ABSTRACT
Gastric ulceration is a relatively uncommon but well-described complication of yttrium
90 (Y90) radioembolization therapy in the locoregional treatment of hepatic tumors.
Meticulous attention to vascular anatomy, an assessment of antegrade hepatic arterial
flow, and knowledge of the dynamic embolic effect of the chosen Y90 particulate at
treatment are requirements to reduce the risk of nontarget embolization to gastrointestinal
structures. Radiation-associated gastrointestinal ulceration is difficult to treat,
and may be associated with gastrointestinal bleeding, bowel obstruction, and perforation.
Surgical excision of the involved segment with bypass may be necessary. The increased
use of coil embolization of at-risk vessels combined with administration of Y90 particulates
with minimal embolic effect has reduced the incidence of radioembolization associated
gastrointestinal ulceration.
KEYWORDS
Radioembolization - ulceration - complication
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Riad SalemM.D.
Department of Radiology, Northwestern University, 676 North St. Clair Street
Suite 800, Chicago, IL 60611
eMail: r-salem@northwestern.edu
