Abstract
Although transcatheter arterial chemoembolization is one of the established treatments for hepatocellular carcinoma (HCC), it is difficult to treat HCCs with prominent arterioportal (AP) shunts because anticancer drugs and embolic materials migrate into the non-tumorous liver through the AP shunts and may cause liver infarction. We developed a novel method of balloon-assisted chemoembolization using a micro-balloon catheter alongside a microcatheter simultaneously inserted through a single 4.5-Fr guiding sheath, comprising proximal chemoembolization with distal arterial balloon occlusion. We applied this method to treat an HCC with a prominent distal AP shunt induced by previous proton beam therapy and achieved successful chemoembolization without non-tumorous liver infarction under temporal balloon occlusion of a distal AP shunt.
Similar content being viewed by others
References
Matsui O, Kadoya M, Yoshikawa J, Gabata T, Arai K, Demachi H, Miyayama S, Takashima T, Unoura M, Kogayashi K. Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization. Radiology. 1993;188(1):79–83.
Miyayama S, Matsui O, Yamashiro M, Ryu Y, Kaito K, Ozaki K, Takeda T, Yoneda N, Notsumata K, Toya D, Tanaka N, Mitsui T. Ultraselective transcatheter arterial chemoembolization with a 2-f tip microcatheter for small hepatocellular carcinomas: relationship between local tumor recurrence and visualization of the portal vein with iodized oil. J Vasc Interv Radiol. 2007;18(3):365–76.
Murata S, Tajima H, Abe Y, Komada Y, Fukunaga T, Nakazawa K, Kumazaki T. Transcatheter management for multiple liver tumors after hepatic artery obstruction following reservoir placement. Hepatogastroenterology. 2005;52(63):852–6.
Murata S, Tajima H, Nakazawa K, Onozawa S, Kumita S, Nomura K. Initial experience of transcatheter arterial chemoembolization during portal vein occlusion for unresectable hepatocellular carcinoma with marked arterioportal shunts. Eur Radiol. 2009;19(8):2016–23.
Sonomura T, Kawai N, Kishi K, Ikoma A, Sanda H, Nakata K, Minamiguchi H, Nakai M, Hosokawa S, Tamai H, Sato M. N-butyl cyanoacrylate embolization with blood flow control of an arterioportal shunt that developed after radiofrequency ablation of hepatocellular carcinoma. Korean J Radiol. 2014;15(2):250–3.
Shi HB, Yang ZQ, Liu S, Zhou WZ, Zhou CG, Zhao LB, Xia JG, Li LS. Transarterial embolization with cyanoacrylate for severe arterioportal shunt complicated by hepatocellular carcinoma. Cardiovasc Intervent Radiol. 2013;36(2):412–21.
Koganemaru M, Abe T, Anai H, Tanaka N, Nonoshita M, Iwamoto R, Kusumoto M, Kuhara A, Kugiyama T, Hayabuchi N. A newly developed double lumen microballoon catheter with a side hole: initial experience of intraarterial infusion chemotherapy and/or embolization. Jpn J Radiol. 2012;30(10):870–4.
Itagaki MW. Temporary distal balloon occlusion for hepatic embolization: a novel technique to treat what cannot be selected. Cardiovasc Intervent Radiol. 2014;37(4):1073–7.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All authors declare no conflicts of interest associated with this manuscript.
Informed consent
Informed consent was obtained from the patient.
Human and animal rights
This article does not contain any studies with human or animal subjects.
Rights and permissions
About this article
Cite this article
Hoshiai, S., Mori, K., Ishiguro, T. et al. Balloon-Assisted Chemoembolization Using a Micro-Balloon Catheter Alongside a Microcatheter for a Hepatocellular Carcinoma with a Prominent Arterioportal Shunt: A Case Report. Cardiovasc Intervent Radiol 40, 625–628 (2017). https://doi.org/10.1007/s00270-016-1530-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-016-1530-z