlusion). Grades 2 and 3 were considered to indicate significant HAD. The predictors of HAD were analyzed by multivariate analysis. RESULTS: A total of 161 hepatic arteries were embolized from the lobar (n = 43), segmental (n = 40), subsegmental (n = 72), or more distal (n = 6) level. The follow-up period between the initial and last sessions ranged from 70 to 1505 days (median 497 days). Significant HAD occurred in 37 of 231 subsegmental hepatic arteries (16%) and in 16 of 33 patients (48%). The accumulated dose of epirubicin per artery (P = 0.001) and Child-Pugh score (P < 0.001) were significant predictors. CONCLUSION: TACE is more likely to induce HAD in cirrhoticpatients with impaired liver function and when a high dose of the chemotherapeutic agent was used.
Authors: Jean-Francois H Geschwind; Douglas E Ramsey; Berry Cleffken; B C H van der Wal; Hicham Kobeiter; Krishna Juluru; George G Hartnell; Michael A Choti Journal: Cardiovasc Intervent Radiol Date: 2003-03-06 Impact factor: 2.740
Authors: Anne M Covey; Mary A Maluccio; Johanna Schubert; Leah BenPorat; Lynn A Brody; Constantinos T Sofocleous; George I Getrajdman; Yuman Fong; Karen T Brown Journal: Cancer Date: 2006-05-15 Impact factor: 6.860
Authors: S Ko; Y Nakajima; H Kanehiro; M Hisanaga; Y Aomatsu; T Kin; K Yagura; T Ohyama; K Nishio; K Ohashi; M Sho; T Yamada; H Nakano Journal: Ann Surg Date: 1996-11 Impact factor: 12.969
Authors: E Adachi; T Maeda; T Matsumata; K Shirabe; N Kinukawa; K Sugimachi; M Tsuneyoshi Journal: Gastroenterology Date: 1995-03 Impact factor: 22.682
Authors: O Matsui; M Kadoya; J Yoshikawa; T Gabata; K Arai; H Demachi; S Miyayama; T Takashima; M Unoura; K Kogayashi Journal: Radiology Date: 1993-07 Impact factor: 11.105
Authors: Aparna Goel; Neil Mehta; Jennifer Guy; Nicholas Fidelman; Francis Yao; John Roberts; Norah Terrault Journal: Liver Transpl Date: 2014-10 Impact factor: 5.799