| J Ultrasound Med 1998 Aug;17(8):531-533
Complications of percutaneous ethanol ablation.
Gelczer RK, Charboneau JW, Hussain S, Brown DL
Department of Diagnostic Radiology, Mayo Clinic and Mayo Foundation,
Rochester, Minnesota 55905, USA.
Percutaneous ethanol injection therapy performed with sonographic visualization
is a steadily growing therapeutic method that can be used in the ablation
of solid and cystic masses in a variety of anatomic locations. Ethanol
has been used for many years as an angiographically administered agent
for vascular embolization of tumors such as hepatic and renal neoplasms.
It was first used as a percutaneously injected agent for the sclerosis
of renal cysts. Local infiltration or intravascular injection of ethanol
leads to cell death by causing cell membrane lysis, protein denaturation,
and vascular occlusion. Because of the initial success in the sclerosis
of renal cysts, percutaneously injected ethanol is now used in the ablation
of hepatic cysts and solid tumors, such as hepatocellular carcinomas.
As a treatment agent, ethanol combines the benefits of being widely available,
inexpensive, efficacious, and relatively easy to administer. Optimal results
require that the radiologist have considerable experience in ultrasonographic
scanning techniques and facility with percutaneous needle insertion under
real-time visualization. Alternatively, the radiologist may choose CT
as a method to visualize needle placement. Percutaneous ethanol injection
therapy usually is an effective alternative to conventional surgical resection
of liver lesions and has a low complication rate. We present two patients
in whom hypotensive complications occurred during percutaneous ethanol
injection therapy and discuss the likely causative mechanisms.
PMID: 9697961, UI: 98361426
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