Safe TACE in a patient with SMA stenosis and retrograde flow in a Retroportal artery

Posted By Ahmed Abdel Aal
Safe TACE in a patient with SMA stenosis and retrograde flow in a Retroportal artery

a case of 81year old female with multifocal hepatocellular carcinoma who underwent Transarterial chemoembolization (TACE) as a palliative treatment. The patient had significant ostial stenosis of her superior mesenteric artery (SMA) which led to retrograde flow in her retroportal artery. The authors had concerns about non-target embolization of the SMA territory that might result from the change in the hemodynamics and flow in the hepato-enteric arteries. Therefore, the authors adopted several approaches to avoid this complication by stenting the SMA ostial stenosis as well as the use of the Surefire infusion system (SIS) and balloon occlusion for delivery of chemoembolization material to the right and left hepatic lobes respectively. To our knowledge, the collective use of these approaches to avoid potential risks related to significant SMA ostial stenosis and retrograde flow in a retroportal artery has not been previously described in literature.

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