Gibo Masaki, Unten Shinobu, Yogi Akira, Nakayama Tadashi, Ayukawa Yuichirou, Gibo Shinji, Murayama Sadayuki, Takara Makoto, Shiraishi Masayuki
Department of Radiology, Graduate School of Medical Science, University of Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
Radiat Med. 2007 May;25(4):164-72. doi: 10.1007/s11604-007-0120-z. Epub 2007 May 28.
The purpose of the present study was to show the feasibility and safety of ipsilateral portal vein embolization (PVE) using an improved four-lumen balloon catheter with fibrin glue.
To improve the ipsilateral PVE with fibrin glue, we modified a commercially available four-lumen balloon catheter to create a catheter comprising one lumen with a catheter tip for a guidewire, one lumen for an occlusion balloon, and two lumens, each with a side-hole just proximal to the balloon. Eight patients had hepatobiliary disease (three with bile duct carcinoma, two with gallbladder carcinoma, one with hepatocellular carcinoma, one with Caroli disease, and one with metastatic carcinoma).
All embolization procedures were technically successful. After embolization, the volume of the future remnant liver increased a mean of 131%. There was no inadvertent embolization of portal vein branches and no major procedure-related complications.
Our method is potentially easier and safer than the traditional ipsilateral method with fibrin glue using a three-lumen balloon catheter because the fourth lumen makes possible the use of a guidewire to access the targeted portal vein and measurement of any portal vein pressure elevation following PVE via the fourth lumen.
本研究的目的是展示使用带有纤维蛋白胶的改良四腔球囊导管进行同侧门静脉栓塞术（PVE）的可行性和安全性。
为了改进使用纤维蛋白胶的同侧PVE，我们对市售的四腔球囊导管进行了改良，制成一种导管，其包括一个带有用于导丝的导管尖端的腔、一个用于阻塞球囊的腔以及两个腔，每个腔在球囊近端均有一个侧孔。8例患者患有肝胆疾病（3例胆管癌、2例胆囊癌、1例肝细胞癌、1例卡罗里病和1例转移性癌）。
所有栓塞手术在技术上均获成功。栓塞后，未来残余肝脏的体积平均增加了131%。未发生门静脉分支的意外栓塞，也未出现与手术相关的重大并发症。
我们的方法可能比使用三腔球囊导管的传统纤维蛋白胶同侧方法更容易、更安全，因为第四腔使得能够使用导丝进入目标门静脉，并通过第四腔测量PVE后门静脉压力的任何升高。
