Document Detail


Acute portal hemodynamics and cytokine changesfollowing selective transarterial chemoembolization in patients with cirrhosis and hepatocellular carcinoma.
MedLine Citation:
PMID:  12960926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Altered portal hemodynamics and inflammation may occur following transcatheter arterial chemoembolization (TACE), but early biological and portal perfusion changes are not well characterized when this procedure is performed selectively. MATERIAL/METHODS: We studied variations in portal flow velocity (PFV) using Doppler ultrasonography, as well as serum TNFa, vCAM-1, and E-Selectin at 2 and 24 hours after supraselective TACE in 15 consecutive patients with cirrhosis and hepatocellular carcinoma. RESULTS: Variations in PFV occurred both in the embolized and non-embolized liver lobe. PFV increased significantly at 2 hours in the right and left portal vein. At 24 hours, right PFV remained elevated. Serum TNFa increased significantly at 2 hours, but VCAM-1 and E-Selectin levels remained unchanged. Changes in right and left PFV showed a positive correlation (r=0.9, p<0.001). No correlation could be observed between biological and Doppler changes in portal veins. CONCLUSIONS: In patients with cirrhosis and hepatocellular carcinoma, PFV increased in both liver lobes 2 hours after supraselective TACE, in association with high serum TNFa. Diffuse changes in PFV after TACE suggests that mechanisms involved in the regulation of portal and hepatic arterial hemodynamics are present in patients with cirrhosis. A major role for TNFa in acute portal flow velocity variations is unlikely in this situation.
Authors:
Laurent Spahr; Christoph Becker; Jérôme Pugin; Pietro E Majno; Antonine Hadengue
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical science monitor : international medical journal of experimental and clinical research     Volume:  9     ISSN:  1234-1010     ISO Abbreviation:  Med. Sci. Monit.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-08     Completed Date:  2004-01-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9609063     Medline TA:  Med Sci Monit     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  CR383-8     Citation Subset:  IM    
Affiliation:
Gastroenterology and Hepatology, University Hospital, Geneva, Switzerland. Laurent.Spahr@hcuge.ch
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Alanine Transaminase / blood
Aspartate Aminotransferases / blood
Blood Flow Velocity
Body Temperature / physiology
Carcinoma, Hepatocellular / blood,  blood supply*,  therapy,  ultrasonography
Chemoembolization, Therapeutic*
E-Selectin / blood*
Female
Humans
Liver Cirrhosis / blood,  physiopathology*,  therapy
Liver Neoplasms / blood,  blood supply*,  therapy,  ultrasonography
Male
Middle Aged
Portal Pressure / physiology
Portal Vein / physiology,  ultrasonography
Tumor Necrosis Factor-alpha / metabolism*
Ultrasonography, Doppler, Duplex
Vascular Cell Adhesion Molecule-1 / blood*
Chemical
Reg. No./Substance:
0/E-Selectin; 0/Tumor Necrosis Factor-alpha; 0/Vascular Cell Adhesion Molecule-1; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase

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