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《Contemporary Medicine》 2010-05
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Interventional therapy of arteriovenous shunting in primary hepatocellniar carcinoma

SHANG Jian-qiang,LI Ji-jun,CHEN Jie,Zhang Lei,SUN Zeng-tao,TANG Jun,LIU Zuo-qin Shandong Provincial Medical Imaging Institute,Jinan 250021,China  
Objective To explore the appearances of digital subtraction angiography and therapeutic efficacy of interventional therapy of hepatic carcinoma accompanied with arteriovenous shunting(AVS).Methods To retrospectively analyze clinical material of 85 patients with hepatocellular carcinoma with hepatic arteriovenous shunting.Of whom,70 with hepatic artery-portal vein shunt,6 with hepatic artery-hepatic vein shunt,and 9 with both such two types.A11 the patients were treated with transcatheter arterial chemoembolization(TACE)or transcatheter arterial infusion chemotherapy(TAI).78 patients has their tumors embolized with lipidol and shunts embolized by spongia gelatinosa particle,coil,or PVA particle respectively.The remaining 7 were treated only with TAI.Results 59 shunts were completely closed successfully.19 shunts were partly closed and 7 shunts were not closed.In 26 patients,the shunts reopened or new shunt emerged in later therapy,and they were closed after second embolization.All the patients underwent CT scan a month afer therapy:the tumors were smaller in 56(66%) and lipidol deposition was satisfied,bigger in 16(19%),and 13(15%)were the same in size before and after TACE.In 65 alpha fetoprotein(AFP) positive patients,degree of AFP in59 patientsdecreased.Conclusion Primary hepatic carcinoma with AVS increases difficulty of interventional therapy,while as long as we embolize the shunt effectively,we could make it possible for further treatment and elongate the survival span,improve quality of life.
【CateGory Index】: R735.7
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