J Korean Radiol Soc.  1998 Jun;38(6):1007-1011. 10.3348/jkrs.1998.38.6.1007.

Combined Therapy of Transjugular Intrahepatic Portosystemic Shunt(TIPS) and Transcatheter Hepatic ArteryChemoembolization (TACE) in Patients with Hepatocellular Carcinoma and Gastroesophageal Variceal Bleeding

• Kim YJ
• Kim BK
• Ryeom HK
• Lee JM
• Kang DS

• KMID: 2201337
• DOI: http://doi.org/10.3348/jkrs.1998.38.6.1007

Abstract

PURPOSE: To evaluate the efficacy of combined TIPS and superselective TACE therapy in patients withhepatocellular carcinoma and variceal bleeding.
MATERIALS AND METHODS
Of a total of 132 patients who underwentTIPS, 14 had hepatocellular carcinoma ; of these six with a patent main portal vein who had undergone TACE wereincluded this study. One underwent TIPS 13 months after TACE, and five underwent TACE at various points during theTIPS follow-up period. TIPS followed the standard procedure, while TACE involved superselective segmental orsubsegmental embolization in four patients, lobar artery embolization in one, and non-selective chemoembolizationin one with on advanced tumor.
RESULTS
Except for mild hepatic encephalopathy in two patients, no clinicallysignificant immediate complication was seen after TIPS or TACE. Three patients died due to hepatic failure ; theysurvived for one to three months after combined therapy, a mean of 2.3 months. After combined therapy, otherpatients survived for between five and 49 (mean, 22) months.
CONCLUSION
Combined TIPS and TACE therapy iseffective for the threatment of patients with hepatocellular carcinoma and esophagogastric variceal bleeding.

Keyword

Liver neoplasms, chemotherapeutic infusion; Esophagus, varices; Shunts, portosystemic; Arteries, therapeuticblockade

MeSH Terms

Arteries
Carcinoma, Hepatocellular*
Esophageal and Gastric Varices*
Follow-Up Studies
Hepatic Encephalopathy
Humans
Liver Failure
Portal Vein
Portasystemic Shunt, Surgical