Journal of Ultrasound in Medicine, Vol 17, Issue 8 531-533, Copyright © 1998 by American Institute of Ultrasound in Medicine
Complications of percutaneous ethanol ablation
R. K. Gelczer, J. W. Charboneau, S. Hussain and D. L. Brown
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.
