Hepatocellular carcinoma with portal vein tumor thrombus: embolization of arterioportal shunts.

Abstract:

PURPOSE:To evaluate transcatheter arterial embolization in patients with hepatocellular carcinoma, portal vein tumor thrombus, and arterioportal shunts. MATERIALS AND METHODS:Ten patients with hepatocellular carcinoma, portal vein tumor thrombus, and severe arterioportal shunting were identified; in these patients, portal blood flow before embolization was hepatofugal. Embolization of arterioportal shunts was performed with steel coils that were introduced through a catheter during arteriography. After embolization, changes in portal hemodynamics and clinical signs and performance status of patients were evaluated; survival rates of patients with and patients without severe arterioportal shunting were compared. RESULTS:In all patients after embolization, angiography showed resolution of arterioportal shunting, and portography showed hepatopetal blood flow in the portal vein trunk. After embolization, performance status of five patients with initial scores of 2 or 3 improved. Ascites resolved in four patients and improved in four patients. One patient died of hepatic failure caused by rupture of esophageal varices 7 days after embolization. Median survival was 4.3 months, and the 6-month and 1-year survival rates were 45% and 12%, respectively. There were no significant differences between survival rates in patients with and patients without severe arterioportal shunting. CONCLUSION:Transcatheter arterial embolization of arterioportal shunts is a useful treatment for improving quality of life in patients with hepatocellular carcinoma.

journal_name

Radiology

journal_title

Radiology

authors

Furuse J,Iwasaki M,Yoshino M,Konishi M,Kawano N,Kinoshita T,Ryu M,Satake M,Moriyama N

doi

10.1148/radiology.204.3.9280260

subject

Has Abstract

pub_date

1997-09-01 00:00:00

pages

787-90

issue

3

eissn

0033-8419

issn

1527-1315

journal_volume

204

pub_type

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