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1.
60例肝癌经导管肝动脉栓塞化疗(THAE)前由于导管无法超选择插管而行经导管胃十二指肠动脉栓塞。其中45例用羊毛钢圈栓塞,44例成功:11例以导丝人为损伤血管内膜(导管不能插入)后10例闭塞,另4例导管导丝均不能插入。由于胃十二指肠动脉闭塞,THAE时避免了碘油抗癌药混悬剂或明胶海绵颗粒进入胃十二指肠动脉。所有胃十二指肠动脉栓塞的病例无直接并发症。因此认为,胃十二指扬动脉栓塞是安全的,对防止肝癌THAE时栓塞剂返流所致的胃十二指肠损伤具有重要意义。 相似文献
2.
Transcatheter embolization in management of hemorrhage from duodenal ulcer: long-term results and complications. 总被引:5,自引:0,他引:5
E K Lang 《Radiology》1992,182(3):703-707
Effectiveness of transcatheter embolization for treatment of bleeding duodenal ulcers was evaluated in 57 patients followed up for at least 5 years. Terminal muscular branch vessel embolization was effective for initial control of bleeding in 27 of 28 cases, and gastroduodenal artery embolization was effective in 25 of 29 (P = .371). Terminal vessel embolization was more effective in attaining long-term control of bleeding (15 of 28 patients) than was gastroduodenal artery embolization (eight of 29) (P = .084). Occlusion of terminal vessels with 6-cyanoacrylate resulted in long-term control of bleeding in nine of 10 patients. With selective embolization of terminal vessels, late complications of duodenal stenosis occurred in seven of 28 patients; when occlusion was at the level of the gastroduodenal artery (P = .131), this developed in only two of 29. Occlusion of the proximal gastroduodenal artery by means of epsilon-aminocaproic acid-induced autologous clot was the most innocuous technique. Retrograde perfusion via the superior mesenteric and inferior pancreaticoduodenal artery (though at a reduced flow rate and pressure gradient) and reconstitution of flow after clot lysis are the theoretical advantages of this technique. 相似文献
3.
Successful Transcatheter Embolotherapy with a New Platinum Microcoil: The Berenstein Liquid Coil 总被引:1,自引:0,他引:1
Sang Kil Ha-Kawa Hideji Kariya Takashi Murata Yoshimasa Tanaka 《Cardiovascular and interventional radiology》1998,21(4):297-299
Purpose: To determine the usefulness of a new platinum microcoil, the Berenstein Liquid Coil for vascular embolization.
Methods: Nine patients underwent transcatheter arterial embolization with liquid coils. The occluded vessels included the splenic
artery in four patients, gastroduodenal artery in two, arteriovenous malformation or fistula in two, and middle hepatic artery
in one. All coils were delivered with a saline flush through a Tracker-18 catheter.
Results: All arteries except one were successfully occluded in a one-stage procedure using liquid coils. No friction was observed
between the liquid coils and the microcatheter regardless of the tortuosity of the artery. Platelet counts in all patients
had increased after splenic embolization. In two patients with liver tumors, perfusion to the inappropriate area during intraarterial
chemotherapy was prevented by selective embolization. Life-threatening bleeding was successfully treated by gastroduodenal
artery occlusion. No complications were encountered.
Conclusion: The Berenstein Liquid Coil provides easy, safe, and rapid vascular occlusion. 相似文献
4.
Y Yuki S Tamura M Samejima T Kodama O Uwada N Ogata Y Kihara K Watanabe 《Nihon Igaku Hōshasen Gakkai zasshi. Nippon acta radiologica》1990,50(7):767-771
Chronic pancreatitis is known to cause vascular disorders including pseudoaneurysm of peripancreatic arteries. Although the incidence of pseudoaneurysms due to pancreatitis detected by angiography has been reported as high as 10% in western literature, they are still considered rare in Japan. We reported two cases of pseudoaneurysm caused by chronic pancreatitis, one in splenic artery and the other in gastroduodenal artery, successfully treated by embolization. The embolizations were performed by occluding proximal splenic artery for splenic arterial aneurysm and gastroduodenal artery distal and proximal to the orifice for the aneurysm of gastroduodenal artery with stainless steel coils. Since the surgical therapy has high mortality rate, we consider transcatheter embolization is the treatment of choice for pseudoaneurysms caused by chronic pancreatitis. 相似文献
5.
Cosin O Bilbao JI Alvarez S de Luis E Alonso A Martinez-Cuesta A 《Cardiovascular and interventional radiology》2007,30(1):98-103
Purpose Intra-arterial infusion of yttrium-90 microspheres is a form of radiation treatment for unresectable hepatic neoplasms. Misdeposition
of particles in the gastroduodenal area such as the right gastric artery (RGA) may occur with serious consequences. We present
a series of patients who underwent a detailed vascular study followed by RGA embolization. Special emphasis is placed on anatomic
variations and technical considerations.
Methods In a 1 year period, 27 patients were treated. Initial vascular evaluation was performed, with careful attention to anatomic
variants or extrahepatic arterial supply, especially to the gastroduodenal area. Embolization of such arteries was planned
if needed. RGA embolization was performed antegradely from the hepatic artery or retrogradely via the left gastric artery
(LGA). Postprocedural follow-up included clinical interview and gastroscopy if necessary.
Results RGA embolization was performed in 9 patients presenting with primary (n = 3) or metastatic liver tumors (n = 6). Six patients underwent antegrade RGA embolization and 3 had embolization done retrogradely via the LGA. Retrograde
access was chosen for anatomic reasons. None of the patients complained of gastroduodenal symptoms.
Conclusion RGA embolization can help minimize the gastroduodenal deposition of radioactive particles. RGA embolization should routinely
be carried out. The procedure can be performed, with similar technical success, by both anterograde and retrograde approaches. 相似文献
6.
Jin Wook Chung M.D. Jae Hyung Park Joon Koo Han Man Chung Han 《Cardiovascular and interventional radiology》1994,17(1):41-43
We encountered 2 cases of guidewire-induced perforation of the gastroduodenal artery after using a hydrophil-coated guidewire. The guidewire penetrated a small side branch of the normal gastroduodenal artery in 1 patient and the weakened gastroduodenal artery due to pancreatic pseudocyst in the other patient. Both complications resulted in serious hemorrhage and were successfully managed by transcatheter embolization using steel coils. In an era of widespread use of hydrophil-coated guidewires for superselective catheterization, it is important to appreciate the possibility of this potentially serious complication. 相似文献
7.
Therapeutic embolization of the gastroduodenal artery in hepatic artery infusion chemotherapy 总被引:1,自引:0,他引:1
S Kuribayashi D A Phillips D P Harrington M A Bettmann J D Garnic S E Come D C Levin 《AJR. American journal of roentgenology》1981,137(6):1169-1172
Transcatheter embolization of the gastroduodenal artery with Gelfoam was performed in 12 patients undergoing percutaneous hepatic artery catheterization for infusion chemotherapy of metastatic liver disease. The purpose of the embolization was to prevent chemotherapeutic drugs from reaching the stomach and duodenum and thereby inducing gastrointestinal toxicity in patients in whom the catheter tip could not be satisfactorily positioned beyond the gastroduodenal origin. Embolization proved safe and effective in eight cases. Three other patients experienced clinical problems that may or may not have been related to embolization. The final patient had a significant complication (necrosis of the pancreatic head and gastric mucosa) that was felt to be directly related to the embolization. Transcatheter gastroduodenal occlusion may help reduce gastrointestinal toxicity of intraarterial infusion chemotherapy. However, it may on occasion be associated with significant complications, particularly in patients who are debilitated due to metastatic disease. 相似文献
8.
Carrafiello G Laganà D Recaldini C Mangini M Lumia D Giorgianni A Leonardi A Fugazzola C 《Emergency radiology》2007,14(1):51-54
A 69-year-old man with a history of acute pancreatitis developed a huge pseudoaneurysm of the gastroduodenal artery (PAGD),
as diagnosed by CT scan. The PAGD was treated by percutaneous thrombin injection (2,000 IU) under ultrasound guidance and
selective embolization of gastroduodenal artery with microcoils with its complete exclusion. The 6-month follow-up confirmed
the complete exclusion of the PAGD sac. 相似文献
9.
Hepatic transcatheter arterial embolization with gastroduodenal artery blocking by finger compression 总被引:1,自引:0,他引:1
Hepatic transcatheter arterial embolization was performed in two patients by blocking the gastroduodenal artery with finger compression on the abdominal surface. The embolizing material, which was injected into the common hepatic artery, did not enter the gastroduodenal artery. No postoperative complications were experienced. This method may be useful for patients in whom superselective catheterization of the proper hepatic artery is not feasible. 相似文献
10.
Basile A Ragazzi S Piazza D Tsetis D Lupattelli T Patti MT 《European radiology》2008,18(11):2579-2581
Endovascular treatment options for visceral artery pseudoaneurysms depend on lesion location and size. Exclusion methods fall
into two categories, embolization and stent placement, and these procedures aim to exclude the pseudoaneurysm from the circulation
and if possible to maintain distal blood flow. Embolization of the afferent artery can be used in pseudoaneurysms that arise
from a donor artery without collateral supply such as a visceral branch, whereas in the case of visceral arteries with well-established
collateral supply, the embolization of both proximal and distal branches to the pseudoaneurysm is mandatory in preventing
backflow from the collateral circulation. A direct embolization delivering coils or glue into the sac can also be performed
if the aneurismal neck is narrow. Stent-graft placement represents another option to exclude the pseudoaneurysm, in the case
of wide neck, reduced arterial tortuosity and large-diameter arteries. We present a case of common hepatic artery pseudoaneurysm
involving the gastroduodenal artery origin treated by a combination of techniques. An hepatic stent-graft implantation plus
retrograde embolization of the gastroduodenal artery through the pancreaticoduodenal anastomosis from the superior mesenteric
artery was performed. 相似文献
11.
本文报道了12例胶囊阻塞法经皮经肝总动脉作肝栓塞的病例,介绍了这一新技术的具体操作方法,该技术的特点在于导管在肝总动脉水平便可作肝栓塞治疗,而不致胃十二指肠动脉栓塞,从而使得肝固有动脉超选择插管不能的肝肿瘤患者行肝栓塞成为可能。本文对2例典型病例进行了详细介绍,还就该技术的作用机理、安全性及使用价值等作了讨论。 相似文献
12.
Percutaneous transcatheter embolization of splanchnic artery aneurysms is a minimally invasive and alternative therapy to
conventional surgical intervention. Due to a high-grade stenosis at the origin of the celiac trunk, a retrograde approach
to the celiac trunk pseudoaneurysm via the gastroduodenal artery was necessary. To prevent undesirable embolization into the
peripheral left gastric artery initial occlusion of the central portion of the left gastric artery was performed with microcoils
using a Tracker catheter. Complete occlusion of the celiac trunk itself and the short adjacent segments of the celiac artery
was achieved by using a mixture of N-butyl-2-cyanoacrylate and ethiodized oil as the embolizing agent.
Received: 22 June 1999; Revised: 7 September 1999; Accepted: 1 October 1999 相似文献
13.
Interventional management of gastroduodenal lesions complicating intra-arterial hepatic chemotherapy
Proietti S De Baere T Bessoud B Doenz F Qanadli SD Schnyder P Denys A 《European radiology》2007,17(8):2160-2165
Herein we report the efficacy of embolization of small patent gastric or duodenal vessels for treating gastroduodenal complications
after hepatic arterial infusion therapy (HAIC). Catheter ports were implanted percutaneously from a femoral approach in three
cases or surgically in the gastroduodenal artery in two cases. Acute abdominal pain developed on average after four HAIC courses
of 5FU-oxaliplatin, mytomycin, oxaliplatin or fotemustine. Esophagogastroduodenoscopy showed gastroduodenal lesions (gastroduodenitis
with or without ulcerations) in all cases. Despite the interruption of the HAIC, symptoms persisted and led to selective hepatic
arteriography showing a patent right gastric artery (n = 4) or a recanalized gastroduodenal artery (n = 1) responsible for gastroduodenal misperfusion. Successful embolizations of the arteries responsible for gastroduodenal
misperfusion (right gastric artery in four cases and gastroduodenal artery in one case) using 0.018 platinium coils relieved
the patients’ symptoms and allowed the HAIC to continue. In gastroduodenal complications of HAIC, a selective hepatic arteriography
should be performed to search any artery responsible for the misperfusion of the toxic agent in the gastroduodenal area. Embolization
of these arteries allowed the HAIC to be restored. 相似文献
14.
The authors present their experience with the percutaneous embolization of 13 splanchnic aneurysms and pseudoaneurysms (2 pseudoaneurysms of gastroduodenal artery, 3 of the hepatic artery, 7 renal pseudoaneurysms, 1 aneurysm of the splenic artery). In 9 of 13 cases the lesions were iatrogenic. Embolizing devices and techniques are described. Percutaneous embolization was successful in 12 of 13 cases, and useless in 1 case of renal pseudoaneurysm. In the 12 successfully treated cases the lesions were still occluded in the follow-up period. Transcatheter percutaneous embolization is the elective treatment in splanchnic aneurysms and pseudoaneurysms; surgery must be performed only when embolization fails. 相似文献
15.
Tajima T Kuroiwa T Yabuuchi H Kawamoto K 《Nihon Igaku Hōshasen Gakkai zasshi. Nippon acta radiologica》2002,62(5):224-226
Intra-arterial infusion chemotherapy using a percutaneously implanted port-catheter system was performed in 21 patients with liver tumors. We developed a new procedure, the gastroepiploic method, using a W Spiral Catheter without embolization around/within the catheter and embolization for the right gastroepiploic artery distal to the catheter tip. After embolizing the gastroduodenal arterial branches, right gastric artery, or aberrant hepatic arteries, we mainly inserted the catheter tip into the right gastroepiploic artery. There were no complications such as peptic ulcer, hepatic artery obstruction, or catheter dislocation (observation time, 5.3 months). This method seemed to be feasible for implantable reservoir therapy of patients with malignant liver tumors. 相似文献
16.
Chikazumi Kuroda M.D. Seiichi Kawamoto Shinichi Hori Hiroyasu Yoshioka Hironobu Nakamura Masahiko Miyata Kazuyasu Nakao 《Cardiovascular and interventional radiology》1983,6(3):167-169
This case of massive duodenal hemorrhage through the pancreatic pseudocyst, caused by rupture of a pseudoaneurysm of the gastroduodenal artery, was successfully controlled by transcatheter embolization. Embolization is a useful alternative to surgery in high-risk patients. 相似文献
17.
Paci E Antico E Candelari R Alborino S Marmorale C Landi E 《Cardiovascular and interventional radiology》2000,23(6):472-474
We report a case of a pseudoaneurysm of the common hepatic artery treated with a stent-graft in a 67-year-old man. The patient
presented with severe catheter bleeding through a drain following surgical and interventional procedures performed for therapeutic
management of a choledochal cholangiocarcinoma. Selective hepatic arteriography showed a pseudoaneurysm close to the origin
of the gastroduodenal artery. After a preliminary attempt at arterial embolization, it was decided to use a stent-graft to
bridge the false aneurysm. Complete pseudoaneurysm exclusion was seen after the procedure with preservation of hepatic arterial
flow. 相似文献
18.
目的:对肝移植术后动脉窃血综合征的诊断和介入治疗进行初步的探讨.方法:5例患者因肝移植治疗术后超声多普勒检查肝内未见动脉血流,提示肝动脉闭塞而行急症DSA检查.血管造影诊断为窃血综合征,并行窃血动脉介入栓塞治疗.结果:5例患者中脾动脉窃血4例,胃十二指肠动脉和胃右动脉窃血1例,患者随访时间3~9个月,随访期间患者移植肝脏功能正常,未见与动脉栓塞相关的并发症发生.结论:肝移植术后动脉窃血综合征虽然发生率不高,但造成的危害严重,应该受到重视,早期诊断、早期治疗彩夺目对于移植肝脏功能的保护相当重要.介入栓塞治疗以其微创、高效、并发症少的优点,应作为首选的治疗方法. 相似文献
19.
Yıldız AE Peynircioğlu B Cil BE 《Diagnostic and interventional radiology (Ankara, Turkey)》2012,18(2):225-230
The purpose of this study was to present our initial experience with the Amplatzer? Vascular Plug (AVP) 4 in various arterial environments. This material was designed for the embolization of peripheral small vessels using a diagnostic catheter. Herein, the following three procedures using the AVP 4 were described: hemodialysis fistula occlusion as a treatment for the steal phenomenon, gastroduodenal artery embolization prior to liver radioembolization, and vertebral artery embolization for the treatment of subclavian artery pseudoaneurysm and arteriovenous fistula. All of the treated vessels were successfully occluded, and the devices remained in the original locations and configurations during the follow-up period. When compared with the previous generation of vascular plugs, the AVP 4 allows faster and safer procedures with less radiation exposure to the patients and angiography team. 相似文献
20.
F Lesak 《R?ntgen-Bl?tter; Zeitschrift für R?ntgen-Technik und medizinisch-wissenschaftliche Photographie》1986,39(1):12-13
A case of embolization of the gastroduodenal artery in a 38-year old man with chronic pancreatitis and uncontrollable bleeding is presented. The advantage of this interventional radiologic procedure is discussed and in selective cases it seems to be the choice of treatment. 相似文献