Smith Justin, Murthy Ravi, Lahoti Amit, Odisio Bruno, Avritscher Rony, Chasen Beth, Mahvash Armeen
Department of Diagnostic and Interventional Imaging, UT Houston Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA.
Case Rep Radiol. 2013;2013:560758. doi: 10.1155/2013/560758. Epub 2013 Apr 27.
The most severe complication of yttrium-90 therapy is gastrointestinal ulceration caused by extrahepatic dispersion of microspheres. Standard pretreatment planning requires extensive angiographic evaluation of the hepatic circulation and embolization of hepatoenteric collaterals; however, in patients with severe renal insufficiency, this evaluation may lead to acute renal failure. In order to minimize iodinated contrast utilization in a patient with preexisting severe renal insufficiency, the authors describe the use of a balloon catheter for temporary occlusion of the common hepatic artery to induce transient redirection of flow of the hepatoenteric arteries towards the liver, in lieu of conventional coil embolization.
钇-90治疗最严重的并发症是微球肝外弥散导致的胃肠道溃疡。标准的预处理计划需要对肝循环进行广泛的血管造影评估以及栓塞肝肠侧支循环；然而，对于严重肾功能不全的患者，这种评估可能会导致急性肾衰竭。为了尽量减少已有严重肾功能不全患者的碘化造影剂用量，作者描述了使用球囊导管临时阻断肝总动脉，以诱导肝肠动脉血流暂时重新导向肝脏，替代传统的弹簧圈栓塞。
