Embolization of parasitized extrahepatic arteries to reestablish intrahepatic arterial supply to tumors before yttrium-90 radioembolization

Mohamed H K Abdelmaksoud, John D. Louie, Nishita Kothary, Gloria L. Hwang, William T. Kuo, Lawrence V. Hofmann, David M. Hovsepian, Daniel Y. Sze

Research output: Contribution to journalArticle

Abstract

Purpose: To perform embolization of parasitized extrahepatic arteries (EHAs) before radioembolization to reestablish intrahepatic arterial supply to large, peripheral tumors, and to evaluate the technical and clinical outcomes of this intervention. Materials and Methods: Among 201 patients retrospectively analyzed, embolization of 73 parasitized EHAs in 35 patients was performed. Most embolization procedures were performed during preparatory angiography using large particles and coils. Digital subtraction angiography (DSA), C-arm computed tomography (CT), and technetium-99m macroaggregated albumin ( 99mTcMAA) scintigraphy were used to evaluate the immediate perfusion via intrahepatic collateral channels of target tumor areas previously supplied by parasitized EHAs. Follow-up imaging of differential regional tumor response was used to evaluate microsphere distribution and clinical outcome. Results: After embolization, reestablishment of intrahepatic arterial supply was confirmed by both DSA and C-arm CT in 94% of territories and by scintigraphy in 96%. In 32% of patients, the differential response of treatment could not be evaluated because of uniform disease progression. However, symmetric regional tumor response in 94% of evaluable patients indicated successful delivery of microspheres to the territories previously supplied by parasitized EHAs. Conclusions: Reestablishment of intrahepatic arterial inflow to hepatic tumors by embolization of parasitized EHAs is safe and effective and results in successful delivery of yttrium-90 microspheres to tumors previously perfused by parasitized EHAs.

Original languageEnglish (US)
Pages (from-to)1355-1362
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume22
Issue number10
DOIs
StatePublished - Oct 2011
Externally publishedYes

Fingerprint

Yttrium
Arteries
Microspheres
Neoplasms
Digital Subtraction Angiography
Radionuclide Imaging
Tomography
Hospital Distribution Systems
Technetium
Disease Progression
Albumins
Angiography
Perfusion
Liver

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Embolization of parasitized extrahepatic arteries to reestablish intrahepatic arterial supply to tumors before yttrium-90 radioembolization. / Abdelmaksoud, Mohamed H K; Louie, John D.; Kothary, Nishita; Hwang, Gloria L.; Kuo, William T.; Hofmann, Lawrence V.; Hovsepian, David M.; Sze, Daniel Y.

In: Journal of Vascular and Interventional Radiology, Vol. 22, No. 10, 10.2011, p. 1355-1362.

Research output: Contribution to journalArticle

Abdelmaksoud, Mohamed H K ; Louie, John D. ; Kothary, Nishita ; Hwang, Gloria L. ; Kuo, William T. ; Hofmann, Lawrence V. ; Hovsepian, David M. ; Sze, Daniel Y. / Embolization of parasitized extrahepatic arteries to reestablish intrahepatic arterial supply to tumors before yttrium-90 radioembolization. In: Journal of Vascular and Interventional Radiology. 2011 ; Vol. 22, No. 10. pp. 1355-1362.
@article{604c512abfe94b3d96998a19ca9bfb15,
title = "Embolization of parasitized extrahepatic arteries to reestablish intrahepatic arterial supply to tumors before yttrium-90 radioembolization",
abstract = "Purpose: To perform embolization of parasitized extrahepatic arteries (EHAs) before radioembolization to reestablish intrahepatic arterial supply to large, peripheral tumors, and to evaluate the technical and clinical outcomes of this intervention. Materials and Methods: Among 201 patients retrospectively analyzed, embolization of 73 parasitized EHAs in 35 patients was performed. Most embolization procedures were performed during preparatory angiography using large particles and coils. Digital subtraction angiography (DSA), C-arm computed tomography (CT), and technetium-99m macroaggregated albumin ( 99mTcMAA) scintigraphy were used to evaluate the immediate perfusion via intrahepatic collateral channels of target tumor areas previously supplied by parasitized EHAs. Follow-up imaging of differential regional tumor response was used to evaluate microsphere distribution and clinical outcome. Results: After embolization, reestablishment of intrahepatic arterial supply was confirmed by both DSA and C-arm CT in 94{\%} of territories and by scintigraphy in 96{\%}. In 32{\%} of patients, the differential response of treatment could not be evaluated because of uniform disease progression. However, symmetric regional tumor response in 94{\%} of evaluable patients indicated successful delivery of microspheres to the territories previously supplied by parasitized EHAs. Conclusions: Reestablishment of intrahepatic arterial inflow to hepatic tumors by embolization of parasitized EHAs is safe and effective and results in successful delivery of yttrium-90 microspheres to tumors previously perfused by parasitized EHAs.",
author = "Abdelmaksoud, {Mohamed H K} and Louie, {John D.} and Nishita Kothary and Hwang, {Gloria L.} and Kuo, {William T.} and Hofmann, {Lawrence V.} and Hovsepian, {David M.} and Sze, {Daniel Y.}",
year = "2011",
month = "10",
doi = "10.1016/j.jvir.2011.06.007",
language = "English (US)",
volume = "22",
pages = "1355--1362",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "10",

}

TY - JOUR

T1 - Embolization of parasitized extrahepatic arteries to reestablish intrahepatic arterial supply to tumors before yttrium-90 radioembolization

AU - Abdelmaksoud, Mohamed H K

AU - Louie, John D.

AU - Kothary, Nishita

AU - Hwang, Gloria L.

AU - Kuo, William T.

AU - Hofmann, Lawrence V.

AU - Hovsepian, David M.

AU - Sze, Daniel Y.

PY - 2011/10

Y1 - 2011/10

N2 - Purpose: To perform embolization of parasitized extrahepatic arteries (EHAs) before radioembolization to reestablish intrahepatic arterial supply to large, peripheral tumors, and to evaluate the technical and clinical outcomes of this intervention. Materials and Methods: Among 201 patients retrospectively analyzed, embolization of 73 parasitized EHAs in 35 patients was performed. Most embolization procedures were performed during preparatory angiography using large particles and coils. Digital subtraction angiography (DSA), C-arm computed tomography (CT), and technetium-99m macroaggregated albumin ( 99mTcMAA) scintigraphy were used to evaluate the immediate perfusion via intrahepatic collateral channels of target tumor areas previously supplied by parasitized EHAs. Follow-up imaging of differential regional tumor response was used to evaluate microsphere distribution and clinical outcome. Results: After embolization, reestablishment of intrahepatic arterial supply was confirmed by both DSA and C-arm CT in 94% of territories and by scintigraphy in 96%. In 32% of patients, the differential response of treatment could not be evaluated because of uniform disease progression. However, symmetric regional tumor response in 94% of evaluable patients indicated successful delivery of microspheres to the territories previously supplied by parasitized EHAs. Conclusions: Reestablishment of intrahepatic arterial inflow to hepatic tumors by embolization of parasitized EHAs is safe and effective and results in successful delivery of yttrium-90 microspheres to tumors previously perfused by parasitized EHAs.

AB - Purpose: To perform embolization of parasitized extrahepatic arteries (EHAs) before radioembolization to reestablish intrahepatic arterial supply to large, peripheral tumors, and to evaluate the technical and clinical outcomes of this intervention. Materials and Methods: Among 201 patients retrospectively analyzed, embolization of 73 parasitized EHAs in 35 patients was performed. Most embolization procedures were performed during preparatory angiography using large particles and coils. Digital subtraction angiography (DSA), C-arm computed tomography (CT), and technetium-99m macroaggregated albumin ( 99mTcMAA) scintigraphy were used to evaluate the immediate perfusion via intrahepatic collateral channels of target tumor areas previously supplied by parasitized EHAs. Follow-up imaging of differential regional tumor response was used to evaluate microsphere distribution and clinical outcome. Results: After embolization, reestablishment of intrahepatic arterial supply was confirmed by both DSA and C-arm CT in 94% of territories and by scintigraphy in 96%. In 32% of patients, the differential response of treatment could not be evaluated because of uniform disease progression. However, symmetric regional tumor response in 94% of evaluable patients indicated successful delivery of microspheres to the territories previously supplied by parasitized EHAs. Conclusions: Reestablishment of intrahepatic arterial inflow to hepatic tumors by embolization of parasitized EHAs is safe and effective and results in successful delivery of yttrium-90 microspheres to tumors previously perfused by parasitized EHAs.

UR - http://www.scopus.com/inward/record.url?scp=80053327896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053327896&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2011.06.007

DO - 10.1016/j.jvir.2011.06.007

M3 - Article

C2 - 21961979

AN - SCOPUS:80053327896

VL - 22

SP - 1355

EP - 1362

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 10

ER -