Feasibility of a dual microcatheter-dual interlocking detachable coil technique in preoperative embolization in preparation for distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer

Journal of Hepato-Biliary-Pancreatic Sciences - Tập 19 - Trang 431-437 - 2011
Daisuke Abo1, Yu Hasegawa1, Yusuke Sakuhara1, Satoshi Terae1, Tadashi Shimizu1, Khin Khin Tha1, Eiichi Tanaka, Satoshi Hirano2, Satoshi Kondo2, Hiroki Shirato1
1Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
2Department of Surgical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

Tóm tắt

To describe the feasibility of a dual microcatheter-dual interlocking detachable coil (DMDI) technique for preoperative embolization of the common hepatic artery (CHA) in preparation for distal pancreatectomy with en bloc celiac axis resection (DP-CAR) for locally advanced pancreatic body cancer. From January 2007 to December 2009, 26 patients underwent embolization of the CHA by the DMDI technique. We compared the results with those of 37 patients in whom the CHA was embolized by conventional techniques from August 1998 to February 2007. With the DMDI technique, no coil migration or other embolization-related complications occurred. The success rate was 100%. The rate of embolization-related complications was significantly lower in the DMDI embolization group (0%) than in the conventional embolization group (24.3%) (P = 0.008). The frequency of improper positioning of the embolic material necessitating its removal during DP-CAR was significantly lower in the DMDI embolization group (10%) than in the conventional embolization group (37.5%) (P = 0.044). The DMDI technique allows the development of collateral pathways, reduces the surgeon's burden in ligating the distal CHA, and prevents coil migration. For these reasons, we believe that this technique is feasible for embolization of the CHA in preparation for DP-CAR for locally advanced pancreatic body cancer.

Tài liệu tham khảo

Takahashi T, Ishikura H, Motohara T, Okushiba S, Dohke M, Katoh H. Perineural invasion by ductal adenocarcinoma of the pancreas. J Surg Oncol. 1997;65:164–70. Takahashi S, Hasebe T, Oda T, Sasaki S, Kinoshita T, Konishi M, et al. Extra-tumor perineural invasion predicts postoperative development of peritoneal dissemination in pancreatic ductal adenocarcinoma. Anticancer Res. 2001;21:1407–12. Hirano S, Kondo S, Hara T, Ambo Y, Tanaka E, Shichinohe T, et al. Distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer: long-term results. Ann Surg. 2007;246(1):46–51. Kondo S, Katoh H, Hirano S, Ambo Y, Tanaka E, Saito K, et al. Ischemic gastropathy after distal pancreatectomy with celiac axis resection. Surg Today. 2004;34:337–40. Kondo S, Katoh H, Shimizu T, Omi M, Hirano S, Ambo Y, et al. Preoperative embolization of the common hepatic artery in preparation for radical pancreatectomy for pancreas body cancer. Hepatogastroenterology. 2000;47(35):1447–9. Mori T, Sugimoto K, Taniguchi T, Tsurusaki M, Izaki K, Konishi J, et al. Renal arteriovenous fistula with rapid blood flow successfully treated by transcatheter arterial embolization: application of interlocking detachable coil as coil anchor. Cardiovasc Interv Radiol. 2004;27(4):374–6. Qureshi SA, Reidy JF, Alwi MB, Lim MK, Wong J, Tay J, et al. Use of interlocking detachable coils in embolization of coronary arteriovenous fistulas. Am J Cardiol. 1996;78(1):110–3. Reidy JF, Qureshi SA. Interlocking detachable platinum coils, a controlled embolization device: early clinical experience. Cardiovasc Interv Radiol. 1996;19(2):85–90. Mori K, Shiigai M, Saida T, Anno I, Wada M, Minami M, et al. A modified metallic coil embolization technique for pulmonary arteriovenous malformations using coil anchors and occlusion balloon catheters. Cardiovasc Interv Radiol. 2008;31(3):638–42. Lund G, Cragg AH, Rysavy JA, Castaneda F, Castaneda-Zuniga WR, Amplatz K. Detachable stainless-steel spider. A new device for vessel occlusion. Radiology. 1983;148(2):567–8. Tuite DJ, Kessel DO, Nicholson AA, Patel JV, McPherson SJ, Shaw DR. Initial clinical experience using the Amplatzer vascular plug. Cardiovasc Interv Radiol. 2007;30(4):650–4. Lustberg H, Pollak JS. Mechanical embolization agents. In: Baum S, Pentecost MJ, editors. Abrams’ angiography interventional radiology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 176–86. Osuga K, Mikami K, Higashihara H, Maeda N, Tsuboyama T, Kuwabara M, et al. Principles and techniques of transcatheter embolotherapy for peripheral vascular lesions. Radiat Med. 2006;24(4):309–14. Butto F, Hunter DW, Castaneda-Zuniga W, Amplatz K. Coil-in-coil technique for vascular embolization. Radiology. 1986;161(2):554–5.