Back to Search
Start Over
Iatrogenic celiac and hepatic artery dissections during intra-arterial regional tumor therapies: a 16-year retrospective review.
- Source :
-
Abdominal radiology (New York) [Abdom Radiol (NY)] 2019 Oct; Vol. 44 (10), pp. 3480-3485. - Publication Year :
- 2019
-
Abstract
- Purpose: To identify the incidence and outcomes of iatrogenic celiac and hepatic artery dissections during transarterial therapies, including bland embolization, chemoembolization, radioembolization (TARE), and pre-TARE scintigraphic mapping.<br />Methods: The institution's quality assessment database, electronic medical record, and picture archiving and communication system were reviewed to identify all patients who underwent transarterial locoregional therapy from 1/2001 to 7/2017 and to determine the incidence of iatrogenic dissection, to assess patency of the arteries after dissection, and to assess the ability to complete therapy.<br />Results: 2253 patients underwent 3776 transarterial hepatic oncology procedures. Among 3776 procedures, 40 (1.1%) were associated with dissection of the visceral vasculature, affecting 39 patients (1.7%). The incidence of flow-limiting dissections was 0.3% (13/3776) and non-flow-limiting dissections was 0.7% (27/3776). After dissection, 68% (27/40) of treatments were completed the same day. Among the 13 aborted treatments, 8 (62%) were completed on a subsequent encounter. Follow-up imaging was obtained in 26 of 40 cases at median time of 63 days. Complete resolution of the dissection was seen in 15/26 cases (58%), near complete resolution (< 30% luminal narrowing) in 3/26 (12%), unchanged appearance of a non-flow-limiting dissection in 4/26 (15%), progressive luminal narrowing in 3/26 (12%), and complete occlusion in 1/26 (4%).<br />Conclusion: Iatrogenic dissections of visceral arteries rarely occur during tumor embolization procedures. 35/39 (90%) of patients underwent successful treatment despite the dissection.
- Subjects :
- Aged
Angiography
Chemoembolization, Therapeutic adverse effects
Female
Humans
Iatrogenic Disease
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed
Vascular Patency
Brachytherapy adverse effects
Celiac Artery diagnostic imaging
Celiac Artery injuries
Embolization, Therapeutic adverse effects
Hepatic Artery diagnostic imaging
Hepatic Artery injuries
Liver Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2366-0058
- Volume :
- 44
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Abdominal radiology (New York)
- Publication Type :
- Academic Journal
- Accession number :
- 31471705
- Full Text :
- https://doi.org/10.1007/s00261-019-02203-z