Skin ischemia and ulceration as a complication of inferior phrenic artery embolization for hepatocellular carcinoma

Koh, Sukjin; Maki, Erik; Kolbeck, Kenneth J.; Farsad, Khashayar

doi:10.1016/j.radcr.2018.02.032

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…There is a pseudoaneurysm at the anterior aspect of the knee joint arising from the inferior lateral geniculate artery (short arrow). b There is successful occlusion of the pseudoaneurysm following coil embolization (2 x Ruby coils, 3 mm × 5 cm and 4 mm × 6 cm) of the feeding artery 300 μm, a phenomenon also reported in other anatomical sites (Koh et al 2018;Khoury et al 2017). Three patients in our cohort underwent embolization with gelatin foam-based slurry (Gelfoam; Pfizer).…”

Section: Discussionmentioning

confidence: 57%

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Endovascular management of recurrent hemarthrosis of the knee: a case series

et al. 2020

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Background: Recurrent hemarthrosis of the knee is an uncommon but potentially debilitating occurrence with multiple etiologies, including previous total knee replacement. The purpose of this study is to present data of a group of patients undergoing angiography and embolization for recurrent hemarthrosis of the knee. Patient characteristics, angiographic findings, safety and efficacy of the procedure are reported. Methods: A retrospective single centre review of patients undergoing angiography and embolization at a tertiary referral centre in Sydney, Australia from March 2006 to April 2018 was performed. A total of 25 patients undergoing a total of 29 procedures were identified (20 female, 5 male; mean age 67), the majority of which (23/25, 92%) had a history of total knee arthroplasty. Embolization was performed in 28 of the 29 procedures (97%). The embolic agent used was either polyvinyl alcohol particles (23/28), gelatin foam (3/28), detachable microcoils (1/28) or a combination of particles and coils (1/28). Results: The most commonly identified dominant vascular abnormality was periarticular synovial hypervascularity (23/25, 92%). A pseudoaneurysm was demonstrated in two patients (8%). Technical success (elimination of angiographic abnormalities) was achieved in 27 of 29 procedures (93%). There were 6 episodes of recurrence (25%) following a single embolization procedure, three of which were managed successfully with repeat embolization. There were no complications relating to skin or periarticular ischemia. Conclusion: Angiography and embolization is a safe and effective tool for the management of recurrent hemarthrosis of the knee following arthroplasty and should be considered first line treatment following failure of conservative management. Level of evidence: Level 4, Case Series.

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Section: Discussionmentioning

confidence: 57%

“…Particles smaller than this were generally avoided due to their potential to contribute to cutaneous ischemia. Increased rates of skin erythema or necrosis were reported in a systematic review by Kolber et al with particles less than 300 μm, a phenomenon also reported in other anatomical sites (Koh et al 2018 ; Khoury et al 2017 ).…”

Section: Discussionmentioning

confidence: 62%

Endovascular management of recurrent hemarthrosis of the knee: a case series

et al. 2020

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“…cTACE is applied in clinical practice with a longer period than DEB-TACE, thus articles focusing on the TACE of EHC blood supplies are limited to cTACE. [12][13][14][15] In the other words, the role of DEB-TACE in the treatment of EHC blood supplies of HCC is still undetermined.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, no grade 3-4 liver toxicity was documented in all patients in our study, indicating that TACE of EHC arteries is safe with regard to liver function. The safety of transarterial management for HCC with the IPA has been evaluated in several studies, [12][13][14][15] and most of the adverse events were pulmonary complications, of which fewer than 5% met the definition for major complications. 13 In our study, DEB-TACE and cTACE showed no significant difference in both major and minor complications.…”

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confidence: 99%