导管开窗技术在右膈下动脉供血的肝癌TACE中的应用

Application of catheter fenestration technology in transcatheter arterial chemoembolization for hepatocellular carcinoma supplied by the right inferior phrenic artery

目的探讨导管开窗技术在右膈下动脉(right inferior phrenic artery,RIPA)供血的肝癌TACE超选择插管中应用的可行性和安全性。方法2023年3月至2023年5月烟台毓璜顶医院对5例合并RIPA供血的肝癌患者进行TACE中采用常规插管技术微导管RIPA超选择插管失败后,应用导管开窗技术完成RIPA的超选插管。结果5例患者均成功完成RIPA超选择插管及TACE治疗,手术成功率100%,超选择插管时间(3.2±2.39)min。术后肝肿瘤指标较前下降,肝功能指标无明显下降,按照mRECIST标准进行评估疗效,其中3例达到部分缓解(PR),2例达到完全缓解(CR)。5例患者均无严重不良反应发生。结论导管开窗技术可提高RIPA供血的肝癌患者TACE时RIPA超选择插管的成功率,安全有效。

Objective To investigate the feasibility and safety of using catheter fenestration technology in transcatheter arterial chemoembolization(TACE)for hepatocellular carcinoma(HCC)supplied by the right inferior phrenic artery(RIPA).Methods From March 2023 to May 2023,five HCC patients,whose HCC lesions were supplied by RIPA,received TACE by using catheter fenestration technology to accomplish the superselective catheterization of RIPA after the conventional microcatheter catheterization of RIPA failed.Results Superselective catheterization of RIPA and TACE were successfully accomplished in all the 5 patients,with a surgical success rate of 100%.The time spent for superselective catheterization of RIPA was(3.2±2.39)minutes.After TACE,the levels of the tumor indicators were decreased when compared with the pre-TACE values,while the liver function indexes showed no obvious damage.Based on the mRECIST criteria,PR was obtained in 3 patients and CR was obtained in 2 patients.None of the five patients developed serious adverse reactions.Conclusion In treating patients with HCC supplied by RIPA,the use of catheter fenestration technology can safely and effectively improve the success rate of superselective catheterization of RIPA during TACE.