[Experimental studies of intrahepatic portal vein embolization and embolic materials]. 1989

T Matsuoka

The author has developed the intrahepatic portal vein embolization for the treatment of liver cancers. The purposes of this new method are 1) extension of indications for surgery by causing compensatory hypertrophy of non-embolized lobe, 2) prevention of dissemination of the tumor cells via the portal vein, 3) causing complete ischemic necrosis of the tumor together with arterial embolization, and 4) blockade of centripetal extension of tumor thrombus. The feasibility and safety of this method were studied experimentally. Three kings of materials were prepared for embolization of the portal vein; a Lipiodol-thrombin mixture (Lp-T), a Lipiodol-fibrin adhesive mixture (Lp-F), and a mixture of Lipiodol with isobutyl-2-cyanoacrylate (Lp-IBC). The portal vein was embolized in 31 dogs, 6 with Lp-T, 14 with Lp-F, and 11 with Lp-IBC. Lp-F was used 30 to 90 seconds after preparation, which had been found to be best in an in vitro study. Lp-T and Lp-IBC could be used at any time after preparation. Embolization was done safely and reliably, except in two cases of Lp-F, by use of a balloon catheter for Lp-T or Lp-F and a coaxial catheter for Lp-IBC. Follow-up portography showed recanalization in one week in the dogs embolized with Lp-T. The obstruction was maintained for two to four weeks in the dogs embolized with Lp-F, and for four weeks in all dogs embolized with Lp-IBC. Damage in the liver was slight both macroscopically and histologically. Changes in liver function and elevation of the pressure of the portal vein were transient. The author concluded that the intrahepatic portal vein embolization was both feasible and safe when the materials tested were used, and could be an effective method for liver cancers. In clinical cases, Lp-T would be suitable for short-term occlusion, Lp-F for a moderate term, and Lp-IBC for long-term. The material should be selected with regard to the purpose.

UI MeSH Term Description Entries
D007459 Iodized Oil A preparation of oil that contains covalently bound IODINE. It is commonly used as a RADIOCONTRAST AGENT and as a suspension medium for CHEMOTHERAPEUTIC AGENTS. Oil, Iodized,Iodized Oils,Iodolipol,Oils, Iodized
D008114 Liver Neoplasms, Experimental Experimentally induced tumors of the LIVER. Hepatoma, Experimental,Hepatoma, Morris,Hepatoma, Novikoff,Experimental Hepatoma,Experimental Hepatomas,Experimental Liver Neoplasms,Hepatomas, Experimental,Neoplasms, Experimental Liver,Experimental Liver Neoplasm,Liver Neoplasm, Experimental,Morris Hepatoma,Novikoff Hepatoma
D011169 Portal Vein A short thick vein formed by union of the superior mesenteric vein and the splenic vein. Portal Veins,Vein, Portal,Veins, Portal
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004621 Embolization, Therapeutic A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage. Embolotherapy,Therapeutic Embolization,Embolizations, Therapeutic,Embolotherapies,Therapeutic Embolizations
D005337 Fibrin A protein derived from FIBRINOGEN in the presence of THROMBIN, which forms part of the blood clot. Antithrombin I
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013917 Thrombin An enzyme formed from PROTHROMBIN that converts FIBRINOGEN to FIBRIN. Thrombase,Thrombin JMI,Thrombin-JMI,Thrombinar,Thrombostat,alpha-Thrombin,beta,gamma-Thrombin,beta-Thrombin,gamma-Thrombin,JMI, Thrombin

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