ABSTRACT
From July 1989 to June 1999, 100 patients, 76 male and 24 female, were admitted for treatment of hepatocellular carcinoma (HCC) with transcatheter oily chemoembolization (TOCE) using lipiodol 10 ml mixed with an anticancer drug (mitomycin C 20 ml) and gelfoam particles, described by Nakamura H et al. The periodic follow-up angiogram showed hepatic collaterals which developed according to the mode of embolization. For peripheral hepatic arterial embolization such as segmental or lobar arterial embolization, the intrahepatic collaterals were commonly demonstrated. However, for more proximal hepatic arterial embolization of the tumor feeder arteries such as the proper hepatic artery and the common hepatic artery, the extrahepatic collaterals were commonly demonstrated with fine, small tortuous vasculatures, rendering a repeat TOCE more difficult. The hepatic collaterals are presented.
Subject(s)
Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/methods , Liver Neoplasms/therapy , Liver/blood supply , Adolescent , Adult , Aged , Aged, 80 and over , Angiography , Carcinoma, Hepatocellular/diagnosis , Carcinoma, Hepatocellular/mortality , Catheterization , Collateral Circulation , Contrast Media , Female , Humans , Iodized Oil , Liver/diagnostic imaging , Liver Neoplasms/diagnosis , Liver Neoplasms/mortality , Male , Middle Aged , Prognosis , Survival Rate , Thailand , Treatment OutcomeABSTRACT
Atherosclerosis was induced in 20 Hanford miniature swine. Subsequently, one iliac artery lesion in each of 16 pigs was stented with either a self-expanding (8 pigs) or a balloon-expanded (8 pigs) stent. Immediately after stent placement, 4 animals in each group were taken off the atherogenic diet and continued on normal chow for the remainder of the study. Four months after stents were placed, atherosclerosis and the mural changes associated with the stent were more clearly evident in the arteries of the pigs continued on the atherogenic diet. These pigs also exhibited significantly more neointimal proliferation. In addition, the arteries containing the balloon-expanded stents showed more extensive and complex intimal changes when compared with arteries with self-expanding stents. Although both stent designs were equally effective in maintaining vascular patency, the balloon-expanded stent was more traumatic to the vessel wall which resulted in a significantly greater neointimal thickness.
