Clinical Application of Transcatheter Arterial Injection of Spongia Gelatinosa and Iodizedoil Emulsion to Treat Hepatocellular Carcinoma with Arteriovenous Fistula_West China Medical Journal

Authors：

LI Jun , LIAO Zhengyin , YOU Xin , et al

Department of Oncology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

肝癌; 动静脉瘘; 明胶海绵; 超液态碘化油; 化学栓塞

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目的:探讨经肝动脉导管注射明胶海绵碘化油乳剂治疗肝癌合并严重动静脉瘘的可行性及临床应用价值。方法:对38例肝癌动静脉瘘患者血管分别行超选择插管注射明胶海绵碘化油乳剂,造影观察动静脉瘘的栓塞率,血管再通率,副作用,并发症及生存率等指标。结果:38例肝癌动静脉瘘患者经肝动脉导管注入明胶海绵碘化油乳剂约2~10mL栓塞,栓塞后造影显示闭塞率为94.7%(36/38),4周后造影显示动静脉瘘再通率为5.56%(2/36),未见确切不良反应,肿瘤碘化油乳剂沉积好,患者6月生存率为94.7%(36/38),12月生存率为60.5%(23/38),24月生存率为21.1%(8/38)。结论:经肝动脉导管注射碘化油乳剂治疗肝癌动静脉瘘安全可靠,对瘘口要求不高,栓塞率高,再通率低,肿瘤的栓塞治疗效果好。

Citation： LI Jun,LIAO Zhengyin,YOU Xin,et al. Clinical Application of Transcatheter Arterial Injection of Spongia Gelatinosa and Iodizedoil Emulsion to Treat Hepatocellular Carcinoma with Arteriovenous Fistula. West China Medical Journal, 2009, 24(5): 1193-1195. doi: Copy

1.
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4.	NGAN H, PEH W C. Arteriovenous shunting in hepatocellularcarcinoma: its prevalence and clinical significance[J]. Clin Radiol,1997,52:3640.
5.	OKUDA K, MUSHA H, YAMASAKI T, et al. Angiographic demonstration of intrahepatic arterioportal anastomoses in hepatocellular carcinoma[J]. Radiology,1977,122:5358.
6.	FURUSE J, IWASAKI M, YOSHINO M, et al. Hepatocellular carcinoma with portal vein tumor thrombus embolization of arterioportal shunts[J]. Radiology,1997,204:787.
7.	OKUYAMA M, FUJIWARA Y, HAYAKAWA T, et al. Esophagogastric varices due to arterioportal shunt in a serous cystadenoma of the pancreas in von HippelLindau disease[J]. Dig Dis Sci,2003,48:19481954.
8.	LAZARIDIS K N, KAMATH P S. Images in hepatology. Arterioportal fistula causing recurrent variceal bleeding[J]. J Hepatol,1998,29:142.
9.	汪邵平,徐位顿,霍枫,等,肝癌合并动静脉瘘71例的诊治体会[J].中华普通外科杂志,2003,18:8486.
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12.	CLARK R A, FREY R T, COLLEY D P, et al. Transcatheter embolization of hepatic arteriovenous fistulas for control of hemobilia[J]. Gastrointest Radiol,1981,6:353356.
13.	FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterialembolization for HCC hepatocellular carinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787 790.
14.	张电波,肖湘生.肝癌伴肝动—静脉瘘的血管造影表现及其临床意义[J].中国医学影像杂志2001,9(5):356357.
15.	VELAZQUEZ R F, RODRIGUEZ M, NAVASCUES C A, et al. Prospective analysis of risk factors for hepatocellular carcinoma in patients with liver cirrhosis[J]. Hepatology,2003,37:520527.
16.	LIN S C, SHIH S C, KAO C R, et al. Transcatheter arterial embolization treatment in patients with hepatocellular carcinoma and risk of pulmonary metastasis[J]. World J Gastroenterol,2003,9:12081211.
17.	刘崎,田建明,贾雨辰,等.肝癌并门脉主干癌栓的介入治疗及其预后的影响因素[J].中华放射学杂志,1999,33(8):538541.
18.	罗鹏飞,陈晓明,张良明,等.肝癌合并动静脉瘘的处理方法探讨[J].中华放射学杂志,2002,36(2):114117.
19.	关守海,单鸿,姜在波,等.经微导管局部灌注无水乙醇治疗肝癌高流量性动静脉瘘[J].中华放射学杂志,2002,36:9971000.
20.	FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterial embolization for HCC carcinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787790.

1.
2.
3. KIDO C, SASAKI T, KANEKO M. Angiography of primary liver cancer[J]. Am J Roentgenol Radium Ther Nacl Med,1971,113:7081.
4. NGAN H, PEH W C. Arteriovenous shunting in hepatocellularcarcinoma: its prevalence and clinical significance[J]. Clin Radiol,1997,52:3640.
5. OKUDA K, MUSHA H, YAMASAKI T, et al. Angiographic demonstration of intrahepatic arterioportal anastomoses in hepatocellular carcinoma[J]. Radiology,1977,122:5358.
6. FURUSE J, IWASAKI M, YOSHINO M, et al. Hepatocellular carcinoma with portal vein tumor thrombus embolization of arterioportal shunts[J]. Radiology,1997,204:787.
7. OKUYAMA M, FUJIWARA Y, HAYAKAWA T, et al. Esophagogastric varices due to arterioportal shunt in a serous cystadenoma of the pancreas in von HippelLindau disease[J]. Dig Dis Sci,2003,48:19481954.
8. LAZARIDIS K N, KAMATH P S. Images in hepatology. Arterioportal fistula causing recurrent variceal bleeding[J]. J Hepatol,1998,29:142.
9. 汪邵平,徐位顿,霍枫,等,肝癌合并动静脉瘘71例的诊治体会[J].中华普通外科杂志,2003,18:8486.
10. KIM Y J, LEE H G, PARK J M, et al. Polyvinyl alcohol embolization adjuvant to oily chemoembolization in advanced hepatocellular carcinoma with arterioportal shunts[J]. Korean J Radiol,2007,8:311319.
11. TARAZOV P G. Intrahepatic arterioportal fistulae: role of transcatheter embolization[J]. Cardiovasc Intervent Radiol,1993,16:368373.
12. CLARK R A, FREY R T, COLLEY D P, et al. Transcatheter embolization of hepatic arteriovenous fistulas for control of hemobilia[J]. Gastrointest Radiol,1981,6:353356.
13. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterialembolization for HCC hepatocellular carinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787 790.
14. 张电波,肖湘生.肝癌伴肝动—静脉瘘的血管造影表现及其临床意义[J].中国医学影像杂志2001,9(5):356357.
15. VELAZQUEZ R F, RODRIGUEZ M, NAVASCUES C A, et al. Prospective analysis of risk factors for hepatocellular carcinoma in patients with liver cirrhosis[J]. Hepatology,2003,37:520527.
16. LIN S C, SHIH S C, KAO C R, et al. Transcatheter arterial embolization treatment in patients with hepatocellular carcinoma and risk of pulmonary metastasis[J]. World J Gastroenterol,2003,9:12081211.
17. 刘崎,田建明,贾雨辰,等.肝癌并门脉主干癌栓的介入治疗及其预后的影响因素[J].中华放射学杂志,1999,33(8):538541.
18. 罗鹏飞,陈晓明,张良明,等.肝癌合并动静脉瘘的处理方法探讨[J].中华放射学杂志,2002,36(2):114117.
19. 关守海,单鸿,姜在波,等.经微导管局部灌注无水乙醇治疗肝癌高流量性动静脉瘘[J].中华放射学杂志,2002,36:9971000.
20. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterial embolization for HCC carcinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787790.

West China Medical Journal

Clinical Application of Transcatheter Arterial Injection of Spongia Gelatinosa and Iodizedoil Emulsion to Treat Hepatocellular Carcinoma with Arteriovenous Fistula

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