Korean J Radiol.  2012 Oct;13(5):643-647. 10.3348/kjr.2012.13.5.643.

Hemorrhagic Cardiac Tamponade: Rare Complication of Radiofrequency Ablation of Hepatocellular Carcinoma

• Loh KB
• Bux SI
• Abdullah B
• Raja Mokhtar RA
• Mohamed R

• KMID: 1392945
• DOI: http://doi.org/10.3348/kjr.2012.13.5.643

Abstract

Local treatment for hepatocellular carcinoma (HCC) has been widely used in clinical practice due to its minimal invasiveness and high rate of cure. Percutaneous radiofrequency ablation (RFA) is widely used because its treatment effectiveness. However, some serious complications can arise from percutaneous RFA. We present here a rare case of hemorrhagic cardiac tamponade secondary to an anterior cardiac vein (right marginal vein) injury during RFA for treatment of HCC.

Keyword

Hepatocellular carcinoma; Percutaneous RFA; RFA complication; Hemorrhagic cardiac tamponade

MeSH Terms

Carcinoma, Hepatocellular/radiography/*surgery
Cardiac Tamponade/*etiology
*Catheter Ablation
Fatal Outcome
Hemorrhage/*etiology
Humans
Iatrogenic Disease
Intraoperative Complications/*etiology
Liver Neoplasms/radiography/*surgery
Male
Middle Aged
Radiography, Interventional
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Hemorrhagic cardiac tamponade secondary to RFA in 56-year-old HCC patient. A-D. Dynamic CT scan of liver showed ill-defined hypervascular HCC nodules in segment Iva, which is in close proximity to diaphragm and right ventricle (black arrow). E, F. Position of expandable RFA needle in largest HCC nodule in segment IVa. G, H. After 1 cycle of RFA, coagulation necrosis is seen within lesion (black arrow). HCC = hepatocellular carcinoma, RFA = radiofrequency ablation, INR = International Normalised Ratio, RF = radiofrequency. I. Plain CT of post-RFA at lower thorax. Haemorrhagic cardiac tamponade (white asterisk) is noted in post-RFA CT when patient developed hypotension. J. Line art to illustrate location of puncture wound (red dot) of anterior cardiac vein (black arrow). RFA = radiofrequency ablation

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