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Temporary Balloon Occlusion of the Common Hepatic Artery for Yttrium-90 Glass Microspheres Administration in a Patient with Hepatocellular Cancer and Renal Insufficiency
oleh: Justin Smith, Ravi Murthy, Amit Lahoti, Bruno Odisio, Rony Avritscher, Beth Chasen, Armeen Mahvash
Format: | Article |
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Diterbitkan: | Hindawi Limited 2013-01-01 |
Deskripsi
The most severe complication of yttrium-90 therapy is gastrointestinal ulceration caused by extrahepatic dispersion of microspheres. Standard pretreatment planning requires extensive angiographic evaluation of the hepatic circulation and embolization of hepatoenteric collaterals; however, in patients with severe renal insufficiency, this evaluation may lead to acute renal failure. In order to minimize iodinated contrast utilization in a patient with preexisting severe renal insufficiency, the authors describe the use of a balloon catheter for temporary occlusion of the common hepatic artery to induce transient redirection of flow of the hepatoenteric arteries towards the liver, in lieu of conventional coil embolization.