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CardioVascular and Interventional Radiology

, Volume 18, Issue 1, pp 9–15 | Cite as

Combined transjugular intrahepatic portosystemic shunt and segmentai lipiodol hepatic artery embolization for the treatment of esophagogastric varices and hepatocellular carcinoma in patients with cirrhosis: Preliminary report

  • Hiroshi Sakaguchi
  • Hideo Uchida
  • Munehiro Maeda
  • Naoki Matsuo
  • Kimihiko Kichikawa
  • Hajime Ohishi
  • Hirotoshi Nishida
  • Kazuto Ueno
  • Kiyoshi Nishimine
  • Josef Rösch
  • Qiyon Guo
Clinical Investigations

Abstract

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, highflow 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 SegLp-TAE will become a new interventional approach for patients with HCC and esophagogastric varices.

Key words

Esophagogastric varices Hepatocellular carcinoma Transjugular intrahepatic portosystemic shun Segmental embolotherapy Lipoidol 

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Copyright information

© Springer-Verlag New York Inc 1995

Authors and Affiliations

  • Hiroshi Sakaguchi
    • 1
  • Hideo Uchida
    • 1
  • Munehiro Maeda
    • 1
  • Naoki Matsuo
    • 1
  • Kimihiko Kichikawa
    • 1
  • Hajime Ohishi
    • 2
  • Hirotoshi Nishida
    • 3
  • Kazuto Ueno
    • 3
  • Kiyoshi Nishimine
    • 4
  • Josef Rösch
    • 4
  • Qiyon Guo
    • 5
  1. 1.Department of RadiologyNara Medical UniversityNaraJapan
  2. 2.Department of OncoradiologyNara Medical UniversityNaraJapan
  3. 3.Department of RadiologyKagoshima University, School of MedicineKagoshimaJapan
  4. 4.Dotter Institute for Interventional TherapyOregon Health Science UniversityPortlandUSA
  5. 5.Department of RadiologySecond Hospital of China Medical UniversityShenyangP. R. China

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