Dual-balloon infusion microcatheter for selective drug-eluting bead transarterial chemoembolization: initial feasibility study

Monsky, Wayne L.; Padia, Siddharth A.; Hardy, Andrew

doi:10.5152/dir.2017.17059

Cited by 9 publications

(4 citation statements)

References 24 publications

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“…When catheterization of the caudate artery fails with all efforts, the use of a microballoon catheter is recommended for distal protection (Fig 16) (35,36).…”

Section: Chemoembolization Through the Caudate Arterymentioning

confidence: 99%

Selective Chemoembolization of Caudate Lobe Hepatocellular Carcinoma: Anatomy and Procedural Techniques

2019

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Transarterial chemoembolization is the most common treatment for unresectable hepatocellular carcinomas (HCCs). However, when an HCC is located in the caudate lobe, many interventional radiologists are reluctant to perform chemoembolization and percutaneous ablation owing to the tumor's complex vascular supply and deep location. With the advent of C-arm CT, rendering the three-dimensional display of the hepatic artery and detecting the tumor-feeding vessels are possible and can help guide interventional radiologists to the tumor. The common origins of the caudate artery include the right hepatic artery, left hepatic artery, right anterior hepatic artery, and right posterior hepatic artery. The origins of the tumor-feeding arteries of a caudate lobe HCC can vary depending on the tumor's subsegmental location. Caudate lobe HCCs are commonly fed by multiple caudate arteries that are connected. In addition, extrahepatic collateral arteries frequently supply recurrent tumors in the caudate lobe. The caudate artery can supply portal vein thrombi or biliary tumor thrombi in patients with HCC. Several techniques such as preshaping the microcatheter or using the shepherd's hook technique are needed to catheterize the caudate artery in complex cases. Although uncommon, bile duct stricture is a serious complication following selective chemoembolization through the caudate artery. Identification and catheterization of the caudate artery have become possible in most patients by using C-arm CT and a fine microcatheter system, respectively. The authors review the anatomy of the caudate artery with C-arm CT and describe basic technical considerations in selective chemoembolization for caudate lobe HCCs. Unusual circumstances that require catheterization and techniques used for catheterizing the caudate artery are also described.

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“…When catheterization of the caudate artery fails with all efforts, the use of a microballoon catheter is recommended for distal protection (Fig 16) (35,36).…”

Section: Chemoembolization Through the Caudate Arterymentioning

confidence: 99%

Selective Chemoembolization of Caudate Lobe Hepatocellular Carcinoma: Anatomy and Procedural Techniques

2019

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“…Innovative techniques have made each anti-reflux microcatheter suitable for different procedures [5]. Transarterial chemoembolization (TACE) of liver cancer has shown good results when performed with a dual-balloon infusion microcatheter [8] that allowed the isolation of the treated area while still guaranteeing the blood flow through a bypass.…”

Section: Discussionmentioning

confidence: 99%

Fluid-dynamic control microcatheter used with glue: preliminary experience on its feasibility and safety

et al. 2022

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Purpose To evaluate feasibility, safety, and success of peripheral embolization procedures carried out using anti-reflux microcatheter with N-butyl-cyanoacrylate (NBCA) as an embolic agent. Methods We retrospectively described 11 patients that suffered from active bleeding in different body districts, who underwent embolization procedure using SeQure microcatheter (Guerbet, France) with NBCA glue (Glubran II, GEM Italy) as an embolic agent. The treatments required NBCA volumes ranged from 0.1 to 0.6 mL, with different dilutions with ethiodized oil (Lipiodol, Guerbet, France), depending on the entity of the bleeding. Technical success, clinical success, and complications were evaluated. ResultsThe procedures were successfully concluded in the totality of the patients, achieving full technical and clinical success. In one patient (9.1%), a small upstream of embolic material was encountered, without any consequence. Conclusion This preliminary experience shows that the use of SeQure is feasible and safe with NBCA.

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“…The CR and ORR of DEB-TACE in HCC patients realize a range of approximately 32% to 42.4% and 51% to 94.5% in several previous studies, displaying good treatment responses. [15–17] While for RFA, previous studies indicate responses rates of RFA in HCC patients with a CR range roughly at 20% to 90%. [18–20] Prior studies show that combining TACE with RFA realizes relatively encouraging treatment responses.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of drug-eluting bead transarterial chemoembolization (DEB-TACE) combined with radiofrequency ablation versus DEB-TACE alone in Chinese hepatocellular carcinoma patients

Zhu

Yuan²,

Wang³

et al. 2019

Medicine

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To compare the efficacy of drug-eluting bead transarterial chemoembolization combined with radiofrequency ablation (DEB-TACE+RFA) versus DEB-TACE alone in Chinese hepatocellular carcinoma (HCC) patients. The 28 patients receiving DEB-TACE+RFA and 74 HCC patients receiving DEB-TACE were recruited in this study. Treatment responses, progression-free survival (PFS), and overall survival (OS) were evaluated. One to 3 months after treatments, the proportion of patients achieving complete response (CR) (78.6% vs 33.8%, P <.001) and objective response rate (ORR) (92.9% vs 78.4%, P =.010) were elevated in DEB-TACE+RFA group compared with DEB-TACE group. Multivariate logistic regression displayed that DEB-TACE+RFA was an independently predicting factor for better CR ( P = .006). Subgroup analysis of CR achievement illuminated that DEB-TACE+RFA disclosed better CR achievement in patients with history of cirrhosis ( P <.001), tumor located in right liver ( P = .003), bilobar disease ( P = .013), tumor size <3.3 cm ( P = .001), no portal vein invasion ( P = .001), no hepatic vein invasion ( P <.001), Child-pugh stage A ( P <.001), Barcelona Clinic Liver Cancer (BCLC) stage 0, A-B ( P <.001), abnormal alpha-fetoprotein (AFP) ( P = .001) and normal AFP ( P = .016). The PFSs were similar between 2 groups ( P = .112), however, the OS was more prolonged in DEB-TACE+RFA group ( P = .025) compared with DEB-TACE group. And subgroup analysis displayed that PFS of patients with largest nodule size >3.3 cm ( P = .025) was longer and patients with unilobar disease ( P = .009), and patients with no hepatic invasion ( P = .019) and Child-pugh stage A ( P = .037) had more favorable OS in DEB-TACE+RFA group compared with DEB-TACE group. DEB-TACE+RFA achieved better treatment responses and OS compared with DEB-TACE alone in Chinese HCC patients.

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Dual-balloon infusion microcatheter for selective drug-eluting bead transarterial chemoembolization: initial feasibility study

Cited by 9 publications

References 24 publications

Selective Chemoembolization of Caudate Lobe Hepatocellular Carcinoma: Anatomy and Procedural Techniques

Selective Chemoembolization of Caudate Lobe Hepatocellular Carcinoma: Anatomy and Procedural Techniques

Fluid-dynamic control microcatheter used with glue: preliminary experience on its feasibility and safety

Efficacy of drug-eluting bead transarterial chemoembolization (DEB-TACE) combined with radiofrequency ablation versus DEB-TACE alone in Chinese hepatocellular carcinoma patients

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