title: Preoperative microcoil embolization of the common hepatic artery for pancreatic body cancer.
abstract: OBJECTIVE
  To evaluate safety and feasibility of microcoil embolization of the common hepatic artery under proper or distal balloon inflation in preoperative preparation for en bloc celiac axis resection for pancreatic body cancer.
  
  
  METHODS
  Fifteen patients (11 males, 4 females; median age, 67 years) with pancreatic body cancer involving the nerve plexus surrounding the celiac artery underwent microcoil embolization. To alter the total hepatic blood flow from superior mesenteric artery (SMA), microcoil embolization of the common hepatic artery (CHA) was conducted in 2 cases under balloon inflation at the proximal end of the CHA and in 13 cases under distal microballoon inflation at the distal end of the CHA.
  
  
  RESULTS
  Of the first two cases of microcoil embolization with proximal balloon inflation, the first was successful, but there was microcoil migration to the proper hepatic artery in the second. The migrated microcoil was withdrawn to the CHA by an inflated microballoon catheter. Microcoil embolization was successful in the other 13 cases with distal microballoon inflation, with no microcoil migration. Compact microcoil embolization under distal microballoon inflation created sufficient resistance against the vascular wall to prevent migration. Distal balloon inflation achieved the requisite 1 cm patency at the CHA end for vascular clamping. All patients underwent en bloc celiac axis resection without arterial reconstruction or liver ischemia.
  
  
  CONCLUSIONS
  To impede microcoil migration to the proper hepatic artery during CHA microcoil embolization, distal microballoon inflation is preferable to proximal balloon inflation.
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama 641-8510, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Takasaka
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kawai
authors.forename: Morio
authors.initials: M
authors.lastname: Sato
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Tanihata
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Sonomura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Minamiguchi
authors.forename: Motoki
authors.initials: M
authors.lastname: Nakai
authors.forename: Akira
authors.initials: A
authors.lastname: Ikoma
authors.forename: Kouhei
authors.initials: K
authors.lastname: Nakata
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sanda
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000628:therapy*