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Yasuaki Arai - One of the best experts on this subject based on the ideXlab platform.

  • Side-Hole Catheter Placement with Fixation and Embolization in Common Hepatic Artery for Hepatic Arterial Infusion Chemotherapy (Modified CHA-Coil Method) for Patients with Celiac Artery Stenosis or Occlusion
    CardioVascular and Interventional Radiology, 2015
    Co-Authors: Yoshitaka Inaba, Hidekazu Yamaura, Yozo Sato, Mina Kato, Hiroshi Kawada, Shinichi Murata, Takaaki Hasegawa, Yasuaki Arai
    Abstract:

    Purpose We retrospectively assessed the feasibility of a side-hole catheter placement with fixation and embolization in the common hepatic Artery (CHA) (modified CHA-coil method) for hepatic arterial infusion (HAI) chemotherapy. Materials and Methods HAI catheter placement was attempted with modified CHA-coil method in five patients with unresectable hepatic malignancies between 2000 and 2013. The reason for using this method, the mode of catheter placement, and the duration of HAI were investigated. Results All patients had either occlusion or Stenosis of the Celiac Artery (CA) or CHA, and, as a result, CHA blood flow had either reversed or decreased and hepatopetal GDA flow was observed. In three patients, the proper hepatic Artery was extremely short. The side-hole catheter was inserted through the left subclavian Artery and was placed from CA to the right gastroepiploic Artery in an anterograde manner ( n  = 4) and from the superior mesenteric Artery to the splenic Artery in a retrograde manner through GDA ( n  = 1). The side hole of the catheter was positioned at the proximal portion of GDA. Using a separate catheter inserted from the right femoral Artery, coils were placed around the indwelling catheter of CHA to embolize CHA and to fix the catheter. Coil mislocation was not observed, and catheter placement was successful in all patients. HAI chemotherapy was administered for a median of 136 days. The catheter displacement was not observed during HAI. Conclusion The modified CHA-coil method can be used as a stable method for catheter placement when CHA is narrow or there is retrograde CHA blood flow.

  • Side-Hole Catheter Placement with Fixation and Embolization in Common Hepatic Artery for Hepatic Arterial Infusion Chemotherapy (Modified CHA-Coil Method) for Patients with Celiac Artery Stenosis or Occlusion
    Cardiovascular and interventional radiology, 2015
    Co-Authors: Yoshitaka Inaba, Hidekazu Yamaura, Yozo Sato, Mina Kato, Hiroshi Kawada, Shinichi Murata, Takaaki Hasegawa, Yasuaki Arai
    Abstract:

    Purpose We retrospectively assessed the feasibility of a side-hole catheter placement with fixation and embolization in the common hepatic Artery (CHA) (modified CHA-coil method) for hepatic arterial infusion (HAI) chemotherapy.

Yoshitaka Inaba - One of the best experts on this subject based on the ideXlab platform.

  • Side-Hole Catheter Placement with Fixation and Embolization in Common Hepatic Artery for Hepatic Arterial Infusion Chemotherapy (Modified CHA-Coil Method) for Patients with Celiac Artery Stenosis or Occlusion
    CardioVascular and Interventional Radiology, 2015
    Co-Authors: Yoshitaka Inaba, Hidekazu Yamaura, Yozo Sato, Mina Kato, Hiroshi Kawada, Shinichi Murata, Takaaki Hasegawa, Yasuaki Arai
    Abstract:

    Purpose We retrospectively assessed the feasibility of a side-hole catheter placement with fixation and embolization in the common hepatic Artery (CHA) (modified CHA-coil method) for hepatic arterial infusion (HAI) chemotherapy. Materials and Methods HAI catheter placement was attempted with modified CHA-coil method in five patients with unresectable hepatic malignancies between 2000 and 2013. The reason for using this method, the mode of catheter placement, and the duration of HAI were investigated. Results All patients had either occlusion or Stenosis of the Celiac Artery (CA) or CHA, and, as a result, CHA blood flow had either reversed or decreased and hepatopetal GDA flow was observed. In three patients, the proper hepatic Artery was extremely short. The side-hole catheter was inserted through the left subclavian Artery and was placed from CA to the right gastroepiploic Artery in an anterograde manner ( n  = 4) and from the superior mesenteric Artery to the splenic Artery in a retrograde manner through GDA ( n  = 1). The side hole of the catheter was positioned at the proximal portion of GDA. Using a separate catheter inserted from the right femoral Artery, coils were placed around the indwelling catheter of CHA to embolize CHA and to fix the catheter. Coil mislocation was not observed, and catheter placement was successful in all patients. HAI chemotherapy was administered for a median of 136 days. The catheter displacement was not observed during HAI. Conclusion The modified CHA-coil method can be used as a stable method for catheter placement when CHA is narrow or there is retrograde CHA blood flow.

  • Side-Hole Catheter Placement with Fixation and Embolization in Common Hepatic Artery for Hepatic Arterial Infusion Chemotherapy (Modified CHA-Coil Method) for Patients with Celiac Artery Stenosis or Occlusion
    Cardiovascular and interventional radiology, 2015
    Co-Authors: Yoshitaka Inaba, Hidekazu Yamaura, Yozo Sato, Mina Kato, Hiroshi Kawada, Shinichi Murata, Takaaki Hasegawa, Yasuaki Arai
    Abstract:

    Purpose We retrospectively assessed the feasibility of a side-hole catheter placement with fixation and embolization in the common hepatic Artery (CHA) (modified CHA-coil method) for hepatic arterial infusion (HAI) chemotherapy.

George Peros - One of the best experts on this subject based on the ideXlab platform.

  • Successful Pancreaticoduodenectomy with Immediate Vascular Reconstruction in a Patient with Cancer of the Pancreatic Head
    2014
    Co-Authors: George Peros, George H. Sakorafas, Dimitrios Manikis, Pantelis Vassiliu, George A Giannopoulos, Elias N. Brountzos
    Abstract:

    Context Celiac Artery Stenosis is observed in a significant percentage of individuals in the general population. Although usually clinically silent and insignificant, due to the presence of extensive collaterals between the Celiac Artery and the superior mesenteric Artery, Celiac Artery Stenosis may be associated with potentially catastrophic ischemic complications in patients undergoing pancreaticoduodenectomy, due to the abrupt interruption of the collateral pathways. Therefore, revascularization may be indicated in selected patients with Celiac Artery Stenosis undergoing a PD. Case report We present a patient with Celiac Artery Stenosis diagnosed intraoperatively during a PD, who underwent vascular reconstruction at the time of the PD. In the immediate postoperative period, he developed hepatic ischemia due to Stenosis at the anastomosis of the stent with the hepatic Artery. He was subsequently treated successfully with the endovascular placement of a stent. In retrospect, a careful reevaluation of the preoperative abdominal CT scan showed the Stenosis at the origin of Celiac Artery. Conclusion A careful evaluation of abdominal CT scan is required to preoperatively identify this not uncommon vascular obstructive disease, especially in asymptomatic patients. Otherwise, the astute surgeon should suspect Celiac Artery Stenosis based on intraoperative findings/changes immediately following ligation of the gastroduodenal Artery during a PD

  • Successful pancreaticoduodenectomy with immediate vascular reconstruction in a patient with cancer of the pancreatic head and Celiac Artery Stenosis. A case report.
    JOP : Journal of the pancreas, 2009
    Co-Authors: George Peros, George H. Sakorafas, George Giannopoulos, Dimitrios Manikis, Pantelis Vassiliu, Elias N. Brountzos
    Abstract:

    Context Celiac Artery Stenosis is observed in a significant percentage of individuals in the general population. Although usually clinically silent and insignificant, due to the presence of extensive collaterals between the Celiac Artery and the superior mesenteric Artery, Celiac Artery Stenosis may be associated with potentially catastrophic ischemic complications in patients undergoing pancreaticoduodenectomy, due to the abrupt interruption of the collateral pathways. Therefore, revascularization may be indicated in selected patients with Celiac Artery Stenosis undergoing a PD. Case report We present a patient with Celiac Artery Stenosis diagnosed intraoperatively during a PD, who underwent vascular reconstruction at the time of the PD. In the immediate postoperative period, he developed hepatic ischemia due to Stenosis at the anastomosis of the stent with the hepatic Artery. He was subsequently treated successfully with the endovascular placement of a stent. In retrospect, a careful reevaluation of the preoperative abdominal CT scan showed the Stenosis at the origin of Celiac Artery. Conclusion A careful evaluation of abdominal CT scan is required to preoperatively identify this not uncommon vascular obstructive disease, especially in asymptomatic patients. Otherwise, the astute surgeon should suspect Celiac Artery Stenosis based on intraoperative findings/changes immediately following ligation of the gastroduodenal Artery during a PD.

  • Celiac Artery Stenosis an underappreciated and unpleasant surprise in patients undergoing pancreaticoduodenectomy
    Journal of The American College of Surgeons, 2008
    Co-Authors: George H. Sakorafas, Michael G Sarr, George Peros
    Abstract:

    V M p eliac Artery Stenosis (CAS) is a relatively common inding. In the presence of CAS, arterial blood supply to he pancreas, stomach, spleen, and liver is usually sustained hrough a well-developed system of pancreaticoduodenal ollateral pathways. Blood supply to these organs has its rigin mainly in the superior mesenteric Artery (SMA). uring pancreaticoduodenectomy (PD), many or most of hese collateral vessels are ligated and divided, thereby genrating an ischemic threat to the liver, biliary tree, and even he stomach. Ischemia of these organs can complicate early nd late results of PD reconstruction and hepatic function. resence of CAS is an important finding during PD, which an require preoperative endovascular stenting or intraoprative revascularization. This work summarizes currently available data about the ascular anatomy of the upper abdominal organs. Both ormal and common variations of anatomy of the Celiac rtery and SMA are presented, specifically about the potenial collateral pathways that can develop in the presence of AS. This information is presented from the perspective of he surgeon who performs or is planning to perform PD in patient with CAS. Awareness of the possibility of this ot-so-uncommon vascular disorder, a high index of suspiion and readiness to perform vascular reconstruction is equired to avoid potentially catastrophic ischemic compliations after PD.

Yasuyuki Yamashita - One of the best experts on this subject based on the ideXlab platform.

  • Simultaneous coil embolization and angioplasty using a self-expanding nitinol stent to treat pancreaticoduodenal Artery aneurysms associated with Celiac Artery Stenosis.
    Acta radiologica (Stockholm Sweden : 1987), 2013
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Koichi Yokoyama, Seijiro Inoue, Yasuyuki Yamashita
    Abstract:

    BackgroundThe degeneration of pancreaticoduodenal arcade vessels due to pancreaticoduodenal Artery aneurysms is associated with Celiac Artery Stenosis or occlusion. While technical advances have ma...

  • Celiac Artery Stenosis occlusion treated by interventional radiology
    European Journal of Radiology, 2009
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuyuki Yamashita
    Abstract:

    Severe Stenosis/occlusion of the proximal Celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and Celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to Celiac axis Stenosis/occlusion appears to be rare because the superior mesenteric Artery (SMA) provides for rich collateral circulation. In patients with Celiac axis Stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with Celiac Artery Stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this Artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal Artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  • Celiac Artery Stenosis/occlusion treated by interventional radiology
    European journal of radiology, 2008
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuyuki Yamashita
    Abstract:

    Severe Stenosis/occlusion of the proximal Celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and Celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to Celiac axis Stenosis/occlusion appears to be rare because the superior mesenteric Artery (SMA) provides for rich collateral circulation. In patients with Celiac axis Stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with Celiac Artery Stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this Artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal Artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  • coil embolization of pancreaticoduodenal Artery aneurysms associated with Celiac Artery Stenosis report of three cases
    CardioVascular and Interventional Radiology, 2007
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Kohichi Kawanaka, Yasuyuki Yamashita
    Abstract:

    Aneurysms of the pancreaticoduodenal Artery are rare. Degeneration of pancreaticoduodenal arcade vessels due to these aneurysms is associated with Celiac Artery Stenosis or occlusion. Untreated lesions enlarge progressively and may rupture spontaneously. As the location of aneurysms of pancreaticoduodenal arcade vessels renders their surgical extirpation a challenge, we examined whether endovascular techniques offer a treatment alternative. We report on 3 patients with aneurysms of the pancreaticoduodenal arcade vessels and concomitant Celiac Artery Stenosis/occlusion due to compression by the median arcuate ligament or chronic pancreatitis. All patients were treated by percutaneous coil embolization of the aneurysm. The aneurysmal sac was successfully excluded and the native circulation was preserved. Endovascular surgery can be used to treat these aneurysms safely and permits retention of the native circulation.

Takaaki Hasegawa - One of the best experts on this subject based on the ideXlab platform.

  • Side-Hole Catheter Placement with Fixation and Embolization in Common Hepatic Artery for Hepatic Arterial Infusion Chemotherapy (Modified CHA-Coil Method) for Patients with Celiac Artery Stenosis or Occlusion
    CardioVascular and Interventional Radiology, 2015
    Co-Authors: Yoshitaka Inaba, Hidekazu Yamaura, Yozo Sato, Mina Kato, Hiroshi Kawada, Shinichi Murata, Takaaki Hasegawa, Yasuaki Arai
    Abstract:

    Purpose We retrospectively assessed the feasibility of a side-hole catheter placement with fixation and embolization in the common hepatic Artery (CHA) (modified CHA-coil method) for hepatic arterial infusion (HAI) chemotherapy. Materials and Methods HAI catheter placement was attempted with modified CHA-coil method in five patients with unresectable hepatic malignancies between 2000 and 2013. The reason for using this method, the mode of catheter placement, and the duration of HAI were investigated. Results All patients had either occlusion or Stenosis of the Celiac Artery (CA) or CHA, and, as a result, CHA blood flow had either reversed or decreased and hepatopetal GDA flow was observed. In three patients, the proper hepatic Artery was extremely short. The side-hole catheter was inserted through the left subclavian Artery and was placed from CA to the right gastroepiploic Artery in an anterograde manner ( n  = 4) and from the superior mesenteric Artery to the splenic Artery in a retrograde manner through GDA ( n  = 1). The side hole of the catheter was positioned at the proximal portion of GDA. Using a separate catheter inserted from the right femoral Artery, coils were placed around the indwelling catheter of CHA to embolize CHA and to fix the catheter. Coil mislocation was not observed, and catheter placement was successful in all patients. HAI chemotherapy was administered for a median of 136 days. The catheter displacement was not observed during HAI. Conclusion The modified CHA-coil method can be used as a stable method for catheter placement when CHA is narrow or there is retrograde CHA blood flow.

  • Side-Hole Catheter Placement with Fixation and Embolization in Common Hepatic Artery for Hepatic Arterial Infusion Chemotherapy (Modified CHA-Coil Method) for Patients with Celiac Artery Stenosis or Occlusion
    Cardiovascular and interventional radiology, 2015
    Co-Authors: Yoshitaka Inaba, Hidekazu Yamaura, Yozo Sato, Mina Kato, Hiroshi Kawada, Shinichi Murata, Takaaki Hasegawa, Yasuaki Arai
    Abstract:

    Purpose We retrospectively assessed the feasibility of a side-hole catheter placement with fixation and embolization in the common hepatic Artery (CHA) (modified CHA-coil method) for hepatic arterial infusion (HAI) chemotherapy.