title: Comparison of Long-Term Results of Percutaneous Treatment Techniques for Hepatic Cystic Echinococcosis Types 2 and 3b.
abstract: OBJECTIVE
  The purpose of this study was to determine the long-term results of a modified catheterization technique for percutaneous treatment of hepatic cystic echinococcosis (CE) types 2 and 3b and to retrospectively compare the results of puncture, aspiration, injection, and reaspiration (PAIR); standard catheterization; and the modified catheterization technique.
  
  
  METHODS
  Seventy-three patients (37 male, 36 female; 75 cysts) with CE types 2 and 3b who underwent percutaneous treatment from March 1991 to August 2008 were included. Informed consent from all patients and approval of the ethics board were obtained. Patients were 6-79 years old. Twenty-three cysts (30.6%) were treated with PAIR, 26 (34.7%) with standard catheterization, and 26 (34.7%) with the modified catheterization technique. The results of the three techniques were statistically compared.
  
  
  RESULTS
  Among all patients, the cysts decreased in volume by 61.1% (range, 5-100%). Cysts recurred in 11 (47.8%) patients treated with PAIR, three (11.5%) treated with standard catheterization, and one (3.8%) treated with the modified catheterization technique. The recurrence rate was not significantly different between standard catheterization and the modified catheterization technique (p > 0.05), whereas significantly more recurrences developed after PAIR than with the other two techniques (p < 0.05). Twelve (16.4%) major and 16 (21.9%) minor complications developed. Significantly fewer major complications occurred with PAIR than with the modified catheterization technique, but the difference between standard catheterization and the other two techniques was not significant.
  
  
  CONCLUSIONS
  Treatment of CE types 2 and 3b with the modified catheterization technique was associated with a recurrence rate lower than what is seen with other techniques, and therefore it appears to be a safe, reliable, and efficient alternative.
authors.affiliation: 1 Department of Radiology, Hacettepe University Faculty of Medicine, 06100, Sıhhıye 06100, Ankara, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Akhan
authors.affiliation: 2 Department of Radiology, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Aysun E
authors.initials: AE
authors.lastname: Salik
authors.affiliation: 1 Department of Radiology, Hacettepe University Faculty of Medicine, 06100, Sıhhıye 06100, Ankara, Turkey.
authors.forename: Turkmen
authors.initials: T
authors.lastname: Ciftci
authors.affiliation: 1 Department of Radiology, Hacettepe University Faculty of Medicine, 06100, Sıhhıye 06100, Ankara, Turkey.
authors.forename: Devrim
authors.initials: D
authors.lastname: Akinci
authors.affiliation: 2 Department of Radiology, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Islim
authors.affiliation: 3 Department of Radiology, Koç University School of Medicine, Ankara, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Akpinar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002406:Catheterization, Peripheral / Q000379:methods*; D002648:Child; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019152:Paracentesis / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods; D013396:Suction / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: catheterization; cystic echinococcosis; liver; percutaneous treatment