title: Percutaneous Endovascular Radiofrequency Ablation for Malignant Portal Obstruction: An Initial Clinical Experience.
abstract: OBJECTIVE
  The Habib™ VesOpen Catheter is a new endovascular radiofrequency ablation (RFA) device used to treat malignant portal obstruction. The purpose of this study was to evaluate the clinical feasibility and safety of RFA with this device.
  
  
  METHODS
  We collected the clinical records and follow-up data of patients with malignant portal obstruction treated with percutaneous endovascular portal RFA using the Habib™ VesOpen Catheter. Procedure-related complications, improvement of symptoms, portal patency, survival, and postoperative biochemical tests were investigated.
  
  
  RESULTS
  The 31 patients enrolled in the study underwent 41 successful endovascular portal RFA procedures. Patients were divided into a portal-stenting (PS) group (n = 13), which underwent subsequent portal stenting with self-expandable metallic stents, and a non-stenting (NS) group (n = 18), which did not undergo stenting. No procedure-related abdominal hemorrhage or portal rupture occurred. Postablation complications included abdominal pain (n = 26), fever (n = 13), and pleural effusion (n = 15). Improvements in clinical manifestations were observed in 27 of the 31 patients. Of the 17 patients experiencing portal restenosis, 10 underwent successful repeat RFA. The rate of successful repeat RFA was significantly higher in the NS group than in the PS group. Median portal patency was shorter in the PS group than in the NS group. No mortality occurred during the 4 weeks after percutaneous endovascular portal RFA.
  
  
  CONCLUSIONS
  Percutaneous endovascular portal RFA is a feasible and safe therapeutic option for malignant portal obstruction. Prospective investigations should be performed to evaluate clinical efficacy, in particular, the need to evaluate the necessity for subsequent portal stenting.
authors.affiliation: Hepatobiliary Surgery Department, The 309th Hospital of PLA, Beijing, 100091, China.
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Wu
authors.affiliation: General Surgery Department, The 307th Hospital of PLA, Beijing, 100071, China.
authors.forename: Hu-Cheng
authors.initials: HC
authors.lastname: Li
authors.affiliation: Hepatobiliary Surgery Department, The 309th Hospital of PLA, Beijing, 100091, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Zheng
authors.affiliation: Radiology Department, The 309th Hospital of PLA, Beijing, 100091, China.
authors.forename: Guo-Kun
authors.initials: GK
authors.lastname: Ao
authors.affiliation: Radiology Department, The 309th Hospital of PLA, Beijing, 100091, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Lin
authors.affiliation: Hepatobiliary Surgery Department, The 309th Hospital of PLA, Beijing, 100091, China. weimin_li_surgery@126.com.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Li
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*
keywords: Endovascular radiofrequency ablation; Hepatocellular carcinoma; Portal patency; Portal stenting; Portal vein tumor thrombus; Portal venous hypertension