Hepatic artery occlusion with perfusion in the treatment of carcinoid syndrome.

In 2 patients with the malignant carcinoid syndrome, a Swam-Ganz balloon tip, flow-directed catheter was used to occlude hepatic arterial flow and perfuse hepatic metastases with 5-fluorouracil. The first patient, symptomatic for 16 months, was rendered asymptomatic for 14 months after treatment. The second patient was relieved of severe diarrhea and generalized urticaria, but progression of the cardiac manifestations were unaffected. Symptoms of the carcinoid syndrome are usually the most debilitating aspect of this illness. When more conservative measures cannot alleviate their symptoms, hepatic artery occlusion with chemotherapeutic perfusion of metastases should be considered.