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Preoperative microcoil embolization of the common hepatic artery for pancreatic body cancer

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World Journal of Gastroenterology 2012年第16期18卷 1940-1945页

作者： Isao Takasaka nobuyuki kawai Morio Sato Hirohiko Tanihata Tetsuo Sonomura Hiroki Minamiguchi Motoki Nakai Akira Ikoma Kouhei Nakata Hiroki Sanda Department of Radiology Wakayama Medical University811-1 KimiideraWakayama-shiWakayama 641-8510Japan

AIM:To evaluate safety and feasibility of microcoil embolization of the common hepatic artery under proper or distal balloon inflation in preoperative preparation for en bloc celiac axis resection for pancreatic body cancer.METHODS:Fifteen patients(11 males,4 females;median age,67 years) with pancreatic body cancer involving the nerve plexus surrounding the celiac artery underwent microcoil embolization.To alter the total hepatic blood flow from superior mesenteric artery(SMA),microcoil embolization of the common hepatic artery(CHA) was conducted in 2 cases under balloon inflation at the proximal end of the CHA and in 13 cases under distal microballoon inflation at the distal end of the CHA.RESULTS:Of the first two cases of microcoil embolization with proximal balloon inflation,the first was successful,but there was microcoil migration to the proper hepatic artery in the second.The migrated microcoil was withdrawn to the CHA by an inflated microballoon catheter.Microcoil embolization was successful in the other 13 cases with distal microballoon inflation,with no microcoil migration.Compact microcoil embolization under distal microballoon inflation created sufficient resistance against the vascular wall to prevent migration.Distal balloon inflation achieved the requisite 1 cm patency at the CHA end for vascular clamping.All patients underwent en bloc celiac axis resection without arterial reconstruction or liver ischemia.CONCLUSION:To impede microcoil migration to the proper hepatic artery during CHA microcoil embolization,distal microballoon inflation is preferable to proximal balloon inflation.

关键词：肝动脉栓塞癌术前准备周围神经通货膨胀肝脏缺血 CHA

Radiofrequency ablation in a porcine liver model:Effects of transcatheter arterial embolization with iodized oil on ablation time,maximum output,and coagulation diameter as well as angiographic characteristics

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World Journal of Gastroenterology 2007年第20期13卷 2841-2845页

作者： Motoki Nakai Morio Sato Shinya Sahara nobuyuki kawai Hirohiko Tanihata Masashi Kimura Masaki Terada Department of Radiology Hidaka General Hospi-tal116-2 SonoGobo ShiWakayama 644-8655Japan Department of Radiol-ogy Wakayama Medical University 811-1KimiideraWakayama ShiWakayama 641-8510Japan

AIM:To evaluate the effects of combined radiofrequen-cy ablation and transcatheter arterial embolization with iodized oil on ablation time,maximum output,coagula-tion diameter,and portal angiography in a porcine liver model. METHODS: Radiofrequency ablation (RFA) was applied to in vivo livers of 10 normal pigs using a 17-gauge 3.0 cm expandable LeVeen RF needle electrode with or with-out transcatheter arterial embolization (TAE) with iodized oil (n = 5). In each animal,2 areas in the liver were ab-lated. Direct portography was performed before and af-ter RFA. Ablation was initiated at an output of 30 W,and continued with an increase of 10 W per minute until roll-off occurred. Ablation time and maximum output until roll-off,and coagulated tissue diameter were compared between the 2 groups. Angiographic changes on portog-raphy before and after ablation were also reviewed. RESULTS: For groups with and without TAE with iodized oil,the ablation times until roll-off were 320.6 ± 30.9 seconds and 445.1 ± 35.9 seconds,respectively,maxi-mum outputs were 69.0 ± 7.38 W and 87.0 ± 4.83 W and maximal diameters of coagulation were 41.7 ± 3.85 mm and 33.2 ± 2.28 mm. Significant reductions of abla-tion time and maximum output,and significantly larger coagulation diameter were obtained with RFA following TAE with iodized oil compared to RFA alone. Portography after RFA following TAE with iodized oil revealed more occlusion of the larger portal branches than with RFA alone. CONCLUSION: RFA following TAE with iodized oil can increase the volume of coagulation necrosis with lower output and shorter ablation time than RFA alone in nor-mal pig liver tissue.

关键词：射频消融猪动物实验肠疾病动脉栓塞

Transhepatic catheter-directed thrombolysis for portal vein thrombosis after partial splenic embolization in combination with balloon-occluded retrograde transvenous obliteration of splenorenal shunt

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World Journal of Gastroenterology 2006年第31期12卷 5071-5074页

作者： Motoki Nakai Morio Sato Shinya Sahara nobuyuki kawai Masashi Kimura Yoshimasa Maeda Yumiko Ibata Katsuhiko Higashi Department of RadiologyWakayama Medical University 811-1KimiideraWakayama ShiWakayama 641-8510Japan the First Department of Internal MedicineHidaka General Hospital 116-2 SonoGobo ShiWakayama 644-8655Japan

一个 66 岁的女人与自发的门静脉高血压(IPH ) 为脾机能亢进经历了部分脾的 embolization (PSE ) 。一个星期以后，提高对比的 CT 揭示了广泛的门静脉血栓(PVT ) 并且扩大了 portosystemic 分流。PVT 没被尿激的静脉内的管理溶解。正确... 详细信息

一个 66 岁的女人与自发的门静脉高血压(IPH ) 为脾机能亢进经历了部分脾的 embolization (PSE ) 。一个星期以后，提高对比的 CT 揭示了广泛的门静脉血栓(PVT ) 并且扩大了 portosystemic 分流。PVT 没被尿激的静脉内的管理溶解。正确的门静脉是经由在超声的指导和 4 Fr 下面的经皮的 transhepatic 线路的 canulated。直导管通过血栓被推进进门静脉。Transhepatic 指导导管的血栓溶解被执行溶解 PVT， splenorenal 分流并发地被堵塞增加门血流，用堵塞汽球后退 transvenous 涂去(BRTO ) 技术。随后的提高对比的 CT 显示出门静脉和形成血栓 splenorenal 分流的好明显。与 BRTO 相结合的 Transhepatic 指导导管的血栓溶解为有 portosystemic 分流的 PVT 可行、有效。

关键词：血栓溶解脾脏栓塞静脉闭塞高血压

Ruptured high flow gastric varices with an intratumoral arterioportal shunt treated with balloon-occluded retrograde transvenous obliteration during temporary balloon occlusion of a hepatic artery

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World Journal of Gastroenterology 2006年第33期12卷 5404-5407页

作者： Motoki Nakai Morio Sato Hirohiko Tanihata Tetsuo Sonomura Shinya Sahara nobuyuki kawai Masashi Kimura Masaki Terada Department of Radiology Hidaka General Hospital 116-2 Sono Gobo Shi Wakayama 644-8655 Japan Department of Radiology Wakayama Medical University 811-1 Kimiidera Wakayama Shi Wakayama 641-8510 Japan

A patient presented with hematemesis due to gastric variceal bleeding with an intratumoral arterioportal shunt. Contrast-enhanced CT revealed gastric varices and hepatocellular carcinoma with tumor thrombi in the right portal vein. Angiography and angio-CT revealed a marked intratumoral arterioportal shunt accompanied with re? ux into the main portal vein and gastric varices. Balloon-occluded retrograde venography from the gastro-renal shunt showed no visualization of gastric varices due to rapid blood flow through the intratumoral arterioportal shunt. The hepatic artery was temporarily occluded with a balloon catheter to reduce the blood ? ow through the arterioportal shunt, and then concurrent balloon-occluded retrograde transvenous obliteration (BRTO) was achieved. Vital signs stabilized immediately thereafter, and contrast-enhanced CT revealed thrombosed gastric varices. Worsening of hepatic function was not recognized. BRTO combined with temporary occlusion of the hepatic artery is a feasible interventional procedure for ruptured high ? ow gastric varices with an intratumoral arterioportal shunt.

关键词：胃血管静脉血管肝细胞癌病理

Emergency balloon-occluded retrograde transvenous obliteration of ruptured gastric varices

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World Journal of Gastroenterology 2013年第31期19卷 5125-5130页

作者： Tetsuo Sonomura Wataru Ono Morio Sato Shinya Sahara Kouhei Nakata Hiroki Sanda nobuyuki kawai Hiroki Minamiguchi Motoki Nakai Kazushi Kishi Department of Radiology Wakayama Medical University Wakayama 641-8510 Japan Department of Gastroenterology Kishiwada Tokushukai Hospital Kishiwada 596-8522 Japan Department of Radiology Kishiwada Tokushukai Hospital Kishiwada 596-8522 Japan

AIM: To evaluate the effectiveness and safety of emergency balloon-occluded retrograde transvenous obliteration(BRTO) for ruptured gastric varices.METHODS: Emergency BRTO was performed in 17 patients with gastric varices and gastrorenal or gastrocaval shunts within 24 h of hematemesis and/or tarry stool.The gastric varices were confirmed by endoscopy,and the gastrorenal or gastrocaval shunts were identified by contrast-enhanced computed tomography(CE-CT).A 6-Fr balloon catheter(Cobra type) was inserted into the gastrorenal shunt via the right internal jugular vein,or into the gastrocaval shunt via the right femoral vein,depending on the varices drainage route.The sclerosant,5% ethanolamine oleate iopamidol,was injected into the gastric varices through the catheter during balloon occlusion.In patients with incom plete thrombosis of the varices after the first BRTO,a second BRTO was performed the following day.Patients were followed up by endoscopy and CE-CT at 1 d,1 wk,and 1,3 and 6 mo after the procedure,and every 6 mo thereafter.RESULTS: Complete thrombosis of the gastric varices was not achieved with the first BRTO in 7/17 patients because of large gastric varices.These patients underwent a second BRTO on the next day,and additional sclerosant was injected through the catheter.Complete thrombosis which led to disappearance of the varices was achieved in 16/17 patients,while the remaining patient had incomplete thrombosis of the varices.None of the patients experienced rebleeding or recurrence of the gastric varices after a median follow-up of 1130 d(range 8-2739 d).No major complications occurred after the procedure.However,esophageal varices worsened in 5/17 patients after a mean follow-up of 8.6 mo.CONCLUSION: Emergency BRTO is an effective and safe treatment for ruptured gastric varices.

关键词： Emergency balloon-occluded retrograde transvenous obliteration Gastric varices Bleeding Portal hypertension Ethanolamine oleate

Complication of radiofrequent ablation for hepatocellular carcinoma

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Complication of radiofrequent ablation for hepatocellular ca...

支气管的动脉和气管的分叉的大动脉的 ostia : MDCT 分析

第八届全国肿瘤介入诊疗学术大会、第一届中国抗癌协会肿瘤介入学护理专业学组会议暨国家级介入诊疗继续教育学习班、肿瘤介入治疗新进展研讨会

作者： Morio Sato Takuya Iwamoto nobuyuki kawai Department of Radiology Wakayama Medical UniversityJapan

Radiofrequent ablation(RFA)for treating hepatocellular carcinoma(HCC)has prevailed in Japan since it was assured legally to use in 2001.According to algorithm of treating HCC,the application of RFA

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World Journal of Radiology 2012年第1期4卷 29-35页

作者： Julaiti Ziyawudong nobuyuki kawai Morio Sato Akira Ikoma Hiroki Sanda Taizo Takeuchi Hiroki Minamiguchi Motoki Nakai Takami Tanaka Tetsuo Sonomura Department of Radiology Wakayama Medical University811-1 KimiideraWakayamashiWakayama 641-8510Japan

AIM:To explore the anatomical relationships between bronchial artery and tracheal bifurcation using computed tomography angiography (CTA).METHODS:One hundred consecutive patients (84 men,16 women;aged 46-85 years) who underwent CTA using multi-detector row CT (MDCT) were investigated retrospectively.The distance between sites of bronchial artery ostia and tracheal bifurcation,and dividing directions were explored.The directions of division from the descending aorta were described as on a clock face.RESULTS:We identified ostia of 198 bronchial arteries:95 right bronchial arteries,67 left bronchial arteries,36 common trunk arteries.Of these,172 (87%) divided from the descending aorta,25 (13%) from the aortic arch,and 1 (0.5%) from the left subclavian artery.The right,left,and common trunk bronchial arteries divided at-1 to 2 cm from tracheal bifurcation with frequencies of 77% (73/95),82% (54/66),and 70% (25/36),respectively.The dividing direction of right bronchial arteries from the descending aorta was 9 to 10 o’clock with a frequency of 81% (64/79);that of left and common tract bronchial arteries was 11 to 1 o’clock with frequencies of 70% (43/62) and 77% (24/31),respectively.CONCLUSION:CTA using MDCT provides details of the relation between bronchial artery ostia and tracheal bifurcation.

关键词： Anatomy Computed tomography Bronchial artery Medical imaging Tracheal bifurcation

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肝细胞肝癌射频消融后的并发症

肝细胞肝癌射频消融后的并发症

Expression of multidrug resistant genes in the human glioblastomas

第八届全国肿瘤介入诊疗学术大会、第一届中国抗癌协会肿瘤介入学护理专业学组会议暨国家级介入诊疗继续教育学习班、肿瘤介入治疗新进展研讨会

作者：佐藤守男 Takuya Iwamoto nobuyuki kawai 汤超和歌山医科大学

射频消融术(RFA)自从2001在日本法定认可后,已经广泛应用于治疗肝细胞肝癌 (HCC)．针对 HCC 的治疗,RFA 用于肿瘤直径小于3cm 的多发肿瘤或者肿瘤直径小于5cm 的单发肿瘤情况下．RFA 治疗仪可分为 expansive needle 和 cool-tip 两型,...

射频消融术(RFA)自从2001在日本法定认可后,已经广泛应用于治疗肝细胞肝癌 (HCC)．针对 HCC 的治疗,RFA 用于肿瘤直径小于3cm 的多发肿瘤或者肿瘤直径小于5cm 的单发肿瘤情况下．RFA 治疗仪可分为 expansive needle 和 cool-tip 两型,后者因为其穿刺孔直径较小而在日本更为人们接受．RFA 治疗后, 射频区域外多于5mm 的范围肿瘤可以得到局部控制．近期

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Expression of multidrug resistant genes in the human gliobla...