The double-balloon technique: a safe and effective adjunctive technique in patients undergoing arterial therapy for hepatic malignancies with vascular supply not amenable to selective administration.
The double-balloon technique: a safe and effective adjunctive technique in patients undergoing arterial therapy for hepatic malignancies with vascular supply not amenable to selective administration.
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双球技术：接受动脉疗法的患者的一种安全有效的辅助技术，可用于肝脏恶性肿瘤的血管供应不适合选择性给药。
DOI：
10.1186/s42155-023-00349-y
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发表时间：
2023-02-07
影响因子：
1.2
通讯作者：
Wehrenberg-Klee, Eric
中科院分区：
文献类型：
--
作者：
Tanaka, Mari;Uppot, Raul;Daye, Dania;Liu, Raymond;Wehrenberg-Klee, Eric
在针对肝脏病变进行导管引导动脉内治疗期间，具有挑战性的肝血管解剖结构有时会妨碍对肝脏肿瘤进行选择性治疗，从而导致对正常肝实质的毒性增加。本研究的目的是描述双球囊技术的一种变体，该技术将近端和远端的肝脏肿瘤的供血动脉隔离，以便为无法通过其他方式选择的病变提供治疗。 IRB 批准对 7 名接受过放射栓塞、化疗栓塞或温和栓塞并采用双球囊技术的患者进行回顾性审查。用于增加流量的装置是两个 2.1 French 球囊微导管（Sniper™，Embolx）。第一个球囊在目标血管远端充气，第二个球囊在近端充气以防止反流。 3例行DEB-TACE，4例行90Y，1例行温和栓塞。该手术没有产生任何副作用，也没有因非目标栓塞产生临床上明显的影响。平均随访时间为 286.4 +/-200.1 天。 7名患者中有6名还活着。一名患者在术后第 121 天死于与手术无关的感染性休克。一名患者通过对单独病灶进行额外的 TACE 来桥接移植。对于接受 90Y 或化疗栓塞的患者来说，双球囊技术是一种安全的辅助技术，用于对无法通过导管直接选择的肝脏病变进行超选择性治疗。这可能会增加可以通过导管定向疗法安全有效治疗的病变范围。在线版本包含可在 10.1186/s42155-023-00349-y 获取的补充材料。
During catheter directed intraarterial therapy for liver lesions, challenging hepatic vascular anatomy can sometimes prevent selective administration of treatment delivery to liver tumors leading to increased toxicity to normal liver parenchyma. The objective of this study is to describe a variation of the double balloon technique that isolates the feeding artery to liver tumors proximally and distally to provide treatment delivery in lesions that cannot be otherwise selected. An IRB-approved retrospective review of 7 patients who had undergone either radioembolization, chemoembolization, or bland embolization and the double balloon technique was employed. The devices used for flow augmentation were two 2.1 French balloon microcatheters (Sniper™, Embolx). One balloon was inflated distal to target vessel and the second was inflated proximal to protect from reflux. DEB-TACE was performed in 3 cases, 90Y was performed in 4, and bland embolization was performed in the last patient. There were no adverse effects from the procedure or clinically evident effects from non-target embolization. Mean follow up time was 286.4 +/− 200.1 days. Six of the 7 patients are alive. One patient passed away on post-procedure day 121 from septic shock unrelated to the procedure. One patient was bridged to transplant with an additional TACE of a separate lesion. Double-balloon technique for patients undergoing 90Y or chemoembolization is a safe adjunctive technique for super selective treatment of hepatic lesions where direct selection via catheter is not feasible. This may increase the range of lesions that can be both safely and effectively treated by catheter directed therapies. The online version contains supplementary material available at 10.1186/s42155-023-00349-y.
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作者：
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通讯作者：
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DOI：
10.1016/j.jvir.2019.12.017
发表时间：
2020-06-01
影响因子：
2.9
作者：
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通讯作者：
Toskich, Beau B.