Right gastric artery embolization to prevent acute gastric mucosal lesions in patients undergoing repeat hepatic arterial infusion chemotherapy.
OBJECTIVE
The purpose of the study was to investigate the technical outcome and clinical effect of right gastric artery (RGA) embolization to prevent acute gastric mucosal lesions caused by influx of anticancer agents into the RGA in patients undergoing repeat hepatic arterial infusion chemotherapy (HAIC).


METHODS
In 217 patients with malignant hepatic tumors, we attempted RGA embolization with use of metallic coils and/or a mixture of n-butyl cyanoacrylate (n-BCA) and iodized oil, along with the embolization of the gastroduodenal artery. After this procedure, an infusion catheter was placed radiologically and HAIC was performed. We then evaluated the technical outcome and clinical effect of RGA embolization.


RESULTS
RGA embolization was technically successful in 201 of 217 patients (93%). Major complications--nausea, epigastric pain, and fever--were noted in 12%, 4%, and 2% of successful cases, respectively, and were treated conservatively. Recanalization occurred in 4% (nine of 201) of the patients. Eventually, sufficient RGA embolization was achieved in 192 patients. The incidence of acute gastric mucosal lesions confirmed endoscopically was only 3% (five of 192) in patients with sufficient RGA embolization, whereas it was 36% (nine of 25) in patients without sufficient RGA embolization, with a significant difference (P <.01).


CONCLUSIONS
RGA embolization is a highly feasible procedure that can reduce the incidence of acute gastric mucosal lesions associated with HAIC.
Inaba
Y
Y
Department of Diagnostic Radiology, Aichi Cancer Center, 1-1 Kanokoden Chikusa-ku, Nagoya 464-8681, Japan. 105824@acc.pref.aichi.jp
Arai
Y
Y
Matsueda
K
K
Takeuchi
Y
Y
Aramaki
T
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003487:Cyanoacrylates; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000098:blood supply*; D013276:Stomach Ulcer / Q000139:chemically induced / Q000517:prevention & control*; D014014:Tissue Adhesives; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D003487:Cyanoacrylates; D014014:Tissue Adhesives