David C Madoff

..We compared the feasibility, safety, and effectiveness of a transarterial approach for PVE (TA-PVE) with those of a transhepatic approach for PVE (TH-PVE) in a swine model...

..This article reviews the care of patients with NETs and hepatic metastases, with emphasis on the increasingly important role of oncologic image-guided interventions...

..Familiarity with the complications that can result from these interventional procedures, including abscess formation and pancreatitis, also is important...

..In addition, the indications and contraindications for performing PVE in patients with and without chronic liver disease and the multidisciplinary approach required for the treatment of these complex cases are emphasized...

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..In both patients, after IA platelet infusion, blood product requirements were immediately reduced, bleeding from the GI tract resolved by clinical and laboratory criteria, and no significant bowel ischemia was seen...

..Further research is necessary to improve our understanding of TIPS-related hepatic encephalopathy so that newer, less invasive and safer procedures can be developed to treat this difficult clinical problem...

..The remaining patient continued to decline and died 3 weeks later. Two endografts completely occluded within 8 months without HE recurrence. This technique offers an attractive alternative to previously described shunt reduction methods...

..Further development of new treatment strategies and modalities is needed to improve the quality of life and survival of patients with this disease...

..Nevertheless, as hepatobiliary surgeons become more experienced at performing extended hepatic resections, PVE may be requested more frequently...

..We report two cases of patients diagnosed with ureteral-iliac artery fistulae who were treated with Wallgraft endoprostheses, a new, commercially available covered stent...

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..We evaluated the efficacy of embolotherapy including hepatic arterial embolization and chemoembolization in patients with imatinib-resistant gastrointestinal stromal tumors with progressive liver metastases...

..Secondary end point was to assess whether preoperative portal vein embolization (PVE) is associated with improved outcome in patients with initial sFLR ? 20%...

..We evaluated response rates and survival durations after HACE in such patients and analyzed factors affecting their survival...

..The purpose of this study was to retrospectively evaluate the sensitivity and accuracy of CT-guided PNB in patients with hilar adenopathy...

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..Patients with massive liver tumor burden, who have additional risk factors, should not be subjected to HAE/HACE because of the high risk of procedure-related mortality...

..Extent of liver disease, presence of extrahepatic disease, number of embolization treatments, and use of imatinib were found to have prognostic influence on PFS, OS, or both...

..To evaluate C-arm computed tomography (CT) and assess its potential impact on hepatic arterial interventions...

..To assess the safety and diagnostic accuracy of percutaneous image-guided splenic biopsy in patients known to have or suspected of having malignancy...

..In this cohort, (90)Y microsphere radioembolization of neuroendocrine hepatic metastases was not precluded by previous nonradioactive embolization procedures, but the effectiveness in this population requires further investigation...

..To develop a clinically relevant porcine model of liver cirrhosis with portal hypertension by means of hepatic transarterial embolization...

..However, whether segment 4 (S4) portal veins should be embolized is controversial. The effect of S4 PVE on the volume gain of segments 2 and 3 (S2+3) was examined...

..We undertook this study to evaluate the feasibility and immediate effectiveness of RFA for treatment of both solitary pulmonary nodules and clusters of lung tumors in a large animal model...

..Additional interventions or prolonged chest tube drainage are needed more frequently in patients with emphysema in the needle path...

..1%). Mean TELV was 1,784.8 cm3. FLR/TELV ratio increase was 8%. CONCLUSION: Preoperative PVE with PVA particles and coils is safe and effective for inducing lobar hypertrophy in patients with advanced hepatobiliary malignancy...

..Effective use of these devices requires knowledge of the accumulated clinical experience and a dedicated multidisciplinary effort to ensure optimal outcomes and avoid therapy-specific life-threatening complications...

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..To retrospectively compare the diagnostic yield and complications associated with the use of short versus long needle paths for computed tomography (CT)-guided biopsy of small subpleural lung lesions...

..This report briefly describes the authors' treatment experience with this cohort of patients...

..The purpose of this study was to compare FLR volumes standardized to BW versus BSA and to assess their utility in predicting postoperative hepatic dysfunction after hepatic resection...

..The impact of complete resection in this well-selected group is controversial...

..Careful planning of the procedure and considerable familiarity with head and neck anatomy are necessary for a biopsy that is both precise and safe...

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..To the authors' knowledge there is limited documentation of its use for percutaneous shunting in patients with hepatic and extrahepatic malignancies. The current study reports the authors' experience with TIPS in the oncology setting...

..CT-guided coaxial needle biopsy by an anterolateral approach through the iliopsoas muscle, with the use of a curved needle in selected cases is safe and effective for obtaining samples from deep pelvic lesions...

..Perioperative outcome and survival after major hepatic resection for HCC, with and without PVE, were investigated...

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..Prolonged survival was seen in patients who responded to HACE (p = .034)...

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..Novel improvements to PVE should expand its scope to patients who were previously not candidates for the procedure...

..All 23 US-guided biopsies resulted in definitive diagnosis. Two of the 12 fluoroscopy- or CT-guided biopsies (17%) were inconclusive...

..It is essential that the interventional radiologist involved in the care of these patients be familiar with these different techniques as well as with the limitations, pitfalls, and possible complications of their use...

..To report the safety, technical success, and effectiveness of percutaneous radiofrequency (RF) ablation for renal tumors...

..Another alternative is the transpulmonary approach, which involves transgression of the lung and visceral pleura by the needle and is associated with a substantial risk of pneumothorax...

..A thorough understanding of the advantages and disadvantages of each approach allows the clinician to choose the most appropriate approach in a given situation...

..The clinical benefit of placing IVC filters in patients with advanced-stage cancer is controversial. The current study reported the authors' experience with IVC filters in patients with cancer...

..The aim of this study was to compare the outcome of patients with CLM treated with preoperative chemotherapy followed by one- or two-stage hepatectomy...

..Systemic paclitaxel is safe and has demonstrated good antitumor activity against breast carcinoma. The objective of this prospective study was to determine the safety and antitumor activity of hepatic intra-arterial paclitaxel therapy...

..The present report describes the authors' experience with chemoembolization after PVE in three patients...

..HAI nab-paclitaxel showed partial hepatic extraction. At doses 260 mg/m(2) or less given for 1 hour every 3 weeks, the treatment was well-tolerated and showed activity in advanced cancer patients with predominant liver metastases...

..A retrospective analysis was performed to determine the technical feasibility of SIR-Sphere treatment in this population...

..We speculate that the hepatic arterial supply increases peripherally and that peribiliary/periportal plexuses maintain the portal supply centrally...

..In high-volume centers, PVE can be safely performed; it increases the resectability rate and results in the same survival rates as those in patients who undergo resection without PVE...

..Herein we present a case of a large post-pancreaticoduodenectomy SMA pseudoaneurysm that required thrombin injection after initial stent-graft deployment to accomplish complete pseudoaneurysm occlusion...

..The authors describe a new simple percutaneous method that allows removal of these T-tubes without complication...

..Our goal was to develop a lung tumor model in a large animal to simulate human lung cancer for preclinical assessment of novel therapeutic options...

..Little information is available to guide clinicians on the optimal approach to managing obstructive jaundice in lymphoma patients...

..In our experimental study, we found no difference between expandable needle systems in vivo. Cooled needles produced slightly smaller and ovoid shape in vivo lesions...

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..Refinement in patient selection criteria and methods to evaluate hepatic hypertrophy and function should increase the potential indications for PVE and expand the field of major liver surgery...

..In addition, the basic principles described in this manuscript apply to all liver-directed transarterial therapies, such as chemoembolization and/or drug-eluting microspheres...

..In addition, the indications and contraindications for performing PVE in patients with and without chronic liver disease, the use of combination therapies, and the concern for tumor growth after PVE will be discussed...