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Kanogawa N, Chiba T, Ogasawara S, et al. Successful interventional treatment for arterioportal fistula caused by radiofrequency ablation for hepatocellular carcinoma. Case Rep Oncol. 2014;7(3):833-9doi: 10.1159/000370305.
Kanogawa, N., Chiba, T., Ogasawara, S., Ooka, Y., Suzuki, E., Motoyama, T., Saito, T., Sekimoto, T., Tawada, A., Maruyama, H., Yoshikawa, M., & Yokosuka, O. (2014). Successful interventional treatment for arterioportal fistula caused by radiofrequency ablation for hepatocellular carcinoma. Case reports in oncology, 7(3), 833-9. https://doi.org/10.1159/000370305
Kanogawa, Naoya, et al. "Successful interventional treatment for arterioportal fistula caused by radiofrequency ablation for hepatocellular carcinoma." Case reports in oncology vol. 7,3 (2014): 833-9. doi: https://doi.org/10.1159/000370305
Kanogawa N, Chiba T, Ogasawara S, Ooka Y, Suzuki E, Motoyama T, Saito T, Sekimoto T, Tawada A, Maruyama H, Yoshikawa M, Yokosuka O. Successful interventional treatment for arterioportal fistula caused by radiofrequency ablation for hepatocellular carcinoma. Case Rep Oncol. 2014 Dec 19;7(3):833-9. doi: 10.1159/000370305. eCollection 2014. PMID: 25685134; PMCID: PMC4307006.
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Case Rep Oncol. 2014 Dec 19;7(3):833-9. doi: 10.1159/000370305. eCollection 2014.

Successful interventional treatment for arterioportal fistula caused by radiofrequency ablation for hepatocellular carcinoma.

Case reports in oncology

Naoya Kanogawa, Tetsuhiro Chiba, Sadahisa Ogasawara, Yoshihiko Ooka, Eiichiro Suzuki, Tenyu Motoyama, Tomoko Saito, Tadashi Sekimoto, Akinobu Tawada, Hitoshi Maruyama, Masaharu Yoshikawa, Osamu Yokosuka

Affiliations

  1. Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.

PMID: 25685134 PMCID: PMC4307006 DOI: 10.1159/000370305

Abstract

Radiofrequency ablation (RFA) is commonly used as a treatment for small hepatocellular carcinoma (HCC). Although several complications such as intraperitoneal bleeding are often observed after RFA, hepatic arterioportal fistula (APF) is a less frequently occurring complication. In this study, we describe two cases of APF caused by RFA, which was successfully occluded by an interventional approach. Case 1 involved a 68-year-old man with solitary HCC in segment VIII of the liver. Both contrast-enhanced computed tomography and color Doppler sonography indicated an APF between the anterosuperior branch of the right hepatic artery (A8) and the portal branch (P8). Concordant with these findings, digital subtraction angiography (DSA) revealed an APF in segment VIII of the liver. Subsequently, the APF was successfully occluded by transarterial embolization (TAE) using gelatin sponge particles. Case 2 involved a 67-year-old man with solitary HCC in segment VII of the liver. Although he developed obstructive jaundice because of hemobilia after RFA, it was improved by endoscopic nasobiliary drainage and the systemic administration of antibiotics. In addition, color Doppler sonography revealed a disturbed flow of the right branch of the portal vein. Similar to case 1, DSA showed an APF between A8 and P8. The APF was successfully embolized by TAE using microcoils. In conclusion, it appears that the formation of APF should be checked after RFA. It is preferable to treat RFA-induced APF promptly by an interventional approach to avoid secondary complications such as portal hypertension and liver dysfunction.

Keywords: Arterioportal fistula; Hepatocellular carcinoma; Radiofrequency ablation; Transarterial embolization

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