Complications of percutaneous ethanol ablation

• Published in: Journal of ultrasound in medicine Vol. 17; no. 8; pp. 531 - 533
• Main Authors: Gelczer, R. K, Charboneau, J. W, Hussain, S, Brown, D. L
• Format: Journal Article
• Language: English
• Published: Laurel, MD Am inst Ulrrasound Med 01-08-1998; American Institute of Ultrasound in Medicine
• Subjects: Aged; Angiocardiography; Angiography; Biological and medical sciences; Cardiovascular system; Cysts - diagnostic imaging; Cysts - therapy; Diagnosis; Ethanol; Ethanol - administration & dosage; Ethanol - adverse effects; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Injections, Intralesional - adverse effects; Liver Diseases - diagnostic imaging; Liver Diseases - therapy; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - therapy; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical imaging; Medical sciences; Middle Aged; Proteins; Sclerotherapy - adverse effects; Tumors; Ultrasonography; Human; Ethanol; Polycystic liver; Cardiovascular disease; Hepatic disease; Injection; Genetic disease; Percutaneous route; Case study; Treatment; Arterial hypotension; Cyst; Digestive diseases; Complication; Benign neoplasm
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/jum.1998.17.8.531

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.