Gallbladder infarction following hepatic transcatheter arterial embolization. Angiographic study.

Abstract

Gallbladder infarction developing after transcatheter arterial embolization (TAE) in patients with malignant hepatic tumors was studied by comparing preoperative angiographic and postoperative macroscopic and histological findings. Eight patients demonstrated occlusion of the cystic artery or its branches by embolic materials on post-TAE angiograms. Surgery revealed infarction of the gallbladder in 6 patients; no infarction was noted in the other 2, although branches of the cystic artery were occluded on the post-TAE angiogram. Due to recanalization of the occluded artery, the infarcted area could be assessed only by follow-up angiography. No patient experienced perforation of the gallbladder as a result of infarction. The authors suggest that patients with post-TAE infarction of the gallbladder can be treated conservatively if they are kept under close observation.

Acute Hepatic Failure following Transcatheter Arterial Embolization for the Treatment of Hepatocellular Carcinoma

“…Embolization procedures are now regarded as impor tant therapy for the management of liver tumors [1,2], Transcatheter arterial embolization (TAE), the most ef fective conservative treatment for patients with hepato cellular carcinoma [3,4], is associated with a number of serious complications: infarction of the biliary system [5,6]; disseminated intravascular coagulation (DIC) [7], and renal and hepatic failure [3], Among these complications, acute hepatic failure is most common because patients with hepatocellular carcinoma frequently suffer from coexisting chronic liver disease [8]. Yamada et al [3] reported TAE-induced hepatic failure in patients with occlusion of the main portal vein.…”

Embolization of the hepatic falciform artery to prevent supraumbilical skin rash during transcatheter arterial chemoembolization for hepatocellular carcinoma

“…With the widespread use of TACE, various complications have been reported [3][4][5]. One such complication is a supraumbilical skin rash caused by the flow of chemotherapy into the hepatic falciform artery (HFA), to date only described for prolonged intraarterial chemotherapy infusion with prevention by surgical ligation of the HFA [6].…”

Repeated Intra-Arterial Therapy via the Cystic Artery for Hepatocellular Carcinoma

“…This complication is caused by unavoidable embolization of the cystic artery during hepatic artery embolization when the catheter tip is inappropriately positioned beyond the cystic artery [3][4][5][6]. Furthermore, the ischemic complication of the gallbladder is more crucial for patients with HCCs fed by the cystic artery [13,14].…”

“…The cystic artery usually supplies the liver parenchyma near the gallbladder bed as well as the gallbladder [1,2]. The clinical significance of the cystic artery during chemoembolization is the possibility of ischemic complications of the gallbladder [3][4][5][6][7][8][9][10][11][12]. The incidence and outcomes of cholecystitis after transcatheter arterial chemoembolization (TACE) is somewhat controversial.…”