Right gastric artery embolization to prevent acute gastric mucosal lesionsin patients undergoing repeat hepatic arterial infusion chemotherapy

PURPOSE: The purpose of the study was to investigate the technical outcome and clinical effect of right gastric artery (RGA) embolization to prevent a cute gastric mucosal lesions caused by influx of anticancer agents into the RGA in patients undergoing repeat hepatic arterial infusion chemotherapy ( HAIC). MATERIALS AND METHODS: In 217 patients with malignant hepatic tumors, we at tempted RGA embolization with use of metallic coils and/or a mixture of n-b utyl cyanoacrylate (n-BCA) and iodized oil, along with the embolization of the gastroduodenal artery. After this procedure, an infusion catheter was p laced radiologically and HAIC was performed. We then evaluated the technica l outcome and clinical effect of RGA embolization. RESULTS: RGA embolization was technically successful in 201 of 217 patients (93%). Major complications-nausea, epigastric pain, and fever-were noted i n 12%, 4%, and 2% of successful cases, respectively, and were treated conse rvatively. Recanalization occurred in 4% (nine of 201) of the patients. Eve ntually, sufficient RGA embolization was achieved in 192 patients. The inci dence of acute gastric mucosal lesions confirmed endoscopically was only 3% (five of 192) in patients with sufficient RGA embolization, whereas it was 36% (nine of 25) in patients without sufficient RGA embolization, with a s ignificant difference (P < .01). CONCLUSION: RGA embolization is a highly feasible procedure that can reduce the incidence of acute gastric mucosal lesions associated with HAIC.