Efficacy of the Left Gastric Artery as a Route for Catheterization of the Right Gastric Artery

Yamagami, Takuji; Kato, Takumi; Iida, Shigeharu; Hirota, Tatsuya

doi:10.2214/ajr.184.1.01840220

Cited by 11 publications

(7 citation statements)

References 24 publications

(42 reference statements)

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“…They succeeded in selective catheterisation of the right gastric artery using this route in 12 of 14 (86%) patients with smooth anastomoses between the right and left gastric artery. In a later report of embolisation of the right gastric artery using the retrograde approach, embolisation was successful in 79 (89.8%) of 88 patients [33].…”

Section: Discussionmentioning

confidence: 93%

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Embolisation of the right gastric artery in patients undergoing hepatic arterial infusion chemotherapy using two possible approach routes

Yamagami

Terayama²,

Yoshimatsu³

et al. 2010

BJR

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We used a retrospective non-randomised study to investigate the clinical effect of selective embolisation of the right gastric artery before hepatic arterial infusion chemotherapy (HAIC) using a port-catheter system. We evaluated whether the hepatic artery or the left gastric artery is the better approach for selecting the right gastric artery. A total of 367 patients (244 men and 123 women; mean age, 64.1 years) with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system. In 294 of these patients, right gastric arterial embolisation with microcoils was attempted before placement of the port-catheter system to prevent gastric mucosal lesions. Approach was either through the hepatic artery (175 patients) or through the left gastric artery (119 patients), with success rates in catheterising the right gastric artery of 78.3% and 77.3%, respectively. If the attempt was unsuccessful, the catheter was redirected to the alternative approach, which increased the final success rate to 96.3%. Only seven patients experienced gastroduodenal mucosal lesions acutely after HAIC, as revealed by endoscopy. Embolisation of the right gastric artery is a feasible procedure that can reduce the incidence of gastric mucosal lesions associated with HAIC. Approach through either the hepatic artery or the left gastric artery is equally acceptable.

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Section: Discussionmentioning

confidence: 93%

“…Failure to embolise the right gastric artery can result [26]. As an alternative method, a retrograde approach to the right gastric artery via the left gastric artery has been introduced [32,33].…”

mentioning

confidence: 99%

Embolisation of the right gastric artery in patients undergoing hepatic arterial infusion chemotherapy using two possible approach routes

Yamagami

Terayama²,

Yoshimatsu³

et al. 2010

BJR

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“…Some studies have reported the efficacy of catheter insertion for the RGA via the LGA through the anastomosis when catheterizing the RGA was difficult, and the RGA is then embolized to prevent a gastric ulcer during hepatic arterial infusion chemotherapy [8-10]. Alternatively, to the best of our knowledge, there have been no reports of catheterizing and embolizing the replaced LHA via the RGA through the anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Catheterization and embolization of a replaced left hepatic artery via the right gastric artery through the anastomosis: a case report

et al. 2011

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IntroductionConversion of multiple hepatic arteries into a single vascular supply is a very important technique for repeat hepatic arterial infusion chemotherapy using an implanted port catheter system. Catheterization of a replaced left hepatic artery arising from a left gastric artery using a percutaneous catheter technique is sometimes difficult, despite the recent development of advanced interventional techniques.Case presentationWe present a case of a 70-year-old Japanese man with multiple hepatocellular carcinomas in whom the replaced left hepatic artery arising from the left gastric artery needed to be embolized. After several failed procedures, the replaced left hepatic artery was successfully catheterized and embolized with a microcatheter and microcoils via the right gastric artery through the anastomosis.ConclusionA replaced left hepatic artery arising from a left gastric artery can be catheterized via a right gastric artery by using the appropriate microcatheter and microguidewires, and multiple hepatic arteries can be converted into a single supply.

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“…In the present study, the flushing proceeded without any serious problems, such as coil migration or the dislocation or occlusion of a catheter. In applying the system to clinical cases, however, it is necessary to judge whether, for each case, we should select the conventional method using a coil pusher (16) or a saline flush technique (15), because careful manipulation using a coil pusher during the embolization procedure is preferable in some cases. On the other hand, the saline flush technique (15) was used for embolization of larger arterial branches through the larger catheters; flushing microcoils through the microcatheter in the small arterial branch may result in rupture of this branch, and, in some cases, "flushing" may be not possible due to peripheral resistance.…”

Section: Discussionmentioning

confidence: 99%

Microcoil embolization through a downsized coaxial catheter system: An experimental study

et al. 2009

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Efficacy of the Left Gastric Artery as a Route for Catheterization of the Right Gastric Artery

Abstract: The left gastric artery is an appropriate route for selective embolization of the right gastric artery as preparation for long-term hepatic artery infusion chemotherapy.

Cited by 11 publications

References 24 publications

Embolisation of the right gastric artery in patients undergoing hepatic arterial infusion chemotherapy using two possible approach routes

Embolisation of the right gastric artery in patients undergoing hepatic arterial infusion chemotherapy using two possible approach routes

Catheterization and embolization of a replaced left hepatic artery via the right gastric artery through the anastomosis: a case report

Microcoil embolization through a downsized coaxial catheter system: An experimental study

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