title: Percutaneous ethanol injection of the supplying artery to hepatocellular carcinoma that is not amenable to conventional treatment.
abstract: The purpose of this study was to evaluate the clinical usefulness of ultrasound-guided percutaneous ethanol injection of the supplying artery (PEISA) to the tumour in the palliative management of hepatocellular carcinoma (HCC) that is not amenable to conventional treatments. A total of 23 cases of HCC, measuring from 3.1 cm to larger than 15 cm (median 5.4 cm) in 17 cirrhotic patients, were treated by PEISA. PEISA was used to control rapid growth of the tumour in seven patients and to reduce abdominal discomfort caused by rapid expansion of the tumour in 10 patients. Tumours with arterial Doppler signals persisting after PEISA underwent repeated treatment. The follow-up period ranged from 2-48 months. PEISA was achieved in 69 out of 76 attempts (90.8%). The amount of ethanol injected on each occasion ranged from 2.5-33 ml. Follow-up colour Doppler scanning showed complete elimination of tumour Doppler signals in 22 out of 23 lesions (95.7%). Following treatment, one tumour disappeared, 13 tumours shrank and nine tumours were unchanged in size. All patients with abdominal discomfort had relief after treatment. The common complications of PEISA were local pain and fever. In conclusion, PEISA is effective at treating painful HCC unsuitable for conventional treatment.
authors.affiliation: Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan, Republic of China.
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Lin
authors.forename: J H
authors.initials: JH
authors.lastname: Wang
authors.forename: M Y
authors.initials: MY
authors.lastname: Hsieh
authors.forename: M L
authors.initials: ML
authors.lastname: Yu
authors.forename: S C
authors.initials: SC
authors.lastname: Chen
authors.forename: W L
authors.initials: WL
authors.lastname: Chuang
authors.forename: L Y
authors.initials: LY
authors.lastname: Wang
authors.forename: J F
authors.initials: JF
authors.lastname: Tsai
authors.forename: W Y
authors.initials: WY
authors.lastname: Chang
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007269:Injections, Intra-Arterial; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D012597:Sclerosing Solutions; D000431:Ethanol