Temporary balloon occlusion of the common hepatic artery for yttrium-90 glass microspheres administration in a patient with hepatocellular cancer and renal insufficiency

Case Rep Radiol. 2013:2013:560758. doi: 10.1155/2013/560758. Epub 2013 Apr 27.

Abstract

The most severe complication of yttrium-90 therapy is gastrointestinal ulceration caused by extrahepatic dispersion of microspheres. Standard pretreatment planning requires extensive angiographic evaluation of the hepatic circulation and embolization of hepatoenteric collaterals; however, in patients with severe renal insufficiency, this evaluation may lead to acute renal failure. In order to minimize iodinated contrast utilization in a patient with preexisting severe renal insufficiency, the authors describe the use of a balloon catheter for temporary occlusion of the common hepatic artery to induce transient redirection of flow of the hepatoenteric arteries towards the liver, in lieu of conventional coil embolization.