Absolute Ethanol Embolization for Peripheral Arteriovenous Malformation: Report of Two Cures

Am, Vinson; Dg, Rohrer; Cw, Willcox; Sv, Sigfred; Wheeler,; Js, Jacobs; W, Ruffin

doi:10.1097/00007611-198808000-00028

Cited by 26 publications

(10 citation statements)

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“…Clinically absolute ethanol has been used intravenously for the ablation of renal tumors 19. It has also been used for hemostasis of bleeding esophageal varices and for sclerotherapy of peripheral arteriovenous malformations 20,21. Its low viscosity, liquid nature, and devastating potential for destroying contacted tissues appear to give it an advantage over other agents such as gelatin sponges.…”

Section: Discussionmentioning

confidence: 99%

Preoperative percutaneous transhepatic portal embolization with absolute ethanol in patients with hepatocellular carcinoma

Une

Haneda

Ogasawara

et al. 1997

J Hep Bil Pancr Surg

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Preoperative percutaneous transhepatic portal vein embolization (PTPE) has been used in recent years to decrease the amount of liver resected and to reduce the risk of postoperative liver failure in patients with hepatocellular carcinoma. Various thrombogenic agents have been employed for this purpose..We evaluated the clinical safety and efficacy of absolute ethanol for PTPE and examined the histopathologic changes that follow ethanol embolization of the liver. We studied nine patients with hepatocellular carcinoma who were not originally regarded as surgical candidates because of a high risk of postoperative liver failure. They received preoperative PTPE of the right portal vein, with an average of 22.8ml of absolute ethanol. The right iobe showed complete obstruction of portal venous branches and massive necrosis of the liver parenchyma. Macroscopically, there was atrophy of the embolized lobes and compensatory hypertrophy of the remaining lobes. The mean volume of the nonembolized lobe increased, from 351 to 585 and 633ml, 2 and 4 weeks after embolization, respectively. The mean regeneration rate of this lobe was 16.7cm3/day for the first 2 weeks after embolization and 10.1 cm3/day for the first 4 weeks. Transient dynamic increases in alanine aminotransferase concentrations were seen. All patients subsequently underwent right lobectomy of the liver and survived without severe complications. Portal vein embolization with absolute ethanol makes more extensive hepatectomy possible by reducing the volume necessary to resect, and it preserves the function of the remaining liver.

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Section: Discussionmentioning

confidence: 99%

Preoperative percutaneous transhepatic portal embolization with absolute ethanol in patients with hepatocellular carcinoma

Une

Haneda

Ogasawara

et al. 1997

J Hep Bil Pancr Surg

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“…17,18 It was effective in producing renal ablation without causing damage to the parenchyma or vasculature of any other area in the body except the kidney. 21 It has an advantage over other agents like gelatin sponge because of its low viscosity, liquid nature, and devastating potential of destroying the contacted tissues. 21 It has an advantage over other agents like gelatin sponge because of its low viscosity, liquid nature, and devastating potential of destroying the contacted tissues.…”

Section: Discussionmentioning

confidence: 99%

Selective portal vein embolization with absolute ethanol induces hepatic hypertrophy and makes more extensive hepatectomy possible

Ogasawara

Uchino

et al. 1996

Hepatology

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Portal vein embolization has been used recently to decrease the amount of the liver to be resected and to enhance the function of the remaining hypertrophied lobes. We have observed a strong contact destructivity of absolute ethanol and used it for portal vein embolization. The present study was performed to produce hepatic hypertrophy and to show histopathologic changes that follow ethanol embolization of rat liver. Hepatic proliferation and histopathology were studied in rats receiving low and high doses of absolute ethanol via portal vein and rats undergoing 70% hepatectomy alone. The liver weight of the unresected and unembolized lobes increased rapidly after embolization and hepatectomy. Although the increase was more rapid in the high-dose group than the low-dose group in early days, the final results were not different from each other and were almost equal to those after hepatectomy. Complete obstruction of portal venous branches and massive necrosis were the main histopathologic observations after portal vein embolization with all doses of ethanol. Because the mortality rate in the low-dose group was lower than in the high-dose group and extensive necrosis of the liver parenchyma and subsequent regeneration was sufficient, using minimum dose of ethanol was much safer. Based on the biochemical and hematologic parameters, portal vein embolization with low-dose ethanol did not impair liver function more than hepatectomy alone during the initial 14 days. Portal vein embolization with absolute ethanol makes more extensive hepatectomy possible by reducing the volume necessary to resect and preserves the function of the remaining liver.

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“…9,15,16 In AVMs, these changes are desirable and responsible for the curative effects and permanence of ethanol embolization. This is quite important for AVMs of the face, considering the aesthetic aspects.…”

Section: Discussionmentioning

confidence: 99%

Absolute Ethanol Embolization of Infiltrating-diffuse Extracranial Arteriovenous Malformations in the Head and Neck

Wang

Han

et al. 2015

European Journal of Vascular and Endovascular Surgery

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Absolute Ethanol Embolization for Peripheral Arteriovenous Malformation: Report of Two Cures

Cited by 26 publications

References 0 publications

Preoperative percutaneous transhepatic portal embolization with absolute ethanol in patients with hepatocellular carcinoma

Preoperative percutaneous transhepatic portal embolization with absolute ethanol in patients with hepatocellular carcinoma

Selective portal vein embolization with absolute ethanol induces hepatic hypertrophy and makes more extensive hepatectomy possible

Absolute Ethanol Embolization of Infiltrating-diffuse Extracranial Arteriovenous Malformations in the Head and Neck

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