1988 Fiscal Year Final Research Report Summary
Experimental and clinical studies of intrahepatic portal vein embolization for hepatocellular carcinoma
| Project/Area Number |
61570515
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Radiation science
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| Research Institution | OSAKA CITY UNIV. |
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Principal Investigator |
MINAKUCHI Kazuo OSAKA CITY UNIV. Medical School, Ass.prof., 医学部, 助教授 (50145794)
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| Co-Investigator(Kenkyū-buntansha) |
TAKASHIMA Sumio OSAKA CITY UNIV. Medical School, assistant, 医学部, 助手 (40187951)
NAKAMURA Kenji OSAKA CITY UNIV. Medical School, assistant, 医学部, 助手 (00145781)
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| Project Period (FY) |
1986 – 1988
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| Keywords | Portal vein embolization / hepatocellular carcinoma / intraportal tumor thrombus / 塞栓物質 |
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| Research Abstract |
Interventional angiography is widely used, especially in transcatheter arterial embolization for the treatment of malignant tumors. The author has developed a new method for treatment of hepatocellular carclnoma in which the portal vein is occluded. The treatment can cause complete ischemic necrosis of the tumor cells together with arterial embolization, and can extend indications for surgery by causing compensatory hypertrophy of non-embolized lobe. It helps to prevent dissemination of the tumor via the portal velu, and helps to block centripetal extension of tumor thrombus. The feasibility and safety of this method were studied experimentally. Two kinds of materials were prepared for embolization of the portal vein, a Lipiodol-fibrin adhesive mixture (Lp-Fibrin), and a mixture of Lipiodol with isobutyl-2-cyanoacrylate (Lp-IBC). The portal vein was embolized in 25, 14 with Lp-F, and 11 IBCh Lp-IBC. Lp-F was used 30 to 90 seconds after preparation, which had been found to be best in an in vitro study. Lp-IBC could be used at any time after preparation. Embolization was done safely and reliably, except in two cases of Lp-F, by use of a balloon catheter for Lp-F and a coaxial catheter for Lp-IBC. The obstruction was maintained for two to four weeks in the dogs embolized with Lp-F, and for four weeks in all dogs embolized with Lp-IBC. damage in the liver was slight both macroscopically and histologically. Changes in liver function and elevation of the pressure of the porta vein were transient. The author concluded that intranepatic portal vein embolization was both feasible and safe when the materials tested were used, and could be an effective method for hepatocellular carcinoma. In clinical cases, Lp-Fibrin would be suitable for moderate-term occlusion, and Lp-IBC for long-term. The meterial should be selected with regard to the purpose.
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