ABSTRACT
[Summary] A 47 years old female presented with palpitation, tremble, sweaty, and weight gain. Insulinoma was suspended and confirmed with hypoglycemia caused by endogenous hyperinsulinemia. The CT scan was failed to localize the tumor. MRI and ASVS showed inconsistent results. A nutrient arterial was found by arterial angiography and explained the different results. Robert assistant surgery successfully removed the tumor and the patient was well recovered.
ABSTRACT
Objective To study blood supply by the internal mammary artery(IMA)for hepatic carcinoma and evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)via IMA. Methods 86 cases of hepatic cancer(HCC)fed by the IMA underwent TACE of the IMA.All of the patients had previously undergone several TACE for HCC.16 patients had undertaken percutaneous microwave coagulation therapy in addition to TAE.4 patients had a history of surgery for upper abdomen.Plain and enhanced CT and MRI scannings were performed before operation.Internal mammary arteriography was carried out during the interventional procedure to clarify the feeding range and then the superselected catheterization of the feeding branch was done with TACE.The IMA angiographic features,tumor location,clinical observation, laboratory tests,imageology were evaluated,and finally were correlated with the angiographic findings of the IMA.Results All lesions were massive type and located at the ventral aspect and subcapsular region of the liver:57 cases in segment 4,5,8,and 29 cases in segment 5,7,8.Recurrent HCCs were supplied by the right IMA in 80 cases,from the left IMA in 5 cases and with the bilateral IMA in 1 case.Lipiodol-TACE of the IMA for HCC can be performed without skin complications in cases of subselective catheterization.Conclusion Tumors located ventrally and superficially in the liver may recruit blood supply through IMA collaterals,often occurring in massive type of HCC after several times of TACE.TACE of IMA is safe and has become technically feasible in almost all patients,although cutaneous damage should be cautious during the interventional procedure.(J Intervent Radiol,2007,16:816-819)
ABSTRACT
Objective To study the safety of transcatheter arterial chemoembolization(TACE)via the intercostal artery(ICA)for hepatic carcinoma.Methods A total of 24 patients with hepatic carcinoma(HCC)fed by the ICA underwent TACE via the artery in our hospital.Among the cases,15 were mass type and 9 were nodular type.Plain and enhanced CT or MRI scan were performed before the operation.During the procedure,we carried out intercostal arteriography.Selected catheterization of the feeding branch and then TACE were done.The ICA angiographic features,tumor location,clinical observation,laboratory tests,and imageology were evaluated after the surgery.Results In our cases,the HCCs supplied by the ICA collaterals were located at segments six and/or seven.Angiography showed that all the ICA collaterals originated from the right side at the levels of T8(7.5%,3/40),T9(15.0%,6/40),T10(47.5%,19/40),or T11(30.0%,12/40).The procedure was completed in 22 of the patients.CT scan performed after the procedure showed that the tumor was completely filled with lipiodol in 87.5%(21/24)of the cases.The serum level of AFP decreased significantly in 82.6%(19/23)of the patients.Three patients complained of severe pain at the shoulder after the operation,1 patient had skin itching during TACE,and 5 developed skin erythema after the procedure.Conclusions HCC supplied with ICA collaterals are often detected in the patients who have the tumor at the right posterior segment(S6 and S7)and had received TACE for several times.TACE via the ICA is safe but may leads to skin injuries.
ABSTRACT
A hypoplastic internal carotid artery is rare condition of uncertain etology, but the associated arterial anomaly in the circle of willis suggests a congenital origin. We report a case of hypoplasia of the right internal carotid artery in 55 year old female suffering from hypertension and showing cerebral ischemic symptoms. The patient was diagnosed with computed tomography(CT), single photon emission computed tomography(SPECT), and conventional angiography and magnetic resonance angiography(MRA). The angiographic examination raised a suspision of right internal carotid agenesis, but the MRA demonstrated conclusively a correct diagnosis as a right internal carotid artery hypoplasia.
Subject(s)
Female , Humans , Middle Aged , Angiography , Brain Ischemia , Carotid Artery, Internal , Circle of Willis , Diagnosis , Hypertension , Tomography, Emission-Computed, Single-PhotonABSTRACT
We have performed arterial angiography of renal angiomyolipoma(RAL)on 15 pa tients,2 of them were hypervascularly,the others manifested,with aeurysmal iascular dilatation and clear cut decreased density area within the tumor.13 of them were embolized.Super selective renal arterial embolization 9/13 cases,the tumors were reseded in 2-6 days of embolization The operation was much more easier and the bleeding was markedly reduced.The absolute ethanol is better than gelfoam for stopping the blood supply.4/13 cases did not operate after embolization and the tumors reduced more than 50% in sige within 6 monthes confrimed by CT.The results suggested diagnostic angiography and the emboligzating treatment could be finished simultaneously.