Our study suggests that TACE through extrahepatic collaterals is possible with high success rates, and is also relatively safe.

We retrospectively evaluated the usefulness of both arterial and venous access with the pull-through technique in endovascular treatment of totally occluded Brescia-Cimino fistulas. We treated 26 patients (17 men, 9 women; age range 43-82 years, mean age 66 years) with occluded Brescia-Cimino fistulas. First, the occluded segment was traversed from the antegrade brachial arterial access using a microcatheter-guidewire system. Second, the vein was retrogradely punctured after confirmation of all diseased segments, and a 0.014- or 0.016-inch guidewire was pulled through the venous access when the occluded segment was long. All interventions including thrombolysis, thromboaspiration, angioplasty, and stent placement were performed via the venous access. The occlusion was successfully crossed via the brachial arterial access in 23 patients (88%). In 2 patients it was done from the venous approach. In the remaining patient it was not possible to traverse the occluded segment. The pull-through technique was successful in all 19 attempts. Clinical success was achieved in 96%, the primary patency rates at 6, 12, and 18 months were 83%, 78%, and 69%, the primary assisted patency rates were 92%, 92%, and 72%, and the secondary patency rates were 92%, 92%, and 92%, respectively. Minor complications in 5 patients included venous perforation in 2 (8%), venous rupture in 1 (4%), and regional hematoma in 2 (8%). Our study suggests that endovascular treatments with both arterial and venous access using the pull-through technique are highly effective in restoring function in totally occluded Brescia-Cimino fistulas.

The results of this study suggest that the caudate arterial branch, which is mainly derived from the right hepatic artery, frequently supplies the posterior aspect of segment IV. This knowledge is important for managing HCC in the posterior aspect of segment IV by means of TACE.

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Permeability coefficients of D‐ and L‐tryptophan (D‐, L‐Trp) were estimated for poly(L‐glutamic acid) (PLG) membranes immersed in aqueous ethanol. D‐tryptophan was selectively transported (the maximum permeability ratio was 2.6) depending on the amount and the species of crosslinking agent, and on the composition of immersing solvent. It is suggested that hydrogen bonding between uncharged permeates and carboxyl and/or amide groups of PLG is an essential factor for the selective transport. © 1999 John Wiley & Sons, Inc. J Polym Sci B: Polym Phys 37: 1035–1041, 1999