Article: article from journal or magazin.
Percutaneous radiofrequency ablation of hepatic tumors during temporary venous occlusion
AJR Am J Roentgenol
0361-803X (Print)0361-803X (Linking)
de Baere, TBessoud, BDromain, CDucreux, MBoige, VLassau, NSmayra, TGirish, B VRoche, AElias, DengEvaluation Studies2002/01/05 10:00AJR Am J Roentgenol. 2002 Jan;178(1):53-9.
OBJECTIVE: We evaluated the feasibility, tolerance, and efficacy of percutaneous hepatic vein or segmental portal branch balloon occlusion during radiofrequency ablation of hepatic malignancies. SUBJECTS AND METHODS: Ten tumors were treated by percutaneous radiofrequency ablation during balloon occlusion of a hepatic vein (n = 8) or a segmental portal branch (n = 2). Venous occlusion was undertaken because the tumor was in contact with a hepatic vein (n = 3) or a portal branch (n = 1); because the tumor exceeded 35 mm in width (mean, 44 mm), which was considered the maximum size amenable to ablation in a single session (n = 2); or because of both large size and contact with a hepatic vein (n = 3) or a portal branch (n = 1). RESULTS: Vascular occlusion was always technically possible. Radiofrequency was delivered to one to three locations (mean, 1.9 locations) with a cluster electrode. The largest axis of radiofrequency-induced lesions after ablation with the cluster needle-between 42 and 51 mm (mean, 49 mm)-was always larger than the targeted tumor. These sizes were statistically larger than in a matched control group of patients who underwent radiofrequency ablation without vascular occlusion (p < 0.0003). After a mean follow-up of 12.6 months, CT and MR imaging revealed complete destruction of nine tumors after a single radiofrequency ablation treatment; one tumor required three treatments to achieve ablation. Five patients are tumor-free 12-18 months (mean, 14.4 months) after the first radiofrequency ablation treatment, and five developed new liver metastases. CONCLUSION: Temporary hepatic vein or portal branch occlusion during radiofrequency ablation can safely facilitate the treatment of large tumors or tumors in contact with the walls of large vessels.
Adult, Aged, *Balloon Occlusion, Carcinoma, Hepatocellular/blood supply/diagnosis/*therapy, Colorectal Neoplasms/blood supply/diagnosis/secondary/therapy, Feasibility Studies, Female, Follow-Up Studies, *Hepatic Veins, Humans, *Hyperthermia, Induced, Liver Neoplasms/blood supply/diagnosis/secondary/*therapy, Male, Middle Aged, *Portal Vein, Treatment Outcome
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