title: Ethanol injection therapy for small hepatocellular carcinomas located beneath a large vessel using a curved percutaneous ethanol injection therapy needle.
abstract: Percutaneous ethanol injection therapy (PEIT) has been administered as a safe therapeutic modality for patients with small hepatocellular carcinoma (HCC). Due to the nature of the straight approaching line of a PEIT or radiofrequency ablation needle, penetrating the vessels that are interposed between the dermal insertion point and the nodule is unavoidable. A device with an overcoat needle and coaxial curved PEIT needle was created that facilitated a detour around interposing large vessels in order to avoid unnecessary harmful effects that result from the PEIT procedure. Two cases of HCC located adjacent to a neighboring large vessel were treated with a curved PEIT needle. The curved PEIT needle, which is connected to an outer needle, enabled deviation around the interposing vessels and successful connection with the HCC. Careful use of the curved line of the PEIT needle enabled the safe and successful performance of the PEIT without any requirement for specific training. This hand-assisted technique may be an applicable treatment for small HCC located beneath large vessels as a direct therapeutic method using ultrasound guidance.
authors.affiliation: Department of Internal Medicine, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa 760-8557, Japan.
authors.forename: Seishiro
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Asahiro
authors.initials: A
authors.lastname: Morishita
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Deguchi
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Nakai
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Sakamoto
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Fujita
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Emiko
authors.initials: E
authors.lastname: Maeda
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Nomura
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Tani
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Hisaaki
authors.initials: H
authors.lastname: Miyoshi
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Yoneyama
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Fujiwara
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kobara
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Mori
authors.affiliation: Department of Integrated Medicine, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Himoto
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki-cho, Kida-gun, Kagawa 761-0793, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Masaki
keywords: curved needle; hepatocellular carcinoma; percutaneous ethanol injection therapy