Efficacy of a microballoon catheter in transarterial chemoembolization of hepatocellular carcinoma using miriplatin, a lipophilic anticancer drug: Short-term results.

AIM: The goal of the study was to evaluate the efficacy and safety of balloon-occluded transarterial chemoembolization (B-TACE) of hepatocellular carcinoma (HCC) using miriplatin (a lipophilic anticancer drug) and gelatin particles. METHODS: B-TACE was performed for 62 HCC nodules in 33 patients who could not be treated by surgical resection or radiofrequency ablation. All 33 patients had a history of transarterial chemoembolization (TACE) treatment prior to B-TACE. As a historical comparison, we investigated 40 nodules in 28 patients treated by TACE using a conventional microcatheter (C-TACE), miriplatin and gelatin particles. The therapeutic effect per tumor was compared between the groups based on the Response Evaluation Criteria in Cancer Study Group of Japan (RECICL) and side-effects were compared based on the Common Terminology Criteria for Adverse Events (ver. 4.0). RESULTS: The therapeutic efficacy after 4-12 weeks was evaluated in 59 nodules in the B-TACE group and in 37 nodules in the C-TACE group. Of these nodules, TE4 occurred in 29 (49.2%) in the B-TACE group and in 10 (27%) in the C-TACE group. Local efficacy was significantly higher in nodules treated by B-TACE than by C-TACE. The side-effects on hepatic function were similar in the two groups. CONCLUSION: Our results suggest that B-TACE with miriplatin is a useful treatment for hepatocellular carcinoma.

Technique of Transbrachial Angiography and Treatment for Abdominal Diseases: A Study of 6262 Patients.

For over 20 years, we have been using the transbrachial approach as the first-line option for abdominal angiography and transcatheter arterial chemoembolization (TACE). The present study involving 6262 patients (success rate of 99.8%) showed that the transbrachial approach could be used for superselective angiography or computed tomography during angiography (angio-CT) and was effective for hemostasis of abdominal aneurysmal hemorrhage, diverticular hemorrhage and partial splenic embolization. The approach was highly safe with no association with serious complications. Bleeding from the puncture site was reported in 225 cases (0.36%), numbness due to nerve damage at the puncture site. was reported in 376 cases (0.6%), and arteriovenous fistula in the puncture site was reported in 84 cases (0.13%). In the treatment of hepatic disease, the guiding catheter could be inserted deeper into the hepatic artery, and hemostasis after sheath removal required shorter time compared with the transfemoral approach. Based on its safety and usefulness, transbrachial angiography and intervention therapy is a first-line treatment for abdominal diseases.