Transcatheter management for multiple liver tumors after hepatic artery obstruction following reservoir placement.

Background/aims: Hepatic arterial infusion chemotherapy via an implantable port system has been widely used to treat unresectable liver neoplasms. Complications of the hepatic artery occlusion following reservoir placement, however, makes it impossible to continue the infusion therapy. The purpose of our study was to assess the possibility of transcatheter treatment after the hepatic artery obstruction following reservoir placement.

Reduction of drug leakage by negative-balance isolated pelvic perfusion: correlation between leakage and in-out flow rate in a pig model.

Purpose: Isolated pelvic perfusion (IPP) therapy exposes target tissues to high doses of anticancer drugs with low systemic concentrations, but the major drawback is drug leakage into the systemic circulation, which often thwarts the increased drug concentration. In this study, the efficacy of altering the in-out flow rate during IPP in order to decrease the leakage was assessed in adult pigs.

Methods: The abdominal aorta and the infrarenal vena cava were occluded with two balloon catheters, blood in the extracorporeal circuit was circulated with twin rotary pumps, and the IPP was performed with platinum.

Hybrid treatment of acute massive pulmonary thromboembolism: mechanical fragmentation with a modified rotating pigtail catheter, local fibrinolytic therapy, and clot aspiration followed by systemic fibrinolytic therapy.

Objective: We sought to evaluate the efficacy and safety of a hybrid treatment for acute massive pulmonary thromboembolism in patients with hemodynamic impairment by combining mechanical fragmentation, local thrombolysis, and clot aspiration.

Subjects And Methods: Within a period of 35 months, 25 patients with hemodynamic impairment (eight men and 17 women; age range, 35-77 years) were treated with mechanical thrombus fragmentation using a modified rotating pigtail catheter. After embolus fragmentation, all patients received an intrapulmonary injection of recombinant human-tissue plasminogen activator and then underwent manual clot aspiration with a large-lumen percutaneous transluminal coronary angioplasty guide catheter.