Arterioportal Shunts in Patients with Hepatocellular Carcinoma Treated Using Ethanol-Soaked Gelatin Sponge: Therapeutic Effects and Prognostic Factors

Zhou, Wei-Zhong; Shi, Haibin; Liu, Sheng; Yang, Zhigang; Zhou, Chun‐Gao; Xia, Jun; Zhao, Lei; Linsun, Li

doi:10.1016/j.jvir.2014.11.002

Cited by 15 publications

(11 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies, APS improvement was shown to be an independent prognostic factor (6). However, most studies focus on materials for the treatment of APS, ignoring the specificity of APS with PVTT.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that embolic materials for the treatment of hepatic arterial shunt (APS) include ethanol-soaked gelatin sponge (ESG) and polyvinyl alcohol (PVA) particles. On the basis of TACE-based therapy, aggressive and thorough APS embolization during surgery can reduce the occurrence of fistula recanalization ( 19 , 20 ). In our study, all patients achieved complete occlusion by using PVA particles during TACE procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Arterioportal shunts have been reported in 27-63.2% ( 5 ) of advanced HCC cases and may be caused by PVTT. The emergence of arterioportal fistulas (APFs) increases the risk of serious complications such as esophageal varices, ascites, and hepatic encephalopathy ( 6 , 7 ), which seriously affects the prognosis and survival of patients.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prospective study of TACE combined with sorafenib vs TACE combined with 125I seed implantation in the treatment of hepatocellular carcinoma with portal vein tumor thrombus and arterioportal fistulas

Zhao

Yuan²,

Xia³

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

PurposeTo compare the efficacy of TACE combined with sorafenib and TACE combined with 125I seed implantation in the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) combined with arterioportal fistulas (APFs), and discuss the efficacy and safety of TACE combined with 125I seed implantation.Patients and methodsBetween January 2017 and December 2018, the clinical data of patients with HCC complicated with PVTT and APFs who were admitted to the Affiliated Cancer Hospital of Zhengzhou University, First Affiliated Hospital of Zhengzhou University, and Henan Provincial People’s Hospital were prospectively collected. The patients were divided into the TACE+sorafenib (TACE-S) group based on their treatment willingness. There were 26 and 32 patients in the TACE-S and TACE-125I groups, respectively. Both groups of patients underwent APFs occlusion during TACE therapy. The embolization effect of APFs was observed and recorded in the two groups, the efficacy of intrahepatic lesions and PVTT was evaluated, and the effects of different treatment methods on the efficacy were analysed.ResultsAll patients completed the 3 months follow-up. The improvement rates of APFs in TACE-S and TACE-125I groups were 30.77% (8/26) and 68.75% (22/32), respectively, and difference was statistically significant (χ2 = 8.287, P=0.004). The median survival time of TACE-S and TACE-125I groups was 8.00 months and 12.8 months, respectively (χ2 = 7.106, P=0.008). Multivariate analysis showed that the PVTT subtype (IIa/IIb) and treatment method (TACE-S or TACE-125I) were independent factors affecting the recanalization of APFs in patients (P<0.05).ConclusionFor patients with HCC with PVTT and APFs, TACE combined with 125I seed implantation can effectively treat portal vein tumor thrombus, thereby reducing the recanalization of APFs and prolonging the survival time of patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prospective study of TACE combined with sorafenib vs TACE combined with 125I seed implantation in the treatment of hepatocellular carcinoma with portal vein tumor thrombus and arterioportal fistulas

Zhao

Yuan²,

Xia³

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…With the advancement of interventional radiology, there is accumulating evidence indicating that TACE may be safe and effective in HCC with HAVS. [7][8][9][10][11][12] As a novel drug-delivering agent for TACE, DEB-TACE showed higher concentrations of chemotherapeutic agents delivered into tumors, reduced adverse events and better patient tolerance. 13 DEB-TACE also revealed its superiority compared to cTACE in the treatment of HCC with a hypovascular pattern 14 and extrahepatic collateral blood supply.…”

Section: Introductionmentioning

confidence: 99%

Combination therapy of sorafenib and drug-eluting bead transarterial chemoembolization for advanced hepatocellular carcinoma with and without hepatic arteriovenous shunt

Chen

Chiu

Tsai

et al. 2022

Journal of the Chinese Medical Association

View full text Add to dashboard Cite

Background: To compare the efficacy and safety of combination therapy with sorafenib and drug-eluting bead transarterial chemoembolization (DEB-TACE) in advanced hepatocellular carcinoma (HCC) with or without hepatic arteriovenous shunt (HAVS). Methods: This retrospective, single-center study enrolled 59 advanced HCC patients treated with combination therapy, of whom 33 (55.9%) patients had HAVS. Tumor response according to the mRECIST criteria was evaluated based on the CT images 1 month after TACE, and changes in the arterial enhancement ratio (AER) of tumors and portal vein tumor thrombosis were also documented. Time-to-progression (TTP), overall survival (OS), and prognostic factors were analyzed. Safety was evaluated with the incidence of TACE-related complications within 6 weeks after TACE. Results: The tumor response between the two groups showed no significant difference in the objective response rate (69.2% in the group without HAVS vs 60.6% in the group with HAVS, p = 0.492) or disease control rate (92.3% vs 87.9%, p = 0.685). The two groups showed comparable TTP (4.23 vs 2.33 months, p = 0.235) and OS (12.77 vs 12.97 months, p = 0.910). A drop in the AER of tumors of more than 20% on post-TACE CT independently predicted better OS. With regard to safety, there was no significant difference between the two groups. Conclusion: For advanced HCC, combination therapy had equal efficacy and safety in patients with HAVS compared to those without HAVS, indicating that DEB-TACE is an optional and effective treatment in these patients.

show abstract

“…17,18 Gelatin sponge particles are a medium-term embolization material, which are typically resorbed within 2-4 weeks, leading to a high recanalization rate. 19 Despite an increase in the reported cases of HAPFs, the clinical characteristics of these patients and the efficacy of the different embolization methods are not well characterized in the contemporary literature. In the present study, we sought to retrospectively summarize the characteristics of HAPFs treated in a single center and compare the efficacy of different embolization methods.…”

Section: Introductionmentioning

confidence: 99%

Hepatic Arterioportal Fistulas: A Retrospective Analysis of 97 Cases

Cao¹,

Tian²,

Zhou³

et al. 2022

J Clin Transl Hepatol

View full text Add to dashboard Cite

Background and Aims: Hepatic arterioportal fistulas (HAPFs) are abnormal shunts or aberrant functional connections between the portal venous and the hepatic arterial systems. Detection of HAPFs has increased with the advances in diagnostic techniques. Presence of HAPFs over a prolonged period can aggravate liver cirrhosis and further deteriorate liver function. However, the underlying causes of HAPFs and the treatment outcomes are now well characterized. This study aimed to summarize the clinical characteristics of patients with HAPFs, and to compare the outcomes of different treatment modalities. Methods: Data of 97 patients with HAPFs who were admitted to the Second Xiangya Hospital between January 2010 and January 2020 were retrospectively reviewed. Demographic information, clinical manifestations, underlying causes, treatment options, and short-term outcomes were analyzed. Results: The main cause of HAPF in our cohort was hepatocellular carcinoma (78/97, 80.41%), followed by cirrhosis (10/97, 10.31%). The main clinical manifestations were abdominal distention and abdominal pain. Treatment methods included transcatheter arterial embolization (n=63, 64.9%), surgery (n=13, 13.4%), and liver transplantation (n=2, 2.1%); nineteen (19.6%) patients received conservative treatment. Among patients who underwent transcatheter arterial embolization, polyvinyl alcohol, lipiodol combined with gelatin sponge, and spring steel ring showed comparable efficacy. Conclusions: Hepatocellular carcinoma and cirrhosis are common causes of HAPFs. Transcatheter arterial embolization is a safe and effective method for the treatment of HAPFs, and polyvinyl alcohol, lipiodol combined with gelatin sponge, and spring steel ring showed comparable efficacy in our cohort.

show abstract

Arterioportal Shunts in Patients with Hepatocellular Carcinoma Treated Using Ethanol-Soaked Gelatin Sponge: Therapeutic Effects and Prognostic Factors

Cited by 15 publications

References 22 publications

Prospective study of TACE combined with sorafenib vs TACE combined with 125I seed implantation in the treatment of hepatocellular carcinoma with portal vein tumor thrombus and arterioportal fistulas

Prospective study of TACE combined with sorafenib vs TACE combined with 125I seed implantation in the treatment of hepatocellular carcinoma with portal vein tumor thrombus and arterioportal fistulas

Combination therapy of sorafenib and drug-eluting bead transarterial chemoembolization for advanced hepatocellular carcinoma with and without hepatic arteriovenous shunt

Hepatic Arterioportal Fistulas: A Retrospective Analysis of 97 Cases

Contact Info

Product

Resources

About