Quantification of Blood Pressure Changes in the Vascular Compartment When Using an Anti-Reflux Catheter during Chemoembolization versus Radioembolization: A Retrospective Case Series

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• 作者：Steven C. Rose ; MD ; ^{scrose@ucsd.edu} ; Kazim H. Narsinh ; MD ; Isabel G. Newton ; MD ; PhD
• 关键词：ANOVA ; analysis of variance ; DEE ; drug-eluting embolic ; HCC ; hepatocellular carcinoma ; ICC ; intrahepatic cholangiocarcinoma ; mCRC ; metastatic colorectal carcinoma ; SHAPD ; systemic-hepatic artery pressure difference ; SIS ; Surefire Infusion System ; TARE ; transarterial radioembolization ; 3-D ; three-dimensional ; 90Y ; yttrium-90
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：28
• 期：1
• 页码：103-110
• 全文大小：577 K
• 卷排序：28

文摘

To assess whether blood pressure changes in the downstream vascular compartment are greater with transarterial chemoembolization than transarterial radioembolization (TARE) when using an anti-reflux catheter.Materials and MethodsThe Surefire Infusion System (Surefire Medical, Inc, Westminster, Colorado) was used for lobar and sublobar administration in 51 drug-eluting embolic transarterial chemoembolization and 55 TARE procedures (22 with resin microspheres [TARE/resin] and 33 with glass microspheres [TARE/glass]). Of patients receiving transarterial chemoembolization and TARE/glass, 97% had hepatocellular carcinomas; 87% of patients receiving TARE/resin had metastases. The absolute (mm Hg) and relative (%) changes in the systemic-hepatic arterial pressure difference (SHAPD) were calculated from simultaneous blood pressure measurements obtained from the femoral artery vascular sheath and the antireflux catheter before, after, and, when feasible, during transarterial chemoembolization or TARE.ResultsTransarterial chemoembolization was associated with a significant reduction in SHAPD compared with TARE (13 mm Hg ± 1.7 vs −4.3 mm Hg ± 1.5; P < .001). A reduction in SHAPD led to early termination of 55.6% of lobar and 53.3% of sublobar transarterial chemoembolization procedures compared with only 5.5% of lobar TARE/resin and no TARE/glass procedures. TARE/resin procedures were associated with a significantly greater change in SHAPD compared with TARE/glass procedures (0.9 mm Hg ± 2.7 vs −8.0 mm Hg ± 1.5; P = .0035).ConclusionsHepatic arterial pressures in the treated vascular compartment increased more after transarterial chemoembolization than after TARE, suggesting that transarterial chemoembolization resulted in more embolic obstruction of the targeted vascular compartment than TARE.