Combined transjugular intrahepatic portosystemic shunt and segmental Lipiodol hepatic artery embolization for the treatment of esophagogastric varices and hepatocellular carcinoma in patients with cirrhosis: preliminary report.

Autor: Sakaguchi, Hiroshi, Uchida, Hideo, Maeda, Munehiro, Matsuo, Naoki, Kichikawa, Kimihiko, Ohishi, Hajime, Nishida, Hirotoshi, Ueno, Kazuto, Nishimine, Kiyoshi, Rösch, Josef, Guo, Qiyon, Sakaguchi, H, Uchida, H, Maeda, M, Matsuo, N, Kichikawa, K, Ohishi, H, Nishida, H, Ueno, K, Nishimine, K
Zdroj: CardioVascular & Interventional Radiology; Jan1995, Vol. 18 Issue 1, p9-15, 7p
Abstrakt: Purpose: To evaluate the feasibility of combining placement of a transjugular intrahepatic portosystemic shunt (TIPS) and transcatheter hepatic segmental artery chemoembolization with Lipiodol (Seg-Lp-TAE) in patients with cirrhosis, esophagogastric varices, and hepatocellular carcinoma (HCC).Methods: Five patients with bleeding or large, high-flow esophagogastric varices and HCC were treated by TIPS and Seg-Lp-TAE.Results: The mean portosystemic pressure gradient decreased from 20.8 cm H2O to 7.8 cm H2O after TIPS. The direct portogram and endoscopic examination revealed reduction of varices. At 6 months, one shunt had functionally occluded and could not be reopened; the other TIPS remained functional. Follow-up CT and the changes of alpha fetoprotein indicated effective therapy of Seg-Lp-TAE for HCC. Four patients are in stabile clinical condition at 9, 6, 1, and 1 months after the combined therapy; one died after 14 months due to decompensated liver cirrhosis.Conclusion: The combined therapy of TIPS and Seg-Lp-TAE will become a new interventional approach for patients with HCC and esophagogastric varices. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index