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Interventional management of gastroduodenal lesions complicating intra-arterial hepatic chemotherapy

  • Vascular-Interventional
  • Published:
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Abstract

Herein we report the efficacy of embolization of small patent gastric or duodenal vessels for treating gastroduodenal complications after hepatic arterial infusion therapy (HAIC). Catheter ports were implanted percutaneously from a femoral approach in three cases or surgically in the gastroduodenal artery in two cases. Acute abdominal pain developed on average after four HAIC courses of 5FU-oxaliplatin, mytomycin, oxaliplatin or fotemustine. Esophagogastroduodenoscopy showed gastroduodenal lesions (gastroduodenitis with or without ulcerations) in all cases. Despite the interruption of the HAIC, symptoms persisted and led to selective hepatic arteriography showing a patent right gastric artery (n = 4) or a recanalized gastroduodenal artery (n = 1) responsible for gastroduodenal misperfusion. Successful embolizations of the arteries responsible for gastroduodenal misperfusion (right gastric artery in four cases and gastroduodenal artery in one case) using 0.018 platinium coils relieved the patients’ symptoms and allowed the HAIC to continue. In gastroduodenal complications of HAIC, a selective hepatic arteriography should be performed to search any artery responsible for the misperfusion of the toxic agent in the gastroduodenal area. Embolization of these arteries allowed the HAIC to be restored.

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Authors and Affiliations

  1. Department of Radiology, Centre Hospitalier , Universitaire Vaudois, 46 rue du Bugnon, 1011, Lausanne, Switzerland

    Stefania Proietti, Francesco Doenz, Salah Dine Qanadli, Pierre Schnyder & Alban Denys

  2. Department of Interventional Radiology, Institut Gustave-Roussy, Villejuif, France

    Thierry De Baere

  3. Department of Radiology, Hôpital Bicêtre, Le Kremlin-Bicêtre, France

    Bertrand Bessoud

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  1. Stefania Proietti
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  2. Thierry De Baere
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  3. Bertrand Bessoud
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  4. Francesco Doenz
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  5. Salah Dine Qanadli
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  6. Pierre Schnyder
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  7. Alban Denys
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Correspondence to Stefania Proietti.

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Proietti, S., De Baere, T., Bessoud, B. et al. Interventional management of gastroduodenal lesions complicating intra-arterial hepatic chemotherapy. Eur Radiol 17, 2160–2165 (2007). https://doi.org/10.1007/s00330-006-0552-3

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  • DOI: https://doi.org/10.1007/s00330-006-0552-3

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