CardioVascular and Interventional Radiology

, Volume 36, Issue 5, pp 1262–1269 | Cite as

Downstream Hepatic Arterial Blood Pressure Changes Caused by Deployment of the Surefire AntiReflux Expandable Tip

  • Steven C. Rose
  • Steven G. Kikolski
  • James E. Chomas
Clinical Investigation



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.


Liver cancer Hepatocellular carcinoma Chemoembolization Radioembolization Embolization 


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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Steven C. Rose
    • 1
  • Steven G. Kikolski
    • 1
  • James E. Chomas
    • 2
  1. 1.Department of Radiology 8756, UCSD Medical CenterUniversity of California, San Diego Health SciencesSan DiegoUSA
  2. 2.Surefire Medical, Inc.WestminsterUSA

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