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

doi:10.1007/BF02807348

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

Dotter Interventional Institute

Research output: Contribution to journal › Article › peer-review

24 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 language	English (US)
Pages (from-to)	9-15
Number of pages	7
Journal	Cardiovascular and interventional radiology
Volume	18
Issue number	1
DOIs	https://doi.org/10.1007/BF02807348
State	Published - 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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Sakaguchi, H., Uchida, H., Maeda, M., Matsuo, N., Kichikawa, K., Ohishi, H., Nishida, H., Ueno, K., Nishimine, K., Rösch, J., & Guo, Q. (1995). 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. Cardiovascular and interventional radiology, 18(1), 9-15. https://doi.org/10.1007/BF02807348

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. / Sakaguchi, Hiroshi; Uchida, Hideo; Maeda, Munehiro et al.

In: Cardiovascular and interventional radiology, Vol. 18, No. 1, 01.01.1995, p. 9-15.

Research output: Contribution to journal › Article › peer-review

Sakaguchi, H, Uchida, H, Maeda, M, Matsuo, N, Kichikawa, K, Ohishi, H, Nishida, H, Ueno, K, Nishimine, K, Rösch, J & Guo, Q 1995, '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', Cardiovascular and interventional radiology, vol. 18, no. 1, pp. 9-15. https://doi.org/10.1007/BF02807348

Sakaguchi H, Uchida H, Maeda M, Matsuo N, Kichikawa K, Ohishi H et al. 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. Cardiovascular and interventional radiology. 1995 Jan 1;18(1):9-15. doi: 10.1007/BF02807348

Sakaguchi, Hiroshi ; Uchida, Hideo ; Maeda, Munehiro et al. / 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. In: Cardiovascular and interventional radiology. 1995 ; Vol. 18, No. 1. pp. 9-15.

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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.",

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author = "Hiroshi Sakaguchi and Hideo Uchida and Munehiro Maeda and Naoki Matsuo and Kimihiko Kichikawa and Hajime Ohishi and Hirotoshi Nishida and Kazuto Ueno and Kiyoshi Nishimine and Josef R{\"o}sch and Qiyon Guo",

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T1 - Combined transjugular intrahepatic portosystemic shunt and segmentai lipiodol hepatic artery embolization for the treatment of esophagogastric varices and hepatocellular carcinoma in patients with cirrhosis

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AU - Sakaguchi, Hiroshi

AU - Uchida, Hideo

AU - Maeda, Munehiro

AU - Matsuo, Naoki

AU - Kichikawa, Kimihiko

AU - Ohishi, Hajime

AU - Nishida, Hirotoshi

AU - Ueno, Kazuto

AU - Nishimine, Kiyoshi

AU - Rösch, Josef

AU - Guo, Qiyon

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N2 - 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.

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KW - Hepatocellular carcinoma

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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

Abstract

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