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DSA Appearances and In terventiona l Theraphy of Arter iovenous Fistula( AVF) in Hepa tocellular Cac inoma
L I Shun - zong,WANG Hong - guang, L I Zh i - gang, ZHAO Jun - jing(Depa rtm ent of Radiology, Hebei Tum or Hospital, Shijiazhuang 050011, China)
Abstract:Objective To exp lore the appearances of DSA and therapeutic methods of tanscatheter hepatic artery chomoembolization ( THACE) of hepatic carcinoma with arteriovenous fistula ( avf). Methods The indirect hepatic portal veinangiography ( Superiormesenteric artery angiography) and celiac trunk angiography ( common hepatic artery) were performed in 673 caseswith hepatic carcinoma confirmed by pathology, then hepatic artery infusion - chemotherapy and /or embolizations were done. Results Hep tic carcinoma to be accompanied with arteriovenous fistula (AVF) 151 was totally cases (22. 4％ ) , including artery - portal vein fistula 127 cases, artery - vein fistula 15 cases, mixed 9 cases. Of them, hepatic artery embolizations in 131 cases with artery - vein fistula ( 86. 6％ ) were performed once or more times, in 20 cases due to the embolization of artery - vein fistula couldn’t be performed and /or with tumor embolus inside common portal vein while only arterial infusion - chemotherapywere performed. Conclusion DSA is accurate and direct diagnostic method in hepatic carcinoma with artery - vein fistula. Hepatic artery embolization and infusion - chemotherapy is an effective way for the patientswith artery – vein fistula.
Key words: hepatic carcinoma ; artery - vein fistula ; interventional radiology
原发性肝癌的动脉灌注及栓塞治疗( TACE) ,效果显著已为所有临床医师认同,但静脉瘤栓(portalvenous tumor thrombus, PVTT)及动静脉瘘( arteriovenous fistula,AVS)等体静脉、门静脉系统受侵的并发症对肝癌的TACE疗效影响很大。笔者结合工作中遇到的一组病例,就肝癌伴肝动脉- 门静脉瘘、肝动脉- 肝静脉瘘DSA的表现及介入治疗方法探讨如下。
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