Hepatitis hepatic arterial injection

Intraarterial infusion of microspheres containing adriamycin was used for the local treatment of breast cancer and recurrent breast cancer with liver metastases (123). A reduction in tumor size was noted when the microspheres were injected into the internal and lateral thoracic arteries for treatment of the primary tumor. However, hepatic artery injection for liver metastases resulted in improvement in only one of three patients treated. 

Bretagne JF, Raoul JL, Bourguet P, Duvauferrier R, Deug-nier Y, Faroux R, Ramee A, Kerry JY, Gastard J (1988) Hepatic artery injection of I-131-labeled lipiodol. Part II. Preliminary results of therapeutic use in patients with hepatocellular carcinoma and liver metastases. Radiology 168 547-550... 

S. Higashi and T. Setoguchi, Hepatic arterial injection chemotherapy for hepatocellular carcinoma with epira-bicin aqueous solution as numerous vesicles in iodinated poppy-seed oil microdroplets Clinical application of water-in-oil-in-water emulsion prepared nsing a membrane emulsification system, Adv. Drug Deliv. Rev. 45 (2000) 57-64. 

Fig. 8.3. a Celiac angiogram in a patient with portal hypertension demonstrating a distal splenic artery aneurysm, b Celiac angiogram from another patient with multiple splenic aneurysms associated with portal hypertension who has undergone liver transplantation. Note the large hepatic pseudoaneurysm just medial to the upper pole of the right kidney, c Selective common hepatic artery injection in the patient from b... 

Figure 10.9 IPSO amount in organs 1 hour after hepatic arterial injection with a W/OAV emulsion consisting of I-IPSO microdroplets that are 10 or 60 pm in diameter. The emulsion was injected into the proper hepatic artery of the rabbits after laparotomy under general anesthesia. The IPSO amount was calculated by measuring the radioactivity of the sample taken from the hver (each 4 lobe), lung (each 5 lobe), spleen, and blood.

The fate of the oil droplets depositing in the tumor is mystifying. We examined HCC tissue resected 30 days after a hepatic arterial injection of chemotherapy with a W/O/W emulsion containing a low dose (8 mg) of epirubicin. As shown in Figure 10.12, the IPSO microdroplets appearing red in color due to the oil-O-stain are seen only in the cytoplasm of the cancer cells, and not in the arterioles or the tumor sinusoids. Electron microscopy of the same specimen revealed that the IPSO microdroplets accumulated in the cytoplasm... 

Miller DM, O Leary TJ, Girton M. 1987. Distribution of iodized oil within the liver after hepatic arterial injection. Radiology 162 849-852. 

Nakuma K, Uemura K, Konno T, Yanaka N, Yokoyama I (1979) Studies on anticancer treatment with an anti-cancer drug injected into the ligated hepatic artery for liver cancer. Nichidoki Iho 24 675... 

Figure 21.3 Histochemical analysis of / -galactosidase gene expression in liver. Ten pa of pCMV-LacZ plasmid DNA were injected into a mouse via the tail vein using the hydrodynamics-based procedure, / -galactosidase gene expression was assayed eight hours post injection. HV, hepatic vein HA, hepatic artery PV, portal vein (50x). (see Color Plate 15)...

Whether rAAV distributes to sperm cells has been of significant concern because of the possibility of introducing mutations in sperm. While AAV DNA can be found in the testes of rodents, rabbits, and dogs following either hepatic arterial or IM injections, these signals appear to be localized to the testis basement membrane and the interstitial space, with no intracellular signal observed. In mice and rats, there was a dose-dependent increase of vector expression in gona-... 

Tc-DTPA Arterial perfusion accounts for 20%-40% of the circulation in portal hypertension, cirrhosis causes arterial perfusion to increase to over 60%. In portal vein thrombosis, only an arterial curve is visible. Liver metastasis usually displays relatively high arterial perfusion. In (rare) occlusions of the hepatic artery, only a portal venous curve is visible. When a bolus injection of 400 MBq "Tc-diethylenetriamine pentaacetic acid (DTPA) is applied, scintigraphy is able to reveal a bi-phasic time-activity curve. The initial increase of activity is produced by the arterial influence and the second peak by the portal venous inflow. Both curves can be evaluated quantitatively. (36) Perfusion scintigraphy may be useful in the case of liver trauma, TIPS, hyper-vascularized hepatic tumours and partial liver resection as well as after liver transplantation. 

As an alternative to percutaneous injection therapy, there is a possibility to develop new local-interventional treatment strategies by selectively exploring the tumourfeeding branch of the proper hepatic artery. 

Once detected, an aneurysm of the hepatic artery requires immediate treatment. Up to a certain size, intrahepatic aneurysms are treated by angiographic embolization. Coagulation by means of direct thrombin injection has also been described. (130) Larger aneurysms are treated by vascular surgery (ligation, vascular reconstruction, resection). (132, 137)... 

Ferrari, A.R, Ferreira, J.RA., de Panio, GA., della Libera, E. Hemo-bilia caused by a mycotic aneurysm of the hepatic artery treated by enbucrilate injection during ERCP (case report). Gastrointest. Endosc. 2003 57 260 - 263... 

Intra-arterial injection of lipiodol (iodized oil) has been used to enhance the accuracy of computed tomography in hepatic tumors. This can cause transient bowel ischemia with nausea, vomiting and diarrhea. 

Intravenous distribution of DNA has been tried without success. This is because DNA is degraded by DNAases and furthermore the whole-body distribution means that the concentration at the tissue level becomes very low. An intermediate solution is arterial injection, for example in the hepatic artery, and tliis may lead to an acceptable concentration at the tissue level, with resultant transgenic expression. 

S-Iabeled BSP has been used for studying the distribution of BSP within tissues (B50, G16) and in investigating the maturation of liver function in chick embryos (B45). It has also been used, in conjuction with imlabeled dye to show that the rate of hepatic uptake of the dye injected into the hepatic artery is the same as that after an injection into the portal vein (B51) (see Section 4.1). Injection of I-labeled BSP with and without unlabeled dye has been used to study the effect of dosage on dye uptake (TIO). 

To optimize the u.se of iodized oil for diagnostic computed tomc raphy and for interstitial radiation therapy, De Baere ct al. quantified the distribution of iodized oil after injection of different formulations of iodized oil into the hepatic artery. The ratio of tumor to nontuiiKKOUS liver uptake of iodized oil was significantly higher with large droplet O/W emulsion than with any other preparation (114). 

Fig. 3.8. Male patient suffering from a multifocal hepatocellular carcinoma (HCC), treated with repeated sessions of transarterial chemoembolization (TACE). Dyna-CT (Siemens Medical Solutions, Erlangen, Germany) image started together with injection of 10 ml iodinated contrast agent via a super-selective catheter system placed in the right hepatic artery compared with a corresponding MDCT section in the arterial phase after i.v. injection of 120 ml iodinated contrast agent. Note the excellent, direct depiction of arterial blood supply of the HCC nodule in liver segment 5/8 (arrow). The artifacts in the left and right liver lobe are caused by spots of Lipiodol in already treated HCC nodules after earlier transarterial chemoembolization...

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