腹腔干动脉狭窄患者肝癌的TACE治疗结果分析

Treatment of liver cancer with TACE in patients with celiac axis stenosis

目的研究腹腔干动脉狭窄后肝癌患者经侧枝循环行导管肝动脉化疗栓塞(TACE)治疗的方法和疗效。方法对11例腹腔干动脉狭窄后肝癌患者应用RH、Cobra配合微导管技术进行治疗。结果 2例经腹腔干插管至肝段水平行化疗栓塞。7例经肠系膜上动脉插管至肝段水平,并行化疗及栓塞治疗,插管成功率为77.8%(7/9);4～6周复查,CT显示肿瘤缩小,碘油沉积致密。2例插管至肝固有动脉行灌注化疗。结论腹腔干动脉狭窄后肝脏可形成丰富的侧枝循环,其中肠系膜上动脉供血尤为常见,应用RH、Cobra导管配合微导管技术,多能顺利插管至肝段水平对肝癌行TACE治疗。

Objective To study the treatment of liver cancer with transcather arterial chemoembolization（TACE） via collateral pathways and to explore its efficacy in patients with celiac axis stenosis （CAS）. Method A total of 11 patients with liver cancer and CAS were treated with RH and Cobra catheter in combination with microcatheter. Results Two patients were treated with chemotherapeutic embolization via catheterization to the liver. The RH and Cobra catheter was used in combination with SP catheter to perform chemotherapy and embolization for the liver cancer via the superior mesenteric artery in 7 patients. The success rate of catheterization was 77.8%（7/9）. Follow-up CT after 4-6 weeks confirmed that there were reduction of tumor size and dense deposition of iodinate oil in 7 patients. The other 2 patients were further treated with chemotherapeutic perfusion through catheterization to the proper hepatic artery. Conclusions Significant collateral pathways might form after CAS of the liver and the superior mesenteric artery is the most common vessel for the pathway. The use of RH and Cobra catheter in combination with SP catheter can ensure the catheterization to the liver for TACE.