Transcatheter Occlusion of the Gastroduodenal Artery

Abstract

The gastroduodenal arteries of 7 patients were occluded for treatment of duodenal bleeding in 4, hepatic devascularization in 2, and redistribution of blood flow for intra-arterial chemotherapy in one patient. In 6 patients, occlusion was performed with Gianturco coils, and with Gelfoam in one. No major complication was encountered. This approach was successful in the control of bleeding from peptic ulcers, arteriovenous malformation and invasion of duodenum by retroperitoneal metastatic lymph nodes from carcinoma of the testicle. Occlusion of the gastroduodenal artery was utilized for further dearterialization of hepatic neoplasms. Redistribution of hepatic blood flow was accomplished by the occlusion of the gastroduodenal and replaced right hepatic arteries allowing infusion of chemotherapeutic agents into the entire liver through the left hepatic artery.

Transarterial embolisation of hepatocellular carcinoma with doxorubicin-eluting beads: single centre early experience

“…Acute cholecystitis attributed to inadvertent embolisation of the cystic artery was reported following DEB TACE [20]. In order to avoid serious adverse effects or damage to the gastroduodenal territory due to misdistribution of embolic or chemotherapeutic agents, embolisation of the gastroduodenal artery can be performed prior to embolisation [32, 33]. Prophylactic embolisation of nontarget arteries is a well-established approach to protection of non target organs in 90 Y SIR-Spheres embolisation [34].…”

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

“…A gastric mucosal lesion caused by inflow of chemotherapeutic agents into the right gastric artery is one such complication [15][16][17][18][19][20][21][22][23][24]. To prevent this complication, researchers have noted the efficacy of selectively embolizing the right gastric artery at the time of implantation of the port-catheter system [21,[25][26][27].…”

Value of Transcatheter Arterial Embolization with Coils and n-Butyl Cyanoacrylate for Long-term Hepatic Arterial Infusion Chemotherapy

“…As a result, only two (1.6%) of 128 patients discontinued scheduled HAIC because of gastrointestinal mucosal lesions. Previous reports have also described the efficacy of selective TAE for arteries that supply blood to extrahepatic adjacent organs to avoid reactive gastric or duodenal mucosal lesions resulting from infusion of chemotherapeutic agents into these organs(7,16,20,24,25). Inaba et al(25) reviewed 217 patients who underwent repeat HAIC and found that only five (2.6%) of 192 patients in whom the right gastric artery was sufficiently embolized before long-term HAIC developed gastric mucosal lesions, whereas nine (36.0%) of 25 patients without sufficient embolization developed such lesions.…”