肝动脉闭塞后肝脏肿瘤的介入治疗

Transarterial management for liver tumors after hepatic artery occlusion

目的探讨肝动脉闭塞后肝脏肿瘤经动脉介入治疗的可行性。方法本组共收集合并肝动脉闭塞的肝脏肿瘤6例,男性5例,女性1例,年龄36岁～59岁,平均47.8±9.8岁。原发疾病:原发性肝癌4例,转移性肝癌2例。肝动脉闭塞原因:肝动脉插管5例,外科手术1例。6例均进行数字减影血管造影显示侧枝循环,并经过侧枝动脉进行介入治疗。结果肝总动脉近端完全闭塞6例,均可见侧枝循环形成。所有病例均通过侧枝动脉完成介入治疗。结论肝动脉闭塞后可以通过侧枝供血动脉进行肝脏肿瘤介入治疗。

Objective To assess the possibility of transarterial management for liver tumors after hepatic artery occlusion.Methods From November 2003 to Jun 2010,six patients with liver tumors had the complication of hepatic artery occlusion following hepatic artery catheterization（n=5） or surgeric procedure（n=1）.Of the 6 patients,5 were men and 1 was woman,with an average age of 47.8 ± 9.8 years（range：36 to 59 years）.We conducted a prospective trial to assess the collateral pathways of feeding artery using digital subtraction angiography（DSA） and the possibility of transcatheter treatment for liver tumors.Results DSA showed complete occlusion of the common hepatic artery in all the six patients.The collateral arteries originated from the superior mesenteric artery in five patients（83.3%） and from the left gastric artery in one（16.7%）.Transarterial management was successfully in all patients（100%）.Conclusion Transarterial management is possible for patients with hepatic artery occlusion.