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Article ; Online: Inferior mesenteric artery arteriovenous malformation, a rare cause of ischemic colitis: A case report.

Chang, Ching-Tang / Lim, Wei-Xiong / Liu, Ting-Ting / Lin, Yueh-Ming / Chang, Ching-Di

2023 Volume 102, Issue 12, Page(s) e33413

Abstract: Rationale: An arteriovenous malformation (AVM) is an abnormal tangle of blood vessels that connects the arteries and the veins. Because normal capillary bed is partially or completely absented in the AVM, the blood passes quickly from the arteries to ... ...

Abstract	Rationale: An arteriovenous malformation (AVM) is an abnormal tangle of blood vessels that connects the arteries and the veins. Because normal capillary bed is partially or completely absented in the AVM, the blood passes quickly from the arteries to the veins, which disrupts normal blood flow and oxygen supply to the surrounding tissues. This is called "steal phenomenon," and in the inferior mesenteric artery (IMA) territory, this may lead to abdominal pain, gastrointestinal bleeding, portal hypertension, and even ischemic colitis. Patient concerns: A 67-year-old man presented to our emergency department because of left side abdominal pain. Diagnoses: The abdominal computed tomography with contrast enhancement revealed a cluster of abnormal vascular lesions abutting the IMA with early opacification of the left colonic marginal vein. In addition, poor enhancement of segmental colonic wall was found from proximal descending colon to middle rectum. The diagnosis of AVM of the IMA and ischemic colitis was made. Interventions: The patient underwent left hemicolectomy as well as the AVM resection. Outcomes: He was discharged uneventfully after the surgery without complications. Lessons: IMA AVM carries the risk of ischemic colitis. computed tomography scan is helpful not only to the diagnosis of AVMs but also to exclude other lesions as well. Treatment options include endovascular embolization, surgical intervention, and a combination of both. Due to the complexity of this disease, treatment requires a case-specific multidisciplinary approach and a coordination of medical, radiological, and surgical staffs.
MeSH term(s)	Male ; Humans ; Aged ; Colitis, Ischemic/diagnosis ; Colitis, Ischemic/etiology ; Colitis, Ischemic/surgery ; Mesenteric Artery, Inferior/diagnostic imaging ; Mesenteric Artery, Inferior/surgery ; Arteriovenous Malformations/complications ; Arteriovenous Malformations/diagnostic imaging ; Arteriovenous Malformations/surgery ; Abdominal Pain
Language	English
Publishing date	2023-03-24
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000033413
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Article ; Online: Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma: The Effectiveness of Different Particle Sizes in Downstaging and Bridging in Living Donor Liver Transplantation.

Lim, Wei-Xiong / Sim, Kuan Siong / Chen, Chao-Long / Ou, Hsin-You / Yu, Chun-Yen / Cheng, Yu-Fan

Transplantation proceedings

2024 Volume 56, Issue 3, Page(s) 596–601

Abstract: Aim: To compare the effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) with different particle sizes in bridging and downstaging in pretransplant hepatocellular carcinoma patients. Assess the recurrent and survival rates after ...

Abstract	Aim: To compare the effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) with different particle sizes in bridging and downstaging in pretransplant hepatocellular carcinoma patients. Assess the recurrent and survival rates after living donor liver transplantation (LDLT). Methods: Retrospective review of 580 patients who underwent TACE using DEB from August 2012 to June 2020 at Taiwan Kaohsiung Chang Gung Memorial Hospital. Pre- and post-TACE computed tomography scan images of the liver were reviewed, and treatment responses were assessed using modified Response Evaluation Criteria in Solid Tumors criteria. Patients were divided by who met the criteria (n = 342) or beyond (n = 238) the University of California San Francisco criteria for successful bridging and downstaging rate evaluation. Each group was divided into subgroups according to DEB particle sizes (group A: <100μm, group B: 100-300 μm, group C: 300-500 μm, and group D: 500-700 μm) to compare objective response rate and post-LDLT survival rate. Results: Overall successful bridging and downstaging rate is 97.1% and 58.4%, respectively, in the group of patients who meet the criteria (n = 332) and are beyond (n = 139) the University of California San Francisco criteria. Group B (100-300 μm) had a higher successful bridging rate (99.5%, P = .003) and downstaging rate (63.8%, P = .443). This subgroup also demonstrated a higher objective response rate in single (93.2%, P = .038) tumors, multiple (83.3%, P = .001) tumors, and tumors with size less than 5 cm (93.9%, P = .005). There are no significant differences in post-LDLT overall survival rate between different particle sizes. Conclusion: TACE with 100 to 300 μm DEB particles is associated with a better chance of bridging and downstaging hepatocellular carcinoma patients to LDLT.
MeSH term(s)	Humans ; Carcinoma, Hepatocellular/therapy ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/mortality ; Liver Neoplasms/therapy ; Liver Neoplasms/pathology ; Liver Neoplasms/mortality ; Chemoembolization, Therapeutic ; Liver Transplantation ; Retrospective Studies ; Male ; Female ; Middle Aged ; Living Donors ; Particle Size ; Treatment Outcome ; Adult ; Neoplasm Staging ; Microspheres ; Aged
Language	English
Publishing date	2024-03-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2024.01.062
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Article ; Online: Short-term clinical outcomes of transarterial embolization for symptomatic hand osteoarthritis refractory to conservative treatment.

Lee, Sieh-Yang / Lim, Wei-Xiong / Wu, Kuan-Ting / Wu, Cheng-Ta / Huang, Chung-Cheng / Chang, Ching-Di

Diagnostic and interventional radiology (Ankara, Turkey)

2023 Volume 30, Issue 1, Page(s) 65–71

Abstract: Purpose: The present study aims to assess the short-term clinical outcomes and safety of transarterial embolization (TAE) for symptomatic hand osteoarthritis (OA) refractory to conservative treatment.: Methods: The present retrospective cohort pilot ... ...

Abstract	Purpose: The present study aims to assess the short-term clinical outcomes and safety of transarterial embolization (TAE) for symptomatic hand osteoarthritis (OA) refractory to conservative treatment. Methods: The present retrospective cohort pilot study included nine patients who underwent TAE for symptomatic OA-associated hand pain in a single tertiary center between November 2022 and January 2023. The baseline and post-procedural OA-associated hand pain and function were assessed using the visual analog scale (VAS) and the Australian Canadian Hand Osteoarthritis Index (AUSCAN). The use of conservative treatment and pain medications was also recorded. Post-procedural adverse events were evaluated according to the Society of Interventional Radiology classification. Results: Compared with the baseline, the overall VAS scores were significantly decreased at 1-week, 1-month, 3-months, and 6-months after TAE (76 ± 15 mm versus 34 ± 18 mm, Conclusion: TAE is a feasible and safe treatment method for symptomatic hand OA refractory to conservative treatment. This minimally invasive procedure effectively relieves debilitating OA-associated joint pain and restores hand function with a durable treatment effect.
MeSH term(s)	Humans ; Retrospective Studies ; Conservative Treatment ; Pilot Projects ; Australia ; Canada ; Pain/etiology ; Osteoarthritis/diagnostic imaging ; Osteoarthritis/therapy ; Treatment Outcome
Language	English
Publishing date	2023-11-06
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2184145-7
ISSN	1305-3612 ; 1305-3612
ISSN (online)	1305-3612
ISSN	1305-3612
DOI	10.4274/dir.2023.232350
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Article: Efficacy and Safety of Combined Ethanol-Lipiodol Mixture and Drug-Eluting Bead TACE for Large HCC.

Chuang, Yi-Hsuan / Cheng, Yu-Fan / Tsang, Leo Leung-Chit / Ou, Hsin-You / Hsu, Hsien-Wen / Lim, Wei-Xiong / Huang, Po-Hsun / Weng, Ching-Chun / Yu, Chun-Yen

Journal of hepatocellular carcinoma

2023 Volume 10, Page(s) 81–90

Abstract: Purpose: To evaluate treatment response, survival and safety of a novel TACE using combination of ethanol-Lipiodol mixture and drug-eluting beads in patients with large unresectable HCC, single tumor >8 cm or multiple tumors with the largest tumor ... ...

Abstract	Purpose: To evaluate treatment response, survival and safety of a novel TACE using combination of ethanol-Lipiodol mixture and drug-eluting beads in patients with large unresectable HCC, single tumor >8 cm or multiple tumors with the largest tumor diameter >5 cm and total tumor diameter >10 cm. Patients and methods: Between June 2016 and February 2020, a total of 27 patients were enrolled in this retrospective cohort study. Treatment response was assessed at first month after the treatment; progression-free survival (PFS) and overall survival (OS) were evaluated. The prognostic factors associated with patient survival were statistically analyzed by the Cox regression model. Adverse events were recorded. Results: The maximum diameter of the tumors ranged from 5 cm to 17 cm (mean 10.48 cm). The objective response and disease control rates were 56% and 78%, respectively, at 1-month follow-up. The median survival time was 15.9 months (95% CI, 9.03-34.76 months). The OS rates were 76.9% at six months, 65.2% at one year and 44.8% at two years. AFP >400 ng/mL (p = 0.0306), maximum tumor size >10cm (p = 0.0240) were potential risk factors for OS. Regarding safety, major complications occurred in one patient (1/27, 3.7%), presenting with transient hepatic encephalopathy. Conclusion: Combined DEB-TACE appeared to have favorable objective tumor response. It can be an effective treatment option for large unresectable HCC.
Language	English
Publishing date	2023-01-15
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2780784-8
ISSN	2253-5969
ISSN	2253-5969
DOI	10.2147/JHC.S398434
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Article: Yttrium-90 Radioembolization as the Major Treatment of Hepatocellular Carcinoma.

Yu, Chun-Yen / Huang, Po-Hsun / Tsang, Leo Leung-Chit / Hsu, Hsien-Wen / Lim, Wei-Xiong / Weng, Ching-Chun / Huang, Tung-Liang / Hsu, Chien-Chin / Chen, Chao-Long / Ou, Hsin-You / Cheng, Yu-Fan

Journal of hepatocellular carcinoma

2023 Volume 10, Page(s) 17–26

Abstract: Background: The purpose of this study was to assess the safety and efficacy of Yttrium-90 radioembolization using in unresectable hepatocellular carcinoma.: Methods: From 2017 to 2021, 32 patients with unresectable hepatocellular carcinoma, with mean ...

Abstract	Background: The purpose of this study was to assess the safety and efficacy of Yttrium-90 radioembolization using in unresectable hepatocellular carcinoma. Methods: From 2017 to 2021, 32 patients with unresectable hepatocellular carcinoma, with mean tumor diameter about 7cm (21 males, 11 females; median age, 57.5 years of age), treated with Yttrium-90 radioembolization using resin microspheres were reviewed at pre-Yttrium-90 and post-Yttrium-90 follow-up. Tumor response was assessed according to the modified Response Evaluation Criteria in Solid Tumors. Outcomes including overall survival and progression-free survival were reported. Results: Median follow-up was 18 months. At follow-up examinations at 3-, 6-, and 12-months follow-up, the overall survival rates were 94%, 87% and 59%, and the progression-free survival rates were 78%, 64% and 60%, respectively. Complete response, partial response, stable disease, and progressive disease were noted in 7 (21.9%), 14 (43.7%), 4 (12.5%), and 7 (21.9%) patients, respectively. The disease control rate was 78.1%, the objective response rate was 65.6%, and the successful downstage rate was 34.4% (11 of 32). Nine of thirty-two patients underwent resection or transplantation after Yttrium-90 radioembolization with 2-year overall survival being 100%. No serious adverse events occurred after Yttrium-90 treatment. Worse overall survival was related to the larger tumor, higher stage, Eastern Cooperative Oncology Group performance status, and Child-Pugh score. And worse progression-free survival was related to the higher tumor burden, and pre-Yttrium-90 serum α-fetoprotein level >100. Conclusion: Yttrium-90 Radioembolization can control hepatocellular carcinoma well even in advanced diseases. Patients successfully downstaging/bridging to resection or transplantation have excellent overall survival.
Language	English
Publishing date	2023-01-11
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2780784-8
ISSN	2253-5969
ISSN	2253-5969
DOI	10.2147/JHC.S385478
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Article: Non-Contrast-Enhanced and Contrast-Enhanced Magnetic Resonance Angiography in Living Donor Liver Vascular Anatomy.

Liao, Chien-Chang / Chen, Meng-Hsiang / Yu, Chun-Yen / Tsang, Leung-Chit Leo / Chen, Chao-Long / Hsu, Hsien-Wen / Lim, Wei-Xiong / Chuang, Yi-Hsuan / Huang, Po-Hsun / Cheng, Yu-Fan / Ou, Hsin-You

Diagnostics (Basel, Switzerland)

2022 Volume 12, Issue 2

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2022-02-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics12020498
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Article: A Scoring System for Predicting Microvascular Invasion in Hepatocellular Carcinoma Based on Quantitative Functional MRI.

Liao, Chien-Chang / Cheng, Yu-Fan / Yu, Chun-Yen / Tsang, Leung-Chit Leo / Chen, Chao-Long / Hsu, Hsien-Wen / Chang, Wan-Ching / Lim, Wei-Xiong / Chuang, Yi-Hsuan / Huang, Po-Hsun / Ou, Hsin-You

Journal of clinical medicine

2022 Volume 11, Issue 13

Abstract: Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is a histopathological marker and risk factor for HCC recurrence. We integrated diffusion-weighted imaging (DWI) and magnetic resonance (MR) image findings of tumors into a scoring system for ...

Abstract	Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is a histopathological marker and risk factor for HCC recurrence. We integrated diffusion-weighted imaging (DWI) and magnetic resonance (MR) image findings of tumors into a scoring system for predicting MVI. In total, 228 HCC patients with pathologically confirmed MVI who underwent surgical resection or liver transplant between November 2012 and March 2021 were enrolled retrospectively. Patients were divided into a right liver lobe group (
Language	English
Publishing date	2022-06-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11133789
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Article ; Online: Efficacy and safety of splenic artery embolization for intractable ascites using Amplatzer vascular plug versus coil after living donor liver transplantation.

Lee, Chih-Ying / Lim, Wei-Xiong / Chen, Chao-Long / Yong, Chee-Chien / Yu, Chun-Yen / Tsang, Leo Leung-Chit / Hsu, Hsien-Wen / Cheng, Yu-Fan / Ou, Hsin-You

Diagnostic and interventional radiology (Ankara, Turkey)

2022 Volume 28, Issue 5, Page(s) 478–485

Abstract: PURPOSE Intractable ascites (IA) is an uncommon but challenging complication after liver transplantation. Splenic artery embolization (SAE) modulates the splenic artery and regulates portal flow. This study aimed to evaluate the efficacy and safety of ... ...

Abstract	PURPOSE Intractable ascites (IA) is an uncommon but challenging complication after liver transplantation. Splenic artery embolization (SAE) modulates the splenic artery and regulates portal flow. This study aimed to evaluate the efficacy and safety of SAE using the Amplatzer vascular plug (AVP) versus coil embolization for post-living-donor liver transplantation (LDLT) IA. METHODS This retrospective study evaluated consecutive patients from 1 center who received LDLT (n=1410) between March 2006 and August 2019. The inclusion criteria for SAE were splenomegaly with IA after LDLT. RESULTS Totally 15 patients underwent SAE for post-LDLT IA. Eleven patients who received AVP embolization (age, 51.2 ± 15.1 years; range, 8-63 years; 5 men and 6 women) were compared with 4 patients receiving coil embolization (age, 30.8 ± 30.8 years; range, 1.5-63 years; 2 men and 2 women). AVP and coil embolization both significantly reduced portal vein hyperflow (plug/ coil; P <.001/.006) and decreased ascites volume (plug/coil; P <.003/.042). The benefits of AVP embolization included shorter procedure time (P =.029), significantly reduced splenic volume (P =.012), increased liver volume (P =.012), decreased spleen/liver ratio (P =.012), and improvement of pancytopenia (P =.008) due to secondary hypersplenism. No significant differences were found between the two groups in the length of hospital stay or complications such as splenic infarction, pancreatitis, or sepsis. CONCLUSION SAE using AVP and coil embolization provide effective and safe methods for managing patients with IA after LDLT. AVP embolization may be more efficient than coil embolization, providing more effective reduction of ascites volume and the advantages of shortened procedure time and improvement of hypersplenism.
MeSH term(s)	Adolescent ; Adult ; Aged ; Ascites/diagnostic imaging ; Ascites/etiology ; Ascites/therapy ; Child ; Child, Preschool ; Embolization, Therapeutic/methods ; Female ; Humans ; Hypersplenism/complications ; Hypersplenism/therapy ; Infant ; Infant, Newborn ; Liver Transplantation/adverse effects ; Living Donors ; Male ; Middle Aged ; Retrospective Studies ; Splenic Artery/diagnostic imaging ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2022-10-08
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2184145-7
ISSN	1305-3612 ; 1305-3612
ISSN (online)	1305-3612
ISSN	1305-3612
DOI	10.5152/dir.2022.21027
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Article ; Online: Clinical Impact of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging on Living Donor Liver Transplant.

Chen, Yueh-Sheng / Lim, Wei-Xiong / Lin, An-Ni / Chen, Chao-Long / Tsang, Leung-Chit Leo / Yu, Chun-Yen / Hsu, Hsien-Wen / Chuang, Yi-Hsuan / Cheng, Yu-Fan / Ou, Hsin-You

Transplantation proceedings

2022 Volume 54, Issue 2, Page(s) 386–390

Abstract: Background: Gadolinium-ethoxybenzyl-diethylene triamine pentaacetic acid (Gd-EOB-DTPA) is a newer magnetic resonance contrast that has the combined effect of conventional and liver-specific contrast. The use of Gd-EOB-DTPA may aid in management of ... ...

Abstract	Background: Gadolinium-ethoxybenzyl-diethylene triamine pentaacetic acid (Gd-EOB-DTPA) is a newer magnetic resonance contrast that has the combined effect of conventional and liver-specific contrast. The use of Gd-EOB-DTPA may aid in management of patients with hepatocellular carcinoma (HCC) undergoing living donor liver transplant (LDLT). Materials and methods: We retrospectively reviewed all HCC patients who received LDLT with Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) as part of a pretransplant evaluation between October 2012 and October 2016. The detection rate and impact on decision making were assessed between multidetector-row computed tomography (MDCT) and Gd-EOB-DTPA-enhanced MRI with pathology of the explanted liver being the reference standard. Results: We analyzed 25 patients with 80 nodules. Gd-EOB-DTPA-enhanced MRI showed superior detection rate for HCCs than MDCT (76.1% vs 35.8%). Among the 25 patients, 16 had additional HCCs detected by Gd-EOB-DTPA-enhanced MRI, which led to changes in therapeutic decisions in 11 patients. The recurrence rate and mortality rate were 4% (1 of 25). In the same period in our institution, the mortality rate was 13.9% (25 of 180) for those who did not receive Gd-EOB-DTPA-enhanced MRI as part of the pretransplant evaluation. Conclusions: The use of Gd-EOB-DTPA-enhanced MRI can aid in characterization of indeterminate nodules and detect more HCCs and thus more adequate downstaging and pretransplant neoadjuvant treatment ensue, which may lower the recurrence rate after LDLT.
MeSH term(s)	Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/surgery ; Contrast Media ; Gadolinium DTPA ; Humans ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/surgery ; Liver Transplantation ; Living Donors ; Magnetic Resonance Imaging/methods ; Retrospective Studies
Chemical Substances	Contrast Media ; gadolinium ethoxybenzyl DTPA ; Gadolinium DTPA (K2I13DR72L)
Language	English
Publishing date	2022-01-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.09.071
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Article ; Online: Portosystemic Shunt in Pediatric Living Donor Liver Transplant.

Lim, Wei-Xiong / Lin, An-Ni / Cheng, Yu-Fan / Lee, Sieh-Yang / Hsu, Hsien-Wen / Chen, Chao-Long / Chang, Wan-Ching / Yu, Chun-Yen / Tsang, Leo Leung-Chit / Chuang, Yi-Hsuan / Ou, Hsin-You

Transplantation proceedings

2022 Volume 54, Issue 2, Page(s) 403–405

Abstract: Background: To evaluate the significance of portosystemic shunts and associated long-term outcomes in living donor liver transplant (LDLT) among pediatric patients.: Methods: Retrospective review of 121 pediatric patients who underwent LDLT between ... ...

Abstract	Background: To evaluate the significance of portosystemic shunts and associated long-term outcomes in living donor liver transplant (LDLT) among pediatric patients. Methods: Retrospective review of 121 pediatric patients who underwent LDLT between May 1994 and December 2015 at Taiwan Kaohsiung Chang Gung Memorial Hospital. Pre- and postoperative computed tomography images of the liver were reviewed, and portal vein complications were assessed. Results: Ninety-seven pediatric patients were included in the study, and 70 had portosystemic shunts before transplant. Thirty-three patients have portal systemic shunt (PSS) 6 months after transplant (mean [SD] shunt size, 4.59 [1.98] mm). Thirty-seven patients' portosystemic shunts closed spontaneously (mean [SD] shunt size, 3.14 [1.06] mm). Smaller PSSs tend to close spontaneously with a cutoff point of 3.35 mm by receiver operating characteristic curve (P = .01). Patients with PSS have more portal vein complications than those without PSS (44.3% vs 11.1%, P = .02). Among PSS recipients, patients with portal vein complications tend to have larger PSS size (mean [SD], 4.14 [1.96] mm vs 3.59 [1.48] mm), although the difference is not statistically significant (P = .19). Conclusions: In pediatric patients, preoperative portosystemic shunts are significantly correlated with portal venous complications, some of which require minimal interventions after LDLT with good outcomes. Shunts larger than 3.35 mm tend to persist after transplant with increased portal venous complications.
MeSH term(s)	Child ; Humans ; Liver Transplantation ; Living Donors ; Portal Vein/diagnostic imaging ; Portal Vein/surgery ; Portasystemic Shunt, Surgical/adverse effects ; Portasystemic Shunt, Surgical/methods ; Portasystemic Shunt, Transjugular Intrahepatic ; Retrospective Studies
Language	English
Publishing date	2022-01-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.09.072
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