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Double-Balloon-Assisted n-Butyl-2-Cyanoacrylate Embolization of Intrahepatic Arterioportal Shunt Prior to Chemoembolization of Hepatocellular Carcinoma

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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.

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Acknowledgments

We wish to thank Dr. Shiori Amemiya for help in constructing a three-dimensional printing model. This work was supported by a Grant-in-Aid for Scientific Research (A) 15H02553 from the Japan Society for the Promotion of Science.

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Authors and Affiliations

  1. Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Hidemasa Takao, Eisuke Shibata & Kuni Ohtomo

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  1. Hidemasa Takao
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  2. Eisuke Shibata
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  3. Kuni Ohtomo
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Correspondence to Hidemasa Takao.

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Takao, H., Shibata, E. & Ohtomo, K. Double-Balloon-Assisted n-Butyl-2-Cyanoacrylate Embolization of Intrahepatic Arterioportal Shunt Prior to Chemoembolization of Hepatocellular Carcinoma. Cardiovasc Intervent Radiol 39, 1479–1483 (2016). https://doi.org/10.1007/s00270-016-1377-3

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  • DOI: https://doi.org/10.1007/s00270-016-1377-3

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