{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T12:04:34Z","timestamp":1792325074473,"version":"4.4.0"},"reference-count":11,"publisher":"BMJ","issue":"6397","license":[{"start":{"date-parts":[[1983,10,1]],"date-time":"1983-10-01T00:00:00Z","timestamp":433814400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1983,10,1]]},"abstract":"<jats:p>Eighteen patients with severe symptoms of the carcinoid syndrome were assessed for hepatic embolisation. Four were too ill, and one had mild symptoms; thus 13 received a periembolisation regimen of cyproheptadine, fenclonine, aprotinin, methylprednisolone, tobramycin, flucloxacillin, and metronidazole. Embolisation was not performed in one patient with an occluded portal vein and was unsatisfactory in two others, in one because she was moribund and in the other because the hepatic artery had been ligated. Dramatic improvement in symptoms occurred in the nine patients in whom embolisation was successfully carried out, with abolition of flushing, severe abdominal pain, and wheeze and reduction in diarrhoea from 10.5 (SD 7.6) to 1.6 (0.9) stools\/day. Urinary excretion of 5-hydroxyindole acetic acid fell from 1048 (716) to 289 (184) mumol\/24 h (200 (137) to 55 (35) mg\/24 h). Complications included one death from septicaemia, a hepatic abscess requiring surgical drainage, abdominal pain in three patients, pleural effusion in two, and transient encephalopathy in one. Relief of symptoms lasted for one to 24 months, and second embolisation in two patients produced further remissions of four to six months. Five patients died, one to 40 months after embolisation, in four cases because of metastases or heart failure. Hepatic embolisation is the treatment of choice for symptoms of the carcinoid syndrome resistant to medical treatment.<\/jats:p>","DOI":"10.1136\/bmj.287.6397.932","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"932-935","source":"Crossref","is-referenced-by-count":76,"title":["Role of hepatic arterial embolisation in the carcinoid syndrome."],"prefix":"10.1136","volume":"287","author":[{"given":"P N","family":"Maton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Camilleri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Griffin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D J","family":"Allison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H J","family":"Hodgson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V S","family":"Chadwick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1983,10,1]]},"reference":[{"key":"ref_1","article-title":"The carcinoid syndrome","author":"Grahame-Smith, D.G.","year":"1972","unstructured":"Grahame-Smith DG. The carcinoid syndrome. London: Heinemann, 1972."},{"key":"ref_2","article-title":"Life history of the carcinoid tumour of the small intestine. Cancer 1961; 14: 901-12. 3Godwin JD 2d. Carcinoid tumours: an analysis of 2837 cases","volume-title":"Cancer","author":"Moetel, C.G.; Sauer, W.G.; Dockerty, M.B.; Baggenstoss, A.M.","unstructured":"Moetel CG, Sauer WG, Dockerty MB, Baggenstoss AM. Life history of the carcinoid tumour of the small intestine. Cancer 1961;14:901-12. 3Godwin JD 2d. Carcinoid tumours: an analysis of 2837 cases. Cancer"},{"key":"ref_3","article-title":"Cancer treatment","year":"1980","unstructured":";36:560-9."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/S0140-6736(77)90369-5","article-title":"Treatment of carcinoid liver metastases by hepatic artery embolization","volume":"ii:","author":"Allison, D.J.; Modlin, I.M.; Jenkins, W.J.","year":"1977","unstructured":"Cancer treatment. Philadelphia: WB Saunders, 1980.","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/BF03025460","article-title":"Theoretical and clinical considerations in anaesthesia for secreting carcinoid tumours","volume":"18","author":"Dery, R.","year":"1971","unstructured":"Allison DJ, Modlin IM, Jenkins WJ. Treatment of carcinoid liver metastases by hepatic artery embolization. Lancet 1977;ii:1323-5.","journal-title":"Can Anaesth SocJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1038\/bjc.1982.208","article-title":"Use of devascularisation and cytotoxic drugs in 30 patients with the carcinoid syndrome","volume":"46","author":"Melia, W.M.; Nunnerly, H.B.; Johnson, P.J.; Williams, R.","year":"1982","unstructured":"Dery R. Theoretical and clinical considerations in anaesthesia for secreting carcinoid tumours. Can Anaesth SocJ 1971;18:245-63.","journal-title":"BrJ Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJM197405022901804","article-title":"Demonstration of collateral arterial flow after interruption of hepatic arteries in man","volume":"290","author":"Mays, E.T.; Wheeler, C.S.","year":"1974","unstructured":"Melia WM, Nunnerly HB, Johnson PJ, Williams R. Use of devascularisation and cytotoxic drugs in 30 patients with the carcinoid syndrome. BrJ Cancer 1982;46:331-9.","journal-title":"N Engly Med"},{"key":"ref_8","article-title":"Intrahepatic gas following embolization","author":"Henessey 0, Allison DJ","unstructured":"Mays ET, Wheeler CS. Demonstration of collateral arterial flow after interruption of hepatic arteries in man. N Engly Med 1974;290:993-6.","journal-title":"Br J Radiol"},{"key":"ref_9","author":"Accepted 143June 1983)","unstructured":"Henessey 0, Allison DJ. Intrahepatic gas following embolization. Br J Radiol (in press)."},{"key":"ref_10","article-title":"Lacunar (small deep cerebral infarcts) infarction is described in association with raised packed cell volumes. Two patients had polycythaemia vera, one stress polycythaemia. They presented with transient ischaemic episodes and were shown by computed tomography to have lacunes deep in the basal ganglia and internal capsule. Such lesions may be caused by small vessel occlusions related to increased viscosity and impaired oxygen consumption by adjacent tissues. Finding a raised packed cell volume in patients with lacunes and transient ischaemic attacks offers a further possibility of treatment","unstructured":"(Accepted 143June 1983)"},{"key":"ref_11","article-title":"Lacunes are small (0-5-15 mm) infarcts in the basal ganglia, internal capsule, and basis pontis resulting from occlusion of penetrating small arteries.'","volume-title":"They also result from rupture of microaneurysms. Fisher examined 114 brains with lacunes and found an association with hypertension in all but one patient.2 We describe three patients who had lacunes in association with a raised packed cell volume due to polycythaemia","year":"2","unstructured":"Lacunar (small deep cerebral infarcts) infarction is described in association with raised packed cell volumes. Two patients had polycythaemia vera, one stress polycythaemia. They presented with transient ischaemic episodes and were shown by computed tomography to have lacunes deep in the basal ganglia and internal capsule. Such lesions may be caused by small vessel occlusions related to increased viscosity and impaired oxygen consumption by adjacent tissues. Finding a raised packed cell volume in patients with lacunes and transient ischaemic attacks offers a further possibility of treatment."}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.287.6397.932","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.287.6397.932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T22:38:18Z","timestamp":1765319898000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.287.6397.932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1983,10,1]]},"references-count":11,"journal-issue":{"issue":"6397","published-online":{"date-parts":[[1983,10,1]]},"published-print":{"date-parts":[[1983,10,1]]}},"alternative-id":["10.1136\/bmj.287.6397.932"],"URL":"https:\/\/doi.org\/10.1136\/bmj.287.6397.932","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"value":"0007-1447","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1983,10,1]]}}}