Haepatocellular carcinoma (HCC) is the most common primary liver malignancy, representing the fifth most common cancer in the world. Without treatment, the median survival of HCC patients has been reported to be 8 weeks from symptomatic presentation. Transarterial chemoembolisation is widely used to manage unresectable HCCs. However, when a tumour is large or locates near the liver capsule, it may receive supplies from vessels other than hepatic arteries. In this paper, we discuss the anatomy of possible extrahepatic collateral arterial supplies of HCCs.
Regarding the site of arterial access during the intervention, transracial intervention can reduce the risk of bleeding and vessel-related complications as well as improve patient comfort. Importantly, the distal radial artery (DRA) approach may reduce the incidence of radial artery occlusion and digital ischemia, but the feasibility and safety of DRA in performing subdiaphragmatic vascular interventions remain unclear. From January 2018 to December 2019, 106 patients were admitted to our department for visceral angiography and intervention by left distal radial artery accessing in an anatomical snuffbox. In total, 152 times of vascular interventions were performed during this period. Patients demographics, procedure details, technical success, and access site-related complications were recorded and evaluated. The mean age was 58.9 (range 22-86) years. Males accounted for 80.2%. Thirty-five patients (33%) had 2 or more procedures via the DRA approach. Technical success was achieved for 96.1% of procedures (146 cases) and 3.9% of cases failed to perform the intended procedure via the DRA approach (6 cases). The 4-Fr sheath was used in 86.8% of cases, and the 5 Fr sheath was used in the rest of the 13.2% of procedures. The rate of asymptomatic radial artery occlusion was 5.7% (6 of 106 patients). No patient suffered from distal limb ischemia after a long-time follow-up. Eight patients suffered postoperative local pain, transient numbness, or local bruised in the anatomical snuffbox without major complications. Patients with postoperative complications recovered quickly by using nonsteroidal anti-inflammatory drugs or without further treatment. Left distal radial artery access is safe and feasible as a new technique for visceral angiography and intervention.
Acne is one of the most frequent and recurring chronic inflammatory diseases of the skin, often persisting for many years. It often occurs in adolescents and is characterized by acne, papules, pustules, nodules, cysts, and mainly affects the face, chest, and back. Many factors contribute to the development of acne, most notably the overproduction of androgens, which leads to high sebum production, hyperkeratosis of the hair follicles, and the proliferation of Propionibacterium acnes, causing an inflammatory response in the
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