title: Percutaneous radiofrequency ablation with cooled electrodes combined with hepatic arterial balloon occlusion in hepatocellular carcinoma.
abstract: BACKGROUND
  We have reported that percutaneous radiofrequency ablation (RFA) with balloon occlusion of the hepatic artery (balloon-occluded RFA), using an expandable electrode, increases the coagulation area. In this study, we investigated the efficacy of balloon-occluded RFA and balloon-microcatheter-occluded RFA, using a cool RF single electrode.
  
  
  METHODS
  We studies 41 patients with 47 hepatocellular carcinoma (HCC) lesions. We treated 28 patients (32 nodules) with balloon-occluded RFA, 5 patients (6 nodules) with balloon-microcatheter-occluded RFA, and 8 patients (9 nodules) with standard RFA. Initial therapeutic efficacy was evaluated with dynamic computed tomography performed 1 week after one session of treatment.
  
  
  RESULTS
  One session of treatment was done for 20 nodules (62.5%) in the balloon-occluded RFA group and for 4 nodules (66.7%) in the balloon-microcatheter-occluded RFA group. We compared the coagulation diameter for balloon-occluded RFA (7 nodules), balloon-microcatheter-occluded RFA (6 nodules), and standard RFA (9 nodules) after one application cycle (12 min). The greatest dimension of the area coagulated by balloon-occluded RFA was significantly larger (greatest long-axis dimension, 47.6 +/- 7.8 mm; greatest short-axis dimension, 33.4 +/- 7.5 mm) than that coagulated by standard RFA (greatest long-axis dimension, 35.3 +/- 4.7 mm; greatest short-axis dimension, 25.9 +/- 3.7 mm; P = 0.002 for greatest long-axis dimension; P = 0.041 for greatest short-axis dimension). However, there was significant difference only in the greatest short-axis dimension of the area coagulated comparing balloon-microcatheter-occluded RFA and standard RFA.
  
  
  CONCLUSIONS
  We consider balloon-occluded RFA using a cool RF electrode to be superior to standard RFA for the treatment of HCC, especially when larger coagulation volumes are required.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Teruaki
authors.initials: T
authors.lastname: Kimura
authors.forename: Fumie
authors.initials: F
authors.lastname: Kurokawa
authors.forename: Kouji
authors.initials: K
authors.lastname: Aoyama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tajima
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Taro
authors.initials: T
authors.lastname: Takami
authors.forename: Kaoru
authors.initials: K
authors.lastname: Omori
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kawaguchi
authors.forename: Masako
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Shuji
authors.initials: S
authors.lastname: Terai
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Okita
mesh_terms: D000368:Aged; D021721:Balloon Occlusion; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004566:Electrodes; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013696:Temperature