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Case Reports in Radiology
Volume 2012 (2012), Article ID 236732, 5 pages
http://dx.doi.org/10.1155/2012/236732
Case Report

Celiac Artery Stenting to Facilitate Hepatic Yttrium-90 Radioembolization Therapy

Bridgeport Hospital, Yale New Haven Health System, 267 Grant Street, Bridgeport, CT 06610, USA

Received 2 October 2012; Accepted 6 November 2012

Academic Editors: E. Bölke, T. Chakera, A. Matsuno, and D. Tsetis

Copyright © 2012 Murthy R. Chamarthy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Radioembolization offers a novel way to treat the nonresectable, liver predominant hepatic malignancies with better tumor response and overall progression-free survival rates. Transarterial catheter-based radioembolization procedure involves the hepatic arterial administration of glass- or resin-based beta emitting Yttirum-90 microspheres. Safe delivery of the tumoricidal radiation dose requires careful angiogram planning and coil embolization to quantify lung shunting and prevent systemic toxicity, respectively. Diagnostic pretreatment angiogram also serves to identify the hepatic arterial variant anatomy and other coexisting pathologies that might require a different or alternative approach. We describe a complex case of celiac artery stenosis with tortuous pancreaticoduodenal arterial arcade precluding access to the right hepatic artery for performing radioembolization. Celiac artery stenting of the stenosis was performed to facilitate subsequent safe and successful Yttrium-90 microsphere radioembolization.