Safety, feasibility, and comfort of hepatic angiography and transarterial intervention with radial access for hepatocellular carcinoma.

BACKGROUND AND AIM: Hepatic angiography procedures such as transarterial chemoembolization (TACE) are essential procedures for managing patients with hepatocellular carcinoma (HCC), and are usually performed with femoral access. However, femoral access causes patient discomfort and may be associated with the risk of hematoma or pseudoaneurysm at puncture site. We evaluated the safety, feasibility, and patient comfort of hepatic angiography procedures performed with radial access. METHODS: In this single-institution, retrospective, time-frame study, a total of 206 patients who underwent hepatic angiography procedures with radial access, which were first used on October 2017 at our institution, were compared with 240 patients who underwent the same procedures with femoral access before this period. Several measures were assessed, including procedure time and safety. In addition, a questionnaire was used to compare the access types regarding procedure-associated discomfort. RESULTS: Hepatic angiography procedures performed with radial access, including TACE, were completed in all patients without complications. The procedure time was comparable between radial access and femoral access. Most patients preferred radial to femoral access. Patients taking anticoagulants were able to complete the procedures without discontinuing these drugs. CONCLUSIONS: Hepatic angiography procedures with radial access resulted in less discomfort than those with femoral access, and the two approaches showed similar feasibility and safety. Radial access can be introduced as a routine technique for hepatic angiography procedures.

Extra-hepatic feeding arteries of hepatocellular carcinoma: An investigation based on intra-arterial CT aortography images using an angio-MDCT system.

OBJECTIVES: We investigated the frequencies and factors associated with the presence of extra-hepatic feeding arteries (EHFAs) of hepatocellular carcinoma (HCC) using intra-arterial CT aortography images. METHODS: A total of 173 patients with HCC who underwent transarterial chemoembolization (TACE) in our institution between January 2013 and March 2015 were enrolled. The types of EHFAs were evaluated by CT aortography images using an apparatus that combines multidetector-row computed tomography and angiography system. In addition, factors associated with the presence of EHFAs were determined. RESULTS: EHFAs were present in 22 (12.7%) patients with HCC. EHFAs most frequently branched from the right inferior phrenic artery (n=19), while others branched from the right adrenal artery (n=2), right renal artery (n=2), right internal thoracic artery (n=2), branches of the superior mesenteric artery (n=1), and an unknown artery from the aorta (n=1). Factors significantly associated with the presence of EHFAs in multivariate analysis were tumor size≥30mm (odds ratio (OR), 5.233 [95% confidence interval (CI), 1.507-17.413]; p=0.009) and number of prior TACE treatments≥3 (OR, 6.847 [95% CI, 1.928-24.311]; p=0.003). CONCLUSIONS: EHFAs of HCC were assessed with CT aortography images. Repeat TACE treatments and large tumor size were risk factors for the presence of EHFAs.

NMDA receptor-dependent long-term potentiation is dependent on low-voltage-activated calcium currents in the sensorimotor cortex of cats.

The role of low-voltage-activated (LVA) calcium channels in the expression of long-term potentiation (LTP) was examined by intracellular recording in slices from cat agranular cortex. In the normal solution, LTP was induced, and the potentiation of low-threshold rebound potential was evoked by negative current injection. In the cells, in which resting membrane potential was depolarized, the incidence of LTP was very low. LTP was blocked completely in the presence of NMDA receptor antagonist or 50-100 microM nickel. It was suggested that LVA calcium channels function downstream of NMDA receptor-dependent signaling.

Properties of voltage dependent potassium currents in acutely isolated rat oculomotor neurons.

Voltage-dependent potassium currents in oculomotor neurons (OMNs) were studied with whole-cell patch clamp recordings. Fast inactivating outward currents (I(fast)) had half activation voltage (Vh) of -37.1 mV with slope factor (Vc) of 10.9 mV. I(fast) had half inactivation voltage (Vh) of -66.5 mV and Vc of 11.4 mV. I(fast) decayed with a time constant(tau) of 5.1 ms at +10 mV. I(fast) were sensitive to 4-aminopyridine, showing 50% inhibitory concentration (IC(50)) of 0.97 mM. Slowly inactivating outward currents (I(slow)) had two components. The low-concentration-TEA-sensitive currents had Vh of -3.7 mV with Vc of 9.7 mV in activation and had Vh of -54.7 mV with Vc of 23.8 mV in inactivation. The persistent currents had Vh of 7.4 mV and Vc of 11.8 mV in activation and Vh of -54.4 mV and Vc of 21.2 mV in inactivation. Decay of I(slow) (+10 mV) followed a double exponential time course (tau 215, 1165.6 ms). Low-concentration-TEA-sensitive currents were blocked completely by tetraethylammonium (TEA) of 3 mM with an IC(50) of 1.52 mM. Higher concentrations (3-20 mM) of TEA blocked the persistent currents, with an IC(50) of 6.9 mM.