scholarly journals Effects of Shorten Bed Rest Time on Back Pain and Vascular Complication in Patients with Hepatocellular Carcinoma Receiving Transcatheter Arterial Chemoembolization

2017 ◽  
Vol 35 (3) ◽  
pp. 239
Author(s):  
Suthisa Temtap ◽  
Rungtip Udomvisatson ◽  
Kittikorn Nilmanat
Keyword(s):  
Hepatocellular Carcinoma ◽  
Back Pain ◽  
Transcatheter Arterial Chemoembolization ◽  
Vascular Complications ◽  
Bed Rest ◽  
Vascular Complication ◽  
Control Group ◽  
Rest Time ◽  
Experimental Group ◽  
Arterial Chemoembolization

Objective: To test the effect of bed rest time reduction on back pain and vascular complication in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization (TACE).Material and Method: This study was two-group randomized controlled trial. A total of 54 patients with hepatocellular carcinoma, receiving TACE enrolled from October 2015-November 2016, were purposively selected and randomly assigned equally to receive either 6 hours (the control group) or 3 hours (the experimental group) of bed rest after TACE was achieved. Patients in both groups were evaluated back pain by the pain Numerical Rating Scale and vascular complications by Hematoma Formation and Bleeding Scale. Data were analyzed by chi-square test and Mann-Whitney U-test.Results: The mean total score on back pain in the experimental group was significantly lower than that of the control group at 6 and 8 hours following TACE (p-value< 0.000). No vascular complications was found in both the groups.Conclusion: Reducing bed rest time from 6 hours to 3 hours of patients following TACE can decrease the severity of back pain and has no effect on the incidence of vascular complications.

scholarly journals Efficacy and safety of a monodisperse solid-in-oil-in-water emulsion in transcatheter arterial chemoembolization in a rabbit VX2 tumor model

2019 ◽  
Author(s):  
Daisuke Yasui ◽  
Aya Yamane ◽  
Hiroshi Itoh ◽  
Masayuki Kobayashi ◽  
Shin-ichiro Kumita
Keyword(s):  
Adverse Events ◽  
Transcatheter Arterial Chemoembolization ◽  
Iodine Concentration ◽  
Control Group ◽  
Efficacy And Safety ◽  
Water Emulsion ◽  
Left Liver Lobe ◽  
Vx2 Tumor ◽  
Experimental Group ◽  
Arterial Chemoembolization

AbstractTranscatheter arterial chemoembolization (TACE) is a standard treatment for unresectable hepatocellular carcinoma; however, it does not always result in tumor control. Nevertheless, treatment outcome can be improved with monodisperse emulsions of anticancer agents. In this study, the efficacy and safety of a monodisperse miriplatin-Lipiodol emulsion were evaluated in Japanese white rabbits. VX2 tumor was implanted into the left liver lobe of each rabbit. The animals were divided into control and experimental groups (of five animals each) and respectively administered a conventional miriplatin suspension or the emulsion via the left hepatic artery. Computed tomography (CT) was performed before, immediately after, and two days following TACE. All rabbits were sacrificed two days after the procedure. Each tumor was removed and cut in half for assessment of iodine concentration in one half by mass spectroscopy and evaluation of Lipiodol accumulation and adverse events in the other half. Mean Hounsfield unit (HU) values were measured using plain CT images taken before and after TACE. Iodine concentration was higher in the experimental group [1100 (750–1500) ppm] than in the control group [840 (660–1800) ppm]. Additionally, the HU value for the experimental group was higher than that for the control group immediately after [199.6 (134.0– 301.7) vs. 165.3 (131.4–280.5)] and two days after [114.2 (56.1–229.8) vs. 58.3 (42.9–132.5)] TACE. Cholecystitis was observed in one rabbit in the control group. Ischemic bile duct injury was not observed in any group. The results show that Lipiodol accumulation and retention in VX2 tumor may be improved by using a monodisperse emulsion. Moreover, no significant adverse events are associated with the use of the emulsion.

scholarly journals Reducing bed rest time from five to three hours does not increase complications after cardiac catheterization: the THREE CATH Trial

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Roselene Matte ◽  
Thamires de Souza Hilário ◽  
Rejane Reich ◽  
Graziella Badin Aliti ◽  
Eneida Rejane Rabelo-Silva
Keyword(s):  
Cardiac Catheterization ◽  
Intervention Group ◽  
Vascular Complications ◽  
Bed Rest ◽  
Group Differences ◽  
Control Group ◽  
Common Complication ◽  
Catheterization Laboratory ◽  
Vasovagal Reaction ◽  
Rest Time

Abstract Objective: to compare the incidence of vascular complications in patients undergoing transfemoral cardiac catheterization with a 6F introducer sheath followed by 3-hour versus 5-hour rest. Methods: randomized clinical trial. Subjects in the intervention group (IG) ambulated 3 hours after sheath removal, versus 5 hours in the control group (CG). All patients remained in the catheterization laboratory for 5 hours and were assessed hourly, and were contacted 24, 48, and 72 h after hospital discharge. Results: the sample comprised 367 patients in the IG and 363 in the GC. During cath lab stay, hematoma was the most common complication in both groups, occurring in 12 (3%) IG and 13 (4%) CG subjects (P=0.87). Bleeding occurred in 4 (1%) IG and 6 (2%) CG subjects (P=0.51), and vasovagal reaction in 5 (1.4%) IG and 4 (1.1%) CG subjects (P=0.75). At 24-h, 48-h, and 72-h bruising was the most commonly reported complication in both groups. None of the comparisons revealed any significant between-group differences. Conclusion: the results of this trial show that reducing bed rest time to 3 hours after elective cardiac catheterization is safe and does not increase complications as compared with a 5-hour rest. ClinicalTrials.gov Identifier: NCT-01740856

scholarly journals FEMORAL VASCULAR COMPLICATIONS

2018 ◽  
Vol 25 (07) ◽  
pp. 987-991
Author(s):  
Muhammad Yasir ◽  
Munir Ahmad ◽  
Liaqat Ali
Keyword(s):  
Coronary Angiography ◽  
Vascular Complications ◽  
Bed Rest ◽  
Control Group ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Experimental Group ◽  
Large Hematoma ◽  
Control Group Group

Background: Coronary angiography is the most important and reliable test todiagnose coronary artery disease. Bed rest of few hours is advised after angiography to reducevascular complications but there is difference of opinion regarding duration of bed rest afterangiography. Objectives: To compare the frequency of vascular complications after 6 hoursof bed rest versus 3 hours of bed rest in patients undergoing femoral coronary angiography.Study Design: Experimental study. Place and Duration of Study: Angiography Department,Faisalabad Institute of Cardiology, Faisalabad from August, 2017 to January, 2018. Methods:A total of 100 patients were divided in two equal groups, group A (interventional group (n=50),3 hours rest) and group B (routine care (n=50), 6 hours rest). A 6 French sheath was insertedunder local anesthesia by seldinger technique in femoral artery. Coronary angiography wasdone using 6 F angiography catheters. At the end of procedure sheaths were immediatelyremoved and manual pressure was applied for 15 minutes. Puncture site was observed forhematoma formation or bleeding every 30 minutes for 2 hours in angiography ward, afterwardsthese observations were made every hour till time of discharge. Patients were called for checkupin outpatient department next day and after 1 week. Results: Out of 50 patients in group A therewere 35 (70%) male and 15 (30%) female and in group B out of 50 patients there were 40 (80%)male and 10 (20%) female patients. In group A mean age was (51.02 ±9.57) years while in groupB mean age was (51.50±10.19) years. There was no significant difference in patients betweenthe two groups regarding their age, gender, body mass index (BMI), coagulation profile and useof antiplatelets. There was no incidence of pre ambulation bleeding, small or large hematoma inboth groups. Post ambulation bleeding occurred in 1(2%) patient in experimental group (GroupA) and in 1 (2%) patient in the control group (Group B). Small hematoma occurred in 2 (4%)patients in experimental group (Group A) and in 1(2%) patient of control group (Group B).There was no incidence of post ambulation large hematoma in both groups. Conclusion: Shortbed rest of 3 hours after femoral angiography does not increase the frequency of puncture sitecomplications.

scholarly journals Application of Traditional Chinese Medicine Combined with TACE in Patients with Primary Hepatocellular Carcinoma and Its Effect on Liver Function

1970 ◽  
Vol 1 (2) ◽  
Author(s):  
Haibin Ding
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Liver Cancer ◽  
Liver Function ◽  
Recurrence Rate ◽  
Transcatheter Arterial Chemoembolization ◽  
Primary Liver Cancer ◽  
Control Group ◽  
Experimental Group ◽  
Arterial Chemoembolization

Objective: To analyze the effects of Chinese herbal medicine combined with transcatheter arterial chemoembolization (TACE) on liver function in patients with primary hepatocellularCarcinoma (HCC). Methods: 122 patients with primary hepatocellular carcinoma admitted in our hospital from March 2014 to October 2016 were divided into experimental group and control group according to the digital table. The number of each group was the same. The patients in the control group were treated by transcatheter arterial chemoembolization. The experimental group was treated with traditional Chinese medicine on the basis of the control group. SPSS20.0 statistical software for statistical analysis of two groups of patients with short-term effect, follow-up of one year primary liver cancer recurrence rate, before and after treatment WBC count, liver function (alanine aminotransferase), alpha-fetoprotein and Karnofsky index parameters. Results: ①The total effective rate of the experimental group was significantly higher than that of the control group (P <0.05); ②The relapse rate of theexperimental group was significantly lower than that of the control group (P <0.05); ③ Before the treatment, the patients in the two groups had significantly higher recurrence rate than those in the control group (P <0.05). After treatment, the white blood cell count, liver function and alpha-fetoprotein levels in the experimental group were significantly better than those in thecontrol group (P <0.05), but no significant difference was found between the two groups (P<0.05). ④ The Karnofsky score of the experimental group was significantly higher than that of the control group (P<0.05). Conclusion: Chinese medicine combined with transcatheter arterial chemoembolization in patients with primary liver cancer in the application value is relatively high.

scholarly journals Effects of Acupressure on Fatigue and Depression in Hepatocellular Carcinoma Patients Treated with Transcatheter Arterial Chemoembolization: A Quasi-Experimental Study

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Su-Chen Lan ◽  
Yueh-E Lin ◽  
Shu-Ching Chen ◽  
Yu-Fang Lin ◽  
Yu-Jen Wang
Keyword(s):  
Transcatheter Arterial Chemoembolization ◽  
Discharge Planning ◽  
Depression Scale ◽  
Control Group ◽  
Control Groups ◽  
Quasi Experimental ◽  
And Control ◽  
Experimental Group ◽  
Improve Fatigue ◽  
Arterial Chemoembolization

This study was to examine the effects of acupressure on fatigue and depression in HCC patients undergoing TACE. A quasiexperimental study design was used. Patients were evaluated at five time points: before treatment (T1) and 2, 3, 4, and 5 days after treating TACE (T2, T3, T4, and T5). Fatigue and depression were assessed by a VAS fatigue scale and a VAS depression scale at each time point. TFRS and BDI were administered at T1 and T5. Patients’ fatigue and depression were significantly higher at T5 than at T1 in two groups. Fatigue and depression increased in both the experimental and control groups’ patients over the five days of hospitalization during which TACE and chemotherapy were administered. The experimental group had significantly less fatigue than the control group, with lower subscale scores on physical, psychosocial, daily, and overall fatigue. There were no differences between the groups on depression. At posttest, the experimental group experienced lower physical, psychosocial, daily, and overall fatigue than the control group. Acupressure can improve fatigue in HCC patients during treatment with TACE but did not alleviate depression. Discharge planning should include home care for management of fatigue and depression.

scholarly journals Clinical Characteristics and Outcomes of Acute Lung Injury Caused by Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Retrospective Cohort Study from a Single Institution in China

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Liang-jie Fang ◽  
Lu-yan Chen ◽  
Jun-hui Sun ◽  
Jian-ying Zhou
Keyword(s):  
Hepatocellular Carcinoma ◽  
Acute Lung Injury ◽  
Mortality Rate ◽  
Lung Injury ◽  
Transcatheter Arterial Chemoembolization ◽  
Pulmonary Complication ◽  
Onset Time ◽  
Control Group ◽  
Lung Field ◽  
Arterial Chemoembolization

Background. Acute lung injury (ALI) is a rare but life-threatening pulmonary complication of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). The aim of this study was to characterize the common risk factors, clinical features, imaging findings, treatments, and outcomes of acute lung injury caused by TACE. Methods. A retrospective study was performed on all TACE-associated ALI cases that were diagnosed at authors’ hospital from January 2015 to June 2018. Results. The study included 14 ALI cases where the mean age of patients was 60.9±11.7 years (range 41-82 years), with a mean onset time of 2.4±1.6 d after TACE. Of the 14 patients, 8 patients (57.1%) developed acute respiratory distress syndrome (ARDS). 7 patients (50%) had underlying chronic respiratory disease and hepatic arteriovenous fistula was detected in 6 patients (42.6%), both of which were significantly higher than control group (P<0.05). Dyspnea (92.9%) was the most common symptoms. Pleural effusion (64.3%), diffuse pulmonary infiltration (42.9%), and accumulation of Lipiodol in lung field (42.9%) were frequent radiologic abnormalities. 11 patients (78.6%) achieved remission after treatment, and the 30-day mortality rate was approximately 21.4%. Patient’s median survival time after the development of ALI was merely 4.3 months, which was obviously worse than control group (4.3 months vs. 13.5 months, P<0.05). Conclusion. This study illustrates that TACE-associated ALI is a rare pulmonary complication with a high mortality rate. We infer that pulmonary Lipiodol embolization might be one of the main causes of TACE-associated ALI. Thus, HCC patients who are at high risk should be closely evaluated and monitored during TACE to avoid such potentially fatal complication.

scholarly journals Comparison of Transcatheter Arterial Chemoembolization-Radiofrequency Ablation and Transcatheter Arterial Chemoembolization Alone for Advanced Hepatocellular Carcinoma with Macrovascular Invasion Using Propensity Score Analysis: A Retrospective Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Yao Liu ◽  
Yuxin Li ◽  
Fangyuan Gao ◽  
Qun Zhang ◽  
Xue Yang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Propensity Score ◽  
Transcatheter Arterial Chemoembolization ◽  
Propensity Score Analysis ◽  
Supportive Therapy ◽  
Control Group ◽  
Tumor Diameter ◽  
Advanced Hepatocellular Carcinoma ◽  
Arterial Chemoembolization

Background. To compare the efficacies of transcatheter arterial chemoembolization (TACE) with radiofrequency ablation (RFA) (TACE + RFA) and TACE alone in patients with hepatocellular carcinoma (HCC) and macrovascular invasion (MVI). Methods. In total, 664 patients having HCC with MVI were included. Of these patients, 141 were treated with TACE + RFA, 254 with TACE alone, and 269 with supportive therapy (control group). The overall survival (OS) was compared among these groups. Propensity score matching (PSM) was performed for balancing the characteristics of the three groups. Results. After one-to-one PSM, the 12-month OS rates were higher in the TACE and TACE + RFA groups than in the control group (p=0.0009 and p=0.0017, respectively). Furthermore, higher 12-month OS rates were observed in the TACE + RFA group than in the TACE group (p=0.0192). The 12-month OS rates of patients were remarkably higher in α-fetoprotein (AFP) < 400 ng/ml, tumor < 3, tumor diameter < 5 cm, or portal vein tumor thrombosis (PVTT) group who were treated with TACE + RFA than in those who were treated with TACE (p=0.0122, p=0.0090, p=0112, and p=0.0071, respectively). Conclusions. TACE + RFA provides a superior survival outcome than TACE alone in HCC patients, especially in AFP <400 ng/ml, tumor <3, tumor diameter <5 cm, or PVTT group.

Is transcatheter arterial chemoembolization plus sorafenib better than chemoembolization plus placebo in the treatment of hepatocellular carcinoma?

2020 ◽  
pp. 030089162094502
Author(s):  
Yong Xie ◽  
Huan Tian ◽  
Hua Xiang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transcatheter Arterial Chemoembolization ◽  
Meta Analysis ◽  
Survival Rates ◽  
Complete Response ◽  
Cochrane Library ◽  
Control Group ◽  
Significant Difference ◽  
Grade 3 ◽  
Arterial Chemoembolization

Objective: To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) plus sorafenib compared with TACE plus placebo for hepatocellular carcinoma (HCC) using meta-analytical techniques. Methods: A search of PubMed, EMBASE, and Cochrane Library databases were done from inception to December 27, 2019. Published trials including a treatment group receiving TACE + sorafenib and a control group receiving TACE + placebo with data for at least 1-year survival or tumor response or time to progression were included. Results: Our study suggested that there was no evidence that TACE plus sorafenib was associated with a lower risk of disease progression compared with TACE plus placebo for treatment of HCC (hazard ratio 0.94 [95% confidence interval (CI), 0.84–1.05]), and no significant difference for treatment of HCC compared with TACE plus placebo in terms of 0.5-, 1-, 1.5-, and 2-year survival rates (risk ratio [RR] 1.01 [95% CI, 0.97–1.05]; RR 1.00 [95% CI, 0.92–1.08], RR 1.04 [95% CI, 0.89–1.23], RR 0.98 [95% CI, 0.72–1.34], respectively). The meta-analysis also showed that TACE + sorafenib seemed to have no significant difference for treatment of HCC compared with TACE + placebo in terms of complete response, partial response, stable disease, progressive disease, overall response rate, and disease control rate. There was an increased incidence of fatigue of grade 3/4 and elevation of aspartate aminotransferase and alanine aminotransferase of grade 3/4 in patients receiving TACE plus sorafenib compared with those receiving TACE plus placebo. Conclusions: There is no additive benefit of TACE plus sorafenib compared to TACE plus placebo for HCC.

scholarly journals Effect and Molecular Mechanisms of Jiedu Recipe on Hypoxia-Induced Angiogenesis after Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Wanfu Lin ◽  
Huan Wang ◽  
Maofeng Zhong ◽  
Shasha Yu ◽  
Shasha Zhao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Metastasis ◽  
Molecular Mechanisms ◽  
Transcatheter Arterial Chemoembolization ◽  
Control Group ◽  
Vegf Mrna ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Arterial Chemoembolization

Transcatheter arterial chemoembolization (TACE) is one of the effective treatment methods for hepatocellular carcinoma (HCC) in middle and late phases. However, TACE-induced hypoxia may promote the angiogenesis and section of some cytokines, such as IL-8, and, thereby, lead to tumor metastasis. Therefore, we investigated the effect of Jiedu Recipe (JR), which has been demonstrated as an effective Traditional Chinese Medicine (TCM) recipe on HCC, on TACE-induced cytokines upregulation and hypoxia-induced angiogenesis. A total of 88 hepatocellular carcinoma (HCC) patients treated with TACE were enrolled and divided into a JR group or control group. TACE induced significant increases of neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), IL-1β, IL-2R, IL-6, and IL-8. JR treatment significantly inhibited the elevation of IL-8 compared with control. In vitro, JR significantly inhibited the hypoxia-induced overexpression of IL-8, HIF-1α, and VEGF mRNA in Huh 7 cells. ELISA assay demonstrated the effect of JR on IL-8 expression. Both hypoxia and IL-8 may promote angiogenesis which was suppressed by JR. Western blot showed that IL-8 upregulated the expression of phosphorylation of AKT, ERK, NF-κB, and VEGFR, which were inhibited by JR. On the other hand, effects of IL-8 on the increase of p-AKT and p-ERK were also blocked by LY294002 and U0126, respectively. In conclusion, our results indicated that JR may inhibit hypoxia-induced angiogenesis through suppressing IL-8/HIF-1α/PI3K and MAPK/ERK pathways after TACE in HCC patients.

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