title: Double-Balloon-Assisted n-Butyl-2-Cyanoacrylate Embolization of Intrahepatic Arterioportal Shunt Prior to Chemoembolization of Hepatocellular Carcinoma.
abstract: A case of multiple hepatocellular carcinomas with a severe intrahepatic arterioportal shunt that was successfully embolized with n-butyl-2-cyanoacrylate with coaxial double-balloon occlusion prior to transcatheter arterial chemoembolization is presented. A proximal balloon positioned at the proper hepatic artery was used for flow control, and a coaxial microballoon, positioned in the closest of three arterial feeding branches to the arterioportal shunt, was used to control the delivery of n-butyl-2-cyanoacrylate. This coaxial double-balloon technique can prevent proximal embolization and distal migration of n-butyl-2-cyanoacrylate and enable precise control of the distribution of n-butyl-2-cyanoacrylate. It could also be applicable to n-butyl-2-cyanoacrylate embolization for other than intrahepatic arterioportal shunt.
authors.affiliation: Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. takaoh-tky@umin.ac.jp.
authors.forename: Hidemasa
authors.initials: H
authors.lastname: Takao
authors.affiliation: Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Shibata
authors.affiliation: Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Kuni
authors.initials: K
authors.lastname: Ohtomo
mesh_terms: D001164:Arteriovenous Fistula / Q000188:drug therapy*; D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000188:drug therapy*; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D004659:Enbucrilate / Q000008:administration & dosage*; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000188:drug therapy*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000098:blood supply* / Q000188:drug therapy*; D011169:Portal Vein
chemical_list: D004659:Enbucrilate
keywords: Arterioportal shunt; Balloon; Embolization; NBCA; n-butyl-2-cyanoacrylate