Percutaneous hepatic infarction therapy for hepatocellular carcinoma.

Imamura, Masatoshi; Shiratori, Yasushi; Sato, Seiya; Obi, Shuntaro; Okudaira, Takehito; Teratani, Takuma; Kato, Naoya; Shiina, Shuichiro; Omata, Masao

doi:10.2214/ajr.171.4.9762991

Cited by 9 publications

(1 citation statement)

References 11 publications

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“…Previously, Imamura et al [9] reported the possibility of treating hepatic infarction by injecting ethanol into the hepatic artery for the treatment of HCC. In recent years, there have been doubts about whether hepatic infarction is desirable to maintain functional hepatic reserve, but an intra-arterial ethanol injection is very effective for hemostasis when HCC ruptures.…”

Section: Discussionmentioning

confidence: 99%

Procedure of Direct Hepatic Artery Puncture for the Treatment of Hepatocellular Carcinoma: Two Case Reports

Takashima¹,

Moriguchi

Yasui

et al. 2020

Case Rep Oncol

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Recently, treatment options for hepatocellular carcinoma (HCC) have expanded due to the development of the tyrosine kinase inhibitor ramucirumab and immune checkpoint inhibitors. Transcatheter arterial chemoembolization is the standard therapy for intermediate-stage HCC; however, in cases with anatomical problems, normal approaches are not possible. In such rare cases, direct hepatic puncture may be considered as an effective therapy and an indispensable treatment. We report our novel method of direct hepatic artery puncture in this case report. In 2011 and 2017, we reported 2 cases in the journal of the Japan Society of Hepatology in Japanese. This therapy is difficult and is associated with a high risk of complications; however, we succeeded in both cases in a similar way. We believe this method may provide an alternative treatment when standard treatment is not possible or when urgent therapy is required. In case 1, direct hepatic artery puncture was performed under ultrasonographic guidance, and we were able to control the disease with percutaneous lipiodol chemotherapy. Case 2 was an emergency case of ruptured HCC. Direct hepatic puncture successfully stopped tumor bleeding; furthermore, tumor necrosis also occurred, as seen on the enhanced computed tomography image. Our new method requires advanced puncture techniques and is not the treatment of choice if there are other safe alternatives available. However, it can be considered as an option if there are no other viable, effective treatments.

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Section: Discussionmentioning

confidence: 99%