Contribution of extrahepatic collaterals to liver parenchymal circulation after proper hepatic artery embolization
Background and Aim To retrospectively evaluate proper hepatic artery embolization, with respect to the development of extrahepatic collaterals. Methods Proper hepatic artery embolization was performed in 18 patients with hemorrhagic arterial lesions in the hepatic hilum. Post‐procedural development...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2014-07, Vol.29 (7), p.1515-1521 |
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| container_title | Journal of gastroenterology and hepatology |
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| creator | Mine, Takahiko Murata, Satoru Ueda, Tatsuo Takeda, Minako Onozawa, Shiro Yamaguchi, Hidenori Kawano, Youichi Kumita, Shin-ichiro |
| description | Background and Aim
To retrospectively evaluate proper hepatic artery embolization, with respect to the development of extrahepatic collaterals.
Methods
Proper hepatic artery embolization was performed in 18 patients with hemorrhagic arterial lesions in the hepatic hilum. Post‐procedural development of extrahepatic collaterals was evaluated by computed tomography or angiography. Embolization data and liver function tests were assessed. The correlation of outcomes with portal venous stenosis, hepatic failure prior to embolization, elevation of prothrombin time, and insufficient collateral development were analyzed.
Results
Postoperative bleeding occurred in 17/18 patients, and one was treated for an idiopathic aneurysm of the proper hepatic artery; all treatments achieved technical success. Extrahepatic collaterals were confirmed in 13 patients. Elevations of liver function test values were transient and returned to baseline within 14 days in patients with collateral development (n = 13), but were unimproved in patients without collaterals (n = 5) (P |
| doi_str_mv | 10.1111/jgh.12571 |
| format | Article |
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To retrospectively evaluate proper hepatic artery embolization, with respect to the development of extrahepatic collaterals.
Methods
Proper hepatic artery embolization was performed in 18 patients with hemorrhagic arterial lesions in the hepatic hilum. Post‐procedural development of extrahepatic collaterals was evaluated by computed tomography or angiography. Embolization data and liver function tests were assessed. The correlation of outcomes with portal venous stenosis, hepatic failure prior to embolization, elevation of prothrombin time, and insufficient collateral development were analyzed.
Results
Postoperative bleeding occurred in 17/18 patients, and one was treated for an idiopathic aneurysm of the proper hepatic artery; all treatments achieved technical success. Extrahepatic collaterals were confirmed in 13 patients. Elevations of liver function test values were transient and returned to baseline within 14 days in patients with collateral development (n = 13), but were unimproved in patients without collaterals (n = 5) (P < 0.001). Portal venous stenosis; prior hepatic failure; unrecovered, elevation of prothrombin time; and insufficient collateral development were significantly correlated with poor outcomes (P < 0.05, respectively).
Conclusions
Proper hepatic artery embolization is effective for hemostasis, and extrahepatic collateral development is expected. Therefore, this is a safe treatment without prolonged hepatic ischemic damage, especially in patients without severe portal venous stenosis or prior hepatic failure.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.12571</identifier><identifier>PMID: 24628501</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; arterial hemorrhage after surgery ; Collateral Circulation - physiology ; collateral of hepatic artery ; Constriction, Pathologic ; Embolization, Therapeutic - methods ; Female ; Hemorrhage - physiopathology ; Hemorrhage - therapy ; Hemostatic Techniques ; Hepatic Artery ; Humans ; interventional radiology ; Liver Circulation - physiology ; Liver Diseases - physiopathology ; Liver Diseases - therapy ; Liver Failure ; Male ; Middle Aged ; pancreatoduodenectomy ; Portal Vein - pathology ; Prothrombin Time ; Retrospective Studies ; transcatheter arterial embolization ; Treatment Outcome</subject><ispartof>Journal of gastroenterology and hepatology, 2014-07, Vol.29 (7), p.1515-1521</ispartof><rights>2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd</rights><rights>2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4291-88bf0be9a527fbf0cd3f159bc65a025bfc128181f9efa4999c084b3b47d26e973</citedby><cites>FETCH-LOGICAL-c4291-88bf0be9a527fbf0cd3f159bc65a025bfc128181f9efa4999c084b3b47d26e973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.12571$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.12571$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24628501$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mine, Takahiko</creatorcontrib><creatorcontrib>Murata, Satoru</creatorcontrib><creatorcontrib>Ueda, Tatsuo</creatorcontrib><creatorcontrib>Takeda, Minako</creatorcontrib><creatorcontrib>Onozawa, Shiro</creatorcontrib><creatorcontrib>Yamaguchi, Hidenori</creatorcontrib><creatorcontrib>Kawano, Youichi</creatorcontrib><creatorcontrib>Kumita, Shin-ichiro</creatorcontrib><title>Contribution of extrahepatic collaterals to liver parenchymal circulation after proper hepatic artery embolization</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
To retrospectively evaluate proper hepatic artery embolization, with respect to the development of extrahepatic collaterals.
Methods
Proper hepatic artery embolization was performed in 18 patients with hemorrhagic arterial lesions in the hepatic hilum. Post‐procedural development of extrahepatic collaterals was evaluated by computed tomography or angiography. Embolization data and liver function tests were assessed. The correlation of outcomes with portal venous stenosis, hepatic failure prior to embolization, elevation of prothrombin time, and insufficient collateral development were analyzed.
Results
Postoperative bleeding occurred in 17/18 patients, and one was treated for an idiopathic aneurysm of the proper hepatic artery; all treatments achieved technical success. Extrahepatic collaterals were confirmed in 13 patients. Elevations of liver function test values were transient and returned to baseline within 14 days in patients with collateral development (n = 13), but were unimproved in patients without collaterals (n = 5) (P < 0.001). Portal venous stenosis; prior hepatic failure; unrecovered, elevation of prothrombin time; and insufficient collateral development were significantly correlated with poor outcomes (P < 0.05, respectively).
Conclusions
Proper hepatic artery embolization is effective for hemostasis, and extrahepatic collateral development is expected. Therefore, this is a safe treatment without prolonged hepatic ischemic damage, especially in patients without severe portal venous stenosis or prior hepatic failure.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>arterial hemorrhage after surgery</subject><subject>Collateral Circulation - physiology</subject><subject>collateral of hepatic artery</subject><subject>Constriction, Pathologic</subject><subject>Embolization, Therapeutic - methods</subject><subject>Female</subject><subject>Hemorrhage - physiopathology</subject><subject>Hemorrhage - therapy</subject><subject>Hemostatic Techniques</subject><subject>Hepatic Artery</subject><subject>Humans</subject><subject>interventional radiology</subject><subject>Liver Circulation - physiology</subject><subject>Liver Diseases - physiopathology</subject><subject>Liver Diseases - therapy</subject><subject>Liver Failure</subject><subject>Male</subject><subject>Middle Aged</subject><subject>pancreatoduodenectomy</subject><subject>Portal Vein - pathology</subject><subject>Prothrombin Time</subject><subject>Retrospective Studies</subject><subject>transcatheter arterial embolization</subject><subject>Treatment Outcome</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEFvFCEYhonR2LV68A-YOephWr4ZGIaj2ehWUzWxNe2NAPvhUmeWLTDa9dfLdru9yeUj8LxP4CXkNdATKOv05ufqBBou4AmZAWO0BsG6p2RGe-C1bEEekRcp3VBKGRX8OTlqWNf0nMKMxHlY5-jNlH1YV8FVeJejXuFGZ28rG4ZBZ4x6SFUO1eB_Y6w2OuLarrajHirro50Ksgtrl3e3MWzKOBh0LIfbCkcTBv_3HnxJnrkixFcP85j8-Pjhcn5Wn39bfJq_P68tayTUfW8cNSg1b4QrW7tsHXBpbMc1bbhxFpoeenASnWZSSkt7ZlrDxLLpUIr2mLzde8uTbidMWY0-WSw_WmOYkgLOBG8FsLag7_aojSGliE5toh913CqgalexKhWr-4oL--ZBO5kRl4_kodMCnO6BP37A7f9N6vPi7KCs9wmfMt49JnT8pTrRCq6uvi7Uhfh-cf3l6lJdt_8AG76YDQ</recordid><startdate>201407</startdate><enddate>201407</enddate><creator>Mine, Takahiko</creator><creator>Murata, Satoru</creator><creator>Ueda, Tatsuo</creator><creator>Takeda, Minako</creator><creator>Onozawa, Shiro</creator><creator>Yamaguchi, Hidenori</creator><creator>Kawano, Youichi</creator><creator>Kumita, Shin-ichiro</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201407</creationdate><title>Contribution of extrahepatic collaterals to liver parenchymal circulation after proper hepatic artery embolization</title><author>Mine, Takahiko ; Murata, Satoru ; Ueda, Tatsuo ; Takeda, Minako ; Onozawa, Shiro ; Yamaguchi, Hidenori ; Kawano, Youichi ; Kumita, Shin-ichiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4291-88bf0be9a527fbf0cd3f159bc65a025bfc128181f9efa4999c084b3b47d26e973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>arterial hemorrhage after surgery</topic><topic>Collateral Circulation - physiology</topic><topic>collateral of hepatic artery</topic><topic>Constriction, Pathologic</topic><topic>Embolization, Therapeutic - methods</topic><topic>Female</topic><topic>Hemorrhage - physiopathology</topic><topic>Hemorrhage - therapy</topic><topic>Hemostatic Techniques</topic><topic>Hepatic Artery</topic><topic>Humans</topic><topic>interventional radiology</topic><topic>Liver Circulation - physiology</topic><topic>Liver Diseases - physiopathology</topic><topic>Liver Diseases - therapy</topic><topic>Liver Failure</topic><topic>Male</topic><topic>Middle Aged</topic><topic>pancreatoduodenectomy</topic><topic>Portal Vein - pathology</topic><topic>Prothrombin Time</topic><topic>Retrospective Studies</topic><topic>transcatheter arterial embolization</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mine, Takahiko</creatorcontrib><creatorcontrib>Murata, Satoru</creatorcontrib><creatorcontrib>Ueda, Tatsuo</creatorcontrib><creatorcontrib>Takeda, Minako</creatorcontrib><creatorcontrib>Onozawa, Shiro</creatorcontrib><creatorcontrib>Yamaguchi, Hidenori</creatorcontrib><creatorcontrib>Kawano, Youichi</creatorcontrib><creatorcontrib>Kumita, Shin-ichiro</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mine, Takahiko</au><au>Murata, Satoru</au><au>Ueda, Tatsuo</au><au>Takeda, Minako</au><au>Onozawa, Shiro</au><au>Yamaguchi, Hidenori</au><au>Kawano, Youichi</au><au>Kumita, Shin-ichiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contribution of extrahepatic collaterals to liver parenchymal circulation after proper hepatic artery embolization</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2014-07</date><risdate>2014</risdate><volume>29</volume><issue>7</issue><spage>1515</spage><epage>1521</epage><pages>1515-1521</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
To retrospectively evaluate proper hepatic artery embolization, with respect to the development of extrahepatic collaterals.
Methods
Proper hepatic artery embolization was performed in 18 patients with hemorrhagic arterial lesions in the hepatic hilum. Post‐procedural development of extrahepatic collaterals was evaluated by computed tomography or angiography. Embolization data and liver function tests were assessed. The correlation of outcomes with portal venous stenosis, hepatic failure prior to embolization, elevation of prothrombin time, and insufficient collateral development were analyzed.
Results
Postoperative bleeding occurred in 17/18 patients, and one was treated for an idiopathic aneurysm of the proper hepatic artery; all treatments achieved technical success. Extrahepatic collaterals were confirmed in 13 patients. Elevations of liver function test values were transient and returned to baseline within 14 days in patients with collateral development (n = 13), but were unimproved in patients without collaterals (n = 5) (P < 0.001). Portal venous stenosis; prior hepatic failure; unrecovered, elevation of prothrombin time; and insufficient collateral development were significantly correlated with poor outcomes (P < 0.05, respectively).
Conclusions
Proper hepatic artery embolization is effective for hemostasis, and extrahepatic collateral development is expected. Therefore, this is a safe treatment without prolonged hepatic ischemic damage, especially in patients without severe portal venous stenosis or prior hepatic failure.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>24628501</pmid><doi>10.1111/jgh.12571</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over arterial hemorrhage after surgery Collateral Circulation - physiology collateral of hepatic artery Constriction, Pathologic Embolization, Therapeutic - methods Female Hemorrhage - physiopathology Hemorrhage - therapy Hemostatic Techniques Hepatic Artery Humans interventional radiology Liver Circulation - physiology Liver Diseases - physiopathology Liver Diseases - therapy Liver Failure Male Middle Aged pancreatoduodenectomy Portal Vein - pathology Prothrombin Time Retrospective Studies transcatheter arterial embolization Treatment Outcome |
| title | Contribution of extrahepatic collaterals to liver parenchymal circulation after proper hepatic artery embolization |
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