Downstream Hepatic Arterial Blood Pressure Changes Caused by Deployment of the Surefire AntiReflux Expandable Tip
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The purpose of this work was to evaluate blood pressure changes caused by deployment of the Surefire antireflux expandable tip. The pressure measurements are relevant because they imply changes in hepatoenteric arterial blood flow within this liver compartment during hepatic artery delivery of cytotoxic agents.
After positioning the Surefire antireflux system in the targeted hepatic artery, blood pressure was obtained initially with the tip collapsed (or through a femoral artery sheath), then again after the tip was expanded before chemoembolization or yttrium 90 (90Y) radioembolization.
Eighteen patients with liver malignancy underwent 29 procedures in 29 hepatic arteries (3 common hepatic, 22 lobar, 4 segmental). Systolic, diastolic, and mean blood pressure were all decreased by a mean of 29 mm Hg (p = 0.000004), 14 mm Hg (p = 0.0000004), and 22 mm Hg (p = 0.00000001), respectively.
When the Surefire expandable tip is deployed to prevent retrograde reflux of agents, it also results in a significant decrease in blood pressure in the antegrade distribution, potentially resulting in hepatopedal blood flow in vessels that are difficult to embolize, such as the supraduodenal arteries.
KeywordsLiver cancer Hepatocellular carcinoma Chemoembolization Radioembolization Embolization
- 10.Hong K, Chomas J, Kraitchman D, Naglreiter B, Arepathy A (2011) Quantification and reduction of reflux during embolotherapy using Micro CT and Tantalum Beads with ex-vivo analysis. World Conference of Interventional Oncology, New YorkGoogle Scholar
- 12.Rose SC, Kikolski SG, Nutting CW, Sze DY (2012) Relationship of aortoceliac angle and the ability to advance a Surefire® Guidecath into the targeted hepatic artery. [Abstract 550209]. Global Embolization Symposium and Therapy Annual Meeting, New YorkGoogle Scholar