Transcatheter arterial chemoembolization for hepatocellular carcinomas in patients with celiac axis occlusion

Jong Won Kwon, Jin Wook Chung, Soon-Young Song, Hyung Guhn Lim, Jae Sung Myung, Young Ho Choi, Jae Hyung Park

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

PURPOSE: To verify the hypothesis that most instances of celiac axis occlusion in patients with hepatocellular carcinoma (HCC) are caused by diaphragmatic compression and, therefore, transcatheter arterial chemoembolization (TACE) can be performed through the compressed lumen of the celiac axis. MATERIALS AND METHODS: The authors attempted to perform TACE in 36 consecutive patients with HCC and celiac axis occlusion. Spiral computed tomographic (CT) images were available in 26 patients. Initially, catheterization of the hepatic arteries was attempted through the occluded celiac axis. If it failed, catheterization was performed through the pancreaticoduodenal arcades. The causes of celiac axis occlusion were evaluated based on spiral CT and angiographic findings, access routes, technical success rates, and related complications in superselective catheterization of hepatic arteries. RESULTS: Among the 26 patients who underwent spiral CT, diaphragmatic compression of the celiac axis was demonstrated in 23. Selective catheterization of hepatic arteries was possible through the occluded celiac axis in 23 patients (64%). In nine (25%) of the remaining 13 patients, TACE was performed through the dilated pancreaticoduodenal arcades from the superior mesenteric artery. As a procedure-related complication, celiac axis dissection occurred in one patient (3%). CONCLUSION: Most patients with celiac axis occlusion had arcuate ligament compression. In TACE, the celiac artery occlusion could be traversed directly and this should be the initial approach.

Original languageEnglish
Pages (from-to)689-694
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume13
Issue number7
DOIs
StatePublished - 2002 Jan 1

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Abdomen
Hepatocellular Carcinoma
Catheterization
Hepatic Artery
Celiac Artery
Superior Mesenteric Artery
Ligaments
Dissection

Keywords

  • Hepatic arteries, embolization
  • Liver neoplasms, chemotherapeutic infusion

Cite this

Kwon, Jong Won ; Chung, Jin Wook ; Song, Soon-Young ; Lim, Hyung Guhn ; Myung, Jae Sung ; Choi, Young Ho ; Park, Jae Hyung. / Transcatheter arterial chemoembolization for hepatocellular carcinomas in patients with celiac axis occlusion. In: Journal of Vascular and Interventional Radiology. 2002 ; Vol. 13, No. 7. pp. 689-694.
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Transcatheter arterial chemoembolization for hepatocellular carcinomas in patients with celiac axis occlusion. / Kwon, Jong Won; Chung, Jin Wook; Song, Soon-Young; Lim, Hyung Guhn; Myung, Jae Sung; Choi, Young Ho; Park, Jae Hyung.

In: Journal of Vascular and Interventional Radiology, Vol. 13, No. 7, 01.01.2002, p. 689-694.

Research output: Contribution to journalArticle

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T1 - Transcatheter arterial chemoembolization for hepatocellular carcinomas in patients with celiac axis occlusion

AU - Kwon, Jong Won

AU - Chung, Jin Wook

AU - Song, Soon-Young

AU - Lim, Hyung Guhn

AU - Myung, Jae Sung

AU - Choi, Young Ho

AU - Park, Jae Hyung

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N2 - PURPOSE: To verify the hypothesis that most instances of celiac axis occlusion in patients with hepatocellular carcinoma (HCC) are caused by diaphragmatic compression and, therefore, transcatheter arterial chemoembolization (TACE) can be performed through the compressed lumen of the celiac axis. MATERIALS AND METHODS: The authors attempted to perform TACE in 36 consecutive patients with HCC and celiac axis occlusion. Spiral computed tomographic (CT) images were available in 26 patients. Initially, catheterization of the hepatic arteries was attempted through the occluded celiac axis. If it failed, catheterization was performed through the pancreaticoduodenal arcades. The causes of celiac axis occlusion were evaluated based on spiral CT and angiographic findings, access routes, technical success rates, and related complications in superselective catheterization of hepatic arteries. RESULTS: Among the 26 patients who underwent spiral CT, diaphragmatic compression of the celiac axis was demonstrated in 23. Selective catheterization of hepatic arteries was possible through the occluded celiac axis in 23 patients (64%). In nine (25%) of the remaining 13 patients, TACE was performed through the dilated pancreaticoduodenal arcades from the superior mesenteric artery. As a procedure-related complication, celiac axis dissection occurred in one patient (3%). CONCLUSION: Most patients with celiac axis occlusion had arcuate ligament compression. In TACE, the celiac artery occlusion could be traversed directly and this should be the initial approach.

AB - PURPOSE: To verify the hypothesis that most instances of celiac axis occlusion in patients with hepatocellular carcinoma (HCC) are caused by diaphragmatic compression and, therefore, transcatheter arterial chemoembolization (TACE) can be performed through the compressed lumen of the celiac axis. MATERIALS AND METHODS: The authors attempted to perform TACE in 36 consecutive patients with HCC and celiac axis occlusion. Spiral computed tomographic (CT) images were available in 26 patients. Initially, catheterization of the hepatic arteries was attempted through the occluded celiac axis. If it failed, catheterization was performed through the pancreaticoduodenal arcades. The causes of celiac axis occlusion were evaluated based on spiral CT and angiographic findings, access routes, technical success rates, and related complications in superselective catheterization of hepatic arteries. RESULTS: Among the 26 patients who underwent spiral CT, diaphragmatic compression of the celiac axis was demonstrated in 23. Selective catheterization of hepatic arteries was possible through the occluded celiac axis in 23 patients (64%). In nine (25%) of the remaining 13 patients, TACE was performed through the dilated pancreaticoduodenal arcades from the superior mesenteric artery. As a procedure-related complication, celiac axis dissection occurred in one patient (3%). CONCLUSION: Most patients with celiac axis occlusion had arcuate ligament compression. In TACE, the celiac artery occlusion could be traversed directly and this should be the initial approach.

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