Combined transjugular intrahepatic portosystemic shunt and segmentai lipiodol hepatic artery embolization for the treatment of esophagogastric varices and hepatocellular carcinoma in patients with cirrhosis: Preliminary report

Hiroshi Sakaguchi, Hideo Uchida, Munehiro Maeda, Naoki Matsuo, Kimihiko Kichikawa, Hajime Ohishi, Hirotoshi Nishida, Kazuto Ueno, Kiyoshi Nishimine, Josef Rösch, Qiyon Guo

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Purpose: To evaluate the feasibility of combining placement of a transjugular intrahepatic portosystemic shunt (TIPS) and transcatheter hepatic segmental artery chemoembolization with Lipiodol (Seg-Lp-TAE) in patients with cirrhosis, esophagogastric varices, and hepatocellular carcinoma (HCC). Methods: Five patients with bleeding or large, highflow esophagogastric varices and HCC were treated by TIPS and Seg-Lp-TAE. Results: The mean portosystemic pressure gradient decreased from 20.8 cm H2O to 7.8 cm H2O after TIPS. The direct portogram and endoscopic examination revealed reduction of varices. At 6 months, one shunt had functionally occluded and could not be reopened; the other TIPS remained functional Follow-up CT and the changes of alpha fetoprotein indicated effective therapy of Seg-Lp-TAE for HCC. Four patients are in stabile clinical condition at 9, 6, 1, and 1 months after the combined therapy; one died after 14 months due to decompensated liver cirrhosis. Conclusion: The combined therapy of TIPS and SegLp-TAE will become a new interventional approach for patients with HCC and esophagogastric varices.

Original languageEnglish (US)
Pages (from-to)9-15
Number of pages7
JournalCardiovascular and interventional radiology
Volume18
Issue number1
DOIs
StatePublished - Jan 1 1995

Keywords

  • Esophagogastric varices
  • Hepatocellular carcinoma
  • Lipoidol
  • Segmental embolotherapy
  • Transjugular intrahepatic portosystemic shun

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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