title: Gastroduodenal injury after radioembolization of hepatic tumors.
abstract: BACKGROUND
  Radioembolization is a new tool for the treatment of hepatic tumors that consists in the injection of biocompatible microspheres carrying radioisotopes into the hepatic artery or its branches.
  
  
  METHODS
  We have performed radioembolization in 78 patients with hepatic tumors using resin-based microspheres loaded with yttrium-90. All patients were previously evaluated to minimize the risk of hazardous irradiation to nontarget organs and to obtain the data needed for dose calculation.
  
  
  RESULTS
  We report a complication found in three cases (3.8%) that consists of abdominal pain resulting from gastroduodenal lesions and that had a chronic, insidious course. Microscopically, microspheres were detected in the specimens obtained from all affected gastric areas. Since these gastroduodenal lesions do not appear when nonradiating microspheres are injected in animals, lesions are likely to be due to radiation and not to an ischemic effect of vascular occlusion by spheres.
  
  
  CONCLUSIONS
  We believe that a pretreatment evaluation that includes a more thorough scrutiny of the hepatic vascularization in search of small collaterals connecting to the gastroduodenal tract can help prevent this awkward complication.
authors.affiliation: Department of Gastroenterology, Liver Unit, University Clinic of Navarra, Navarra, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Carretero
authors.forename: Miguel
authors.initials: M
authors.lastname: Munoz-Navas
authors.forename: Maite
authors.initials: M
authors.lastname: Betes
authors.forename: Ramon
authors.initials: R
authors.lastname: Angos
authors.forename: Jose C
authors.initials: JC
authors.lastname: Subtil
authors.forename: Ignacio
authors.initials: I
authors.lastname: Fernandez-Urien
authors.forename: Susana
authors.initials: S
authors.lastname: De la Riva
authors.forename: Josu
authors.initials: J
authors.lastname: Sola
authors.forename: Jose I
authors.initials: JI
authors.lastname: Bilbao
authors.forename: Esther
authors.initials: E
authors.lastname: de Luis
authors.forename: Bruno
authors.initials: B
authors.lastname: Sangro
mesh_terms: D000818:Animals; D002291:Carcinoma, Papillary / Q000532:radiotherapy; D002292:Carcinoma, Renal Cell / Q000532:radiotherapy; D003097:Collateral Circulation; D004386:Duodenum / Q000098:blood supply / Q000528:radiation effects*; D004621:Embolization, Therapeutic; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000532:radiotherapy; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply / Q000528:radiation effects*; D015021:Yttrium Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects*
chemical_list: D015021:Yttrium Radioisotopes