Liver Infarction after Drug-Eluting Embolic Transarterial Chemoembolization for Hepatocellular Carcinoma in the Setting of a Large Portosystemic Shunt

Park, Benjamin V.; Gaba, Ron C.; Lokken, R. Peter

doi:10.1055/s-0036-1592319

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…The localization of hepatic infarction is frequently described in the right hepatic lobe [28,33,36,39,45,49,60], but can also occur in the left hepatic lobe [48] and may be multifocal particularly in the peripheries of both lobes [43,49,55,61]. Localization to the caudate lobe has also been reported [62].…”

Section: Imagingmentioning

confidence: 99%

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Comments and illustrations of the WFUMB CEUS liver guidelines: Rare vascular pathology, part II

et al. 2023

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In this second part of the topic the hepatic pseudoaneurysm, hepatic infarction, and pylephlebitis are discussed as acute and potentially life-threatening hepatic vascular diseases. The focus is on their appearance on B-mode ultrasonography, duplex ultrasonography, and contrast-enhanced ultrasonography. Zahn’s pseudo infarction is an important differential diagnosis to wedge-shaped hepatic infarction in this context. Knowledge of the data should help raise awareness of these rare findings, to come up with relevant differential diagnoses in the corresponding clinical situation, to interpret the ultrasound images correctly and thus to initiate the appropriate diagnostic and therapeutic steps in time.

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Section: Imagingmentioning

confidence: 99%

“…TACE has traditionally been considered to be contraindicated in cases of portal venous tumor thrombosis, owing to the risk of hepatic infarction and further deteriorate liver function [47]. In the case of TACE and the presence of a transjugular shunt or TIPS, several risk factors are compounded [48].…”

Section: Liver Infarctionmentioning

confidence: 99%

Comments and illustrations of the WFUMB CEUS liver guidelines: Rare vascular pathology, part II

et al. 2023

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“…The development of hepatic infarction also depends on whether an effective collateral circulation to compensate for the blood flow occlusion can be established. Certain medical techniques and procedures such as transjugular portosystemic shunt, 1 , 2 pancreaticobiliary surgery, 3 liver transplantation, and hepatic artery chemoembolization, 4 have been associated with the occurrence of hepatic infarction. Additionally, blood hypercoagulability and blunt liver injury can increase the risk of hepatic infarction.…”

Section: Introductionmentioning

confidence: 99%

Hypervirulent Klebsiella pneumoniae Mediated Hepatic Infarction Septic Shock After Rectal Cancer Surgery: A Case Report

Li,

Yang,

Zheng

et al. 2024

IDR

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The liver receives blood from both the hepatic artery and portal vein. Hepatic infarction is rare in clinical practice as both the hepatic artery and portal vein can supply blood to the liver. Here, we reported a case of a 75-year-old man who underwent radical laparoscopic surgery for rectal cancer and subsequently developed hepatic infarction. The patient experienced severe infection, as well as circulatory and respiratory failure on the third day after surgery. The patient presented with high fever, chest tightness, shortness of breath, decreased blood oxygen saturation and blood pressure. The leukocyte count decreased from 8.10 × 10^9/L to 1.75 × 10^9/L. Procalcitonin (PCT) levels increased from 1.02 ng/mL to 67.14 ng/mL, and eventually reaching levels over 200 ng/mL. Enhanced abdominal computed tomography (CT) confirmed the presence of hepatic infarction, but no thrombosis was observed in the hepatic artery or portal vein. Metagenomic next-generation sequencing (mNGS) identified hypervirulent Klebsiella pneumoniae (hvKp) in the patient's blood and ascites, one day earlier than the detection results using traditional culture methods. The patient was diagnosed with hepatic infarction combined with septic shock caused by hvKp. This case emphasizes that in the high-risk group of thrombosis, infection can trigger exacerbated hepatic infarction events, particularly in cases after surgical procedures. For severely ill patients with infectious diseases who are admitted to the ICU with worsening symptoms, it is important to collect appropriate samples and send them for pathogen detection using mNGS in a timely manner. This may aid in early intervention and improve clinical outcomes.

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“…Despite the theoretical advantages of transarterial treatment, the lack of specificity, variability in treatment protocols, and the unpredictable response of the tumors to the available therapeutic challenges have limited the utility of this treatment regime. Transarterial embolotherapies are also potentially hepatotoxic , particularly in patients with poor liver function (5), and may additionally compromise hepatic blood flow (6,7). Optimally, liver tumors would be treated with a highly targeted approach that safely and specifically destroys tumor cells while preserving functional liver parenchyma.…”

Section: Introductionmentioning

confidence: 99%

Transarterial Delivery of a Biodegradable Single-Agent Theranostic Nanoprobe for Liver Tumor Imaging and Combinatorial Phototherapy

Taratula

Han

Jahangiri

et al. 2019

Journal of Vascular and Interventional Radiology

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Purpose: To assess the selective accumulation of biodegradable nanoparticles within hepatic tumors after trans-arterial delivery for in vivo localization and combinatorial phototherapy. Materials and Methods:A VX2 hepatic tumor model was used in New Zealand white rabbits. Transarterial delivery of silicon naphthalocyanine biodegradable nanoparticles was performed using a microcatheter via the proper hepatic artery. Tumors were exposed via laparotomy and nanoparticles were observed by near-infrared (NIR) fluorescence imaging. For phototherapy, a handheld NIR laser (785 nm) at 0.6 W/cm 2 was used to expose tumor or background liver, and tissue temperatures were assessed with a fiber-optic temperature probe. Intra-tumoral reactive oxygen species (ROS) formation was assessed using a fluorophore H2DCFDA (2',7'dichlorodihydrofluorescein diacetate).Results: Nanoparticles selectively accumulated within viable tumor by NIR fluorescence. Necrotic portions of tumor did not accumulate nanoparticles, consistent with a vascular distribution. NIR-dependent heat generation was observed with nanoparticle-containing tumors, but not in background liver. No heat was generated in the absence of NIR laser light. ROS were formed in nanoparticle-containing tumors exposed to NIR laser light, but not in background liver treated with NIR laser or in tumors in the absence of NIR light. Conclusions:Biodegradable nanoparticle delivery to liver tumors from a transarterial approach enabled selective in vivo tumor imaging and combinatorial phototherapy.

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Liver Infarction after Drug-Eluting Embolic Transarterial Chemoembolization for Hepatocellular Carcinoma in the Setting of a Large Portosystemic Shunt

Cited by 5 publications

References 24 publications

Comments and illustrations of the WFUMB CEUS liver guidelines: Rare vascular pathology, part II

Comments and illustrations of the WFUMB CEUS liver guidelines: Rare vascular pathology, part II

Hypervirulent Klebsiella pneumoniae Mediated Hepatic Infarction Septic Shock After Rectal Cancer Surgery: A Case Report

Transarterial Delivery of a Biodegradable Single-Agent Theranostic Nanoprobe for Liver Tumor Imaging and Combinatorial Phototherapy

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