Embolization for Bleeding after Hepatic Radiofrequency Ablation

作者：Kim Jong Woo; Shin Ji Hoon^*; Kim Pyo Nyun; Shin Yong Moon; Won Hyung Jin; Ko Gi Young; Yoon Hyun Ki

来源：Journal of Vascular and Interventional Radiology, 2017, 28(3): 356-365.

DOI：10.1016/j.jvir.2016.09.031

Purpose: To evaluate safety and clinical efficacy of embolization for Management of bleeding after hepatic radiofrequency (RF) ablation.
Materials and Methods:. From January 2000 to December 2014, 5,196 patients with 9,743 tumors underwent 8,303 RF ablation sessions. Of these patients, 62 experienced bleeding after hepatic RF ablation; 15 patients (12 men and 3 women; mean age 62 y; range, 49-76 y) underwent embolization and composed the final study cohort. Tumors were hepatocellular carcinomas in 13 (87%) patients and metastatic adenocarcinomas from colorectal cancer in 2 (13%) patients. Mean number of tumors was : 1:5 (22 nodules; range, 1-3). Tumor locations were segment I (n = 1), segment II (n = 2), segment III (n = 1), segment IV (n = 1), segment V (n = 3), segment VI (n = 5), segment VII (n = 1), and segment VIII (n = 9). Mean tumor size was 2.3 cm (range, 0.9-5 cm).
Results: Median time interval between presentation and angiography was 22 hours (mean 38.4 h; range, 3-168 h). On angiography, contrast extravasation with or without pseudoaneurysm was seen in all 15 patients; 14 patients underwent transarterial embolization, and 1 patient underwent percutaneous transhepatic portal vein embolization. Successful hemostasis was achieved in all patients. There was no rebleeding within 30 days after embolization. No embolization-related major complications were observed.
Conclusions: Embolization is safe and effective for controlling bleeding related to hepatic RF ablation without the need for surgery.

• 出版日期2017-3