Downstream Hepatic Arterial Blood Pressure Changes Caused by Deployment of the Surefire AntiReflux Expandable Tip

Purpose The purpose of this work was to evaluate blood pressure changes caused by deployment of the Surefire antireflux expandable tip. The pressure measurements are relevant because they imply changes in hepatoenteric arterial blood flow within this liver compartment during hepatic artery delivery...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2013-10, Vol.36 (5), p.1262-1269
Main Authors: Rose, Steven C., Kikolski, Steven G., Chomas, James E.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
ARTERIES
BLOOD FLOW
BLOOD PRESSURE
Blood Pressure Determination - methods
Cardiology
Clinical Investigation
Embolization, Therapeutic - instrumentation
Embolization, Therapeutic - methods
Equipment Design
Female
Hepatic Artery - physiopathology
Humans
Imaging
LIVER
Liver Neoplasms - therapy
Male
Medicine
Medicine & Public Health
Middle Aged
NEOPLASMS
Nuclear Medicine
PATIENTS
PRESSURE MEASUREMENT
RADIOEMBOLIZATION
Radiology
RADIOLOGY AND NUCLEAR MEDICINE
Ultrasound
YTTRIUM 90
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Summary:Purpose The purpose of this work was to evaluate blood pressure changes caused by deployment of the Surefire antireflux expandable tip. The pressure measurements are relevant because they imply changes in hepatoenteric arterial blood flow within this liver compartment during hepatic artery delivery of cytotoxic agents. Methods After positioning the Surefire antireflux system in the targeted hepatic artery, blood pressure was obtained initially with the tip collapsed (or through a femoral artery sheath), then again after the tip was expanded before chemoembolization or yttrium 90 ( 90 Y) radioembolization. Results Eighteen patients with liver malignancy underwent 29 procedures in 29 hepatic arteries (3 common hepatic, 22 lobar, 4 segmental). Systolic, diastolic, and mean blood pressure were all decreased by a mean of 29 mm Hg ( p  = 0.000004), 14 mm Hg ( p  = 0.0000004), and 22 mm Hg ( p  = 0.00000001), respectively. Conclusion When the Surefire expandable tip is deployed to prevent retrograde reflux of agents, it also results in a significant decrease in blood pressure in the antegrade distribution, potentially resulting in hepatopedal blood flow in vessels that are difficult to embolize, such as the supraduodenal arteries.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-012-0538-2