Novel percutaneous radiofrequency ablation of portal vein tumor thrombus: safety and feasibility

Cardiovasc Intervent Radiol. 2013 Feb;36(1):245-8. doi: 10.1007/s00270-012-0451-8. Epub 2012 Aug 2.

Abstract

Purpose: We report our experience of the safety of partial recanalization of the portal vein using a novel endovascular radiofrequency (RF) catheter for portal vein tumor thrombosis.

Methods: Six patients with liver cancer and tumor thrombus in the portal vein underwent percutaneous intravascular radiofrequency ablation (RFA) using an endovascular bipolar RF device. A 0.035-inch guidewire was introduced into a tributary of the portal vein and through which a 5G guide catheter was introduced into the main portal vein. After manipulation of the guide catheter over the thrombus under digital subtraction angiography, the endovascular RF device was inserted and activated around the thrombus.

Results: There were no observed technique specific complications, such as hemorrhage, vessel perforation, or infection. Post-RFA portography showed partial recanalization of portal vein.

Conclusions: RFA of portal vein tumor thrombus in patients with hepatocellular carcinoma is technically feasible and warrants further investigation to assess efficacy compared with current recanalization techniques.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery
  • Catheter Ablation / methods*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplastic Cells, Circulating / pathology*
  • Patient Safety
  • Phlebography / methods
  • Pilot Projects
  • Portal Vein / diagnostic imaging
  • Portal Vein / surgery*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Vascular Patency / physiology
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / surgery*