Skip to main content
Log in

Balloon-Assisted Chemoembolization Using a Micro-Balloon Catheter Alongside a Microcatheter for a Hepatocellular Carcinoma with a Prominent Arterioportal Shunt: A Case Report

  • Case Report
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. 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.

    Article  CAS  PubMed  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. 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.

    PubMed  Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. 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.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sodai Hoshiai.

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

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-016-1530-z

Keywords

Navigation