Hiyoshi Yukiharu, Beppu Toru, Okabe Kazutoshi, Hayashi Hiromitsu, Masuda Toshiro, Okabe Hirohisa, Mizumoto Takao, Komori Hiroyuki, Tanaka Hiroshi, Horino Kei, Ishiko Takatoshi, Takamori Hiroshi, Hirota Masahiko, Baba Hideo
Dept. of Gastroenterological Surgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University.
Gan To Kagaku Ryoho. 2007 Nov;34(12):2093-5.
Transcatheter arterial embolizations of severe arterioportal shunt (A-P shunt) were performed with steel coils in 3 patients with hepatocellurlar carcinoma (HCC) as shown below. Case 1: A 56-year-old man with HCC associated with portal hypertension (esophageal varices and ascites abnominal pain), portal vein tumor thrombus and severe A-P shunt was performed in critical conditions. Case 2: A 51-year-old man with HCC, lung and adrenal gland metastases was accompanied with severe portal hypertention caused by A-P shunt and was in a harmful condition similar to case 1. Case 3: A 68-year-old woman with HCC associated with autoimmune hepatitis was performed a hepatic resection. Then multiple intrahepatic recurrences appeared 6 months later. A-P shunt made impossible to detect the feeding artery of tumor. After embolization of A-P shunt, esophageal varices and ascites resolved, and abdominal pain improved in cases 1 and 2. In addition, embolization enabled to perform transcatheter arterial chemoembolization in case 3. This procedure is a useful tool to improve various symptoms due to A-P shunt and to continue treatments for HCCs.
