The Hepatic Artery

Hepatic Artery Occlusion with Perfusion in the Treatment of Carcinoid Syndrome

“…As métastasés increase in size, surround ing portal vessels are obliterated and the tumor is nourished by arterial blood [7], In 1952, Markowitz [9] suggested hepatic artery ligation in the treatment of metastatic tumors. Reports of accidental or inten tional artery ligation at surgery have confirmed this approach and temporary ligation has been proposed Intra-arterial chemotherapy perfusion of hepatic tumors without arterial occlusion has been used in a variety of tumors including the carcinoid syndrome [5,[12][13][14][15], Simultaneous arterial occlusion and regional perfusion of tumors was first reported by Creech et al [16,17] two decades ago and most experience was achieved with pelvic and extremity tumors [18,19], The technique, often requiring major surgery and general anesthesia, was cumbersome and frequently resulted in hematopoietic suppression.…”

“…Mul tiple blood cultures revealed no bacterial growth and the fevers resolved following termination of the pro cedure. Fever may have resulted from tumor necrosis, but the possibility of endogenous and exogenous bac terial seeding from the necrotic tissue exists [2,9]. Bowel sterilization and prophylactic antibodies were not utilized in either case.…”

Insulinoma

“…Similar to chemotherapy, hepatic interventions should be targeted at patients with later stage disease or symptomatic liver metastases. • Hepatic artery interventions were first proposed by Markowitz [31] in 1952.…”

Hypoglycaemic and Antidiabetic Sulphonamides

“…At this point I should like to recall the fact that Markowitz, Rappaport, and Scott (see Markowitz and Rappaport, 1951) observed that, although dogs usually die if the hepatic artery is ligated, they survive the operation when given large amounts of penicillin to facilitate postoperative recovery. This unexpected finding led Markowitz and Rappaport (1951) to survey the literature concerning the bacteriology of normal liver.…”