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《Journal of Clinical Radiology》 2006-05
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Transcatheter Arterial Embolization Combined with Percutaneous Local ThermalAblation Therapy to Treat Hepatocellular Carcinoma with Hepatic Arteriovenous Shunts

WU Hanping, LIANG Huimin, ZHENG Chuansheng, et al.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University ofScience and Technology, Wuhan, Hubei Province 430022, P. R. China  
Objective To evaluate the feasibility and short term clinical effect of transcatheter arterial embolization therapy combined with percutaneous local thermal therapy in treating hepatocellular carcinoma (HCC) with hepatic arteriovenous shunts (HAPS).Materials and Methods 27 tumors with HAPS were treated in 25 HCC patients. The HAPS and the tumor supplying arteries were embolized by Gelfoam granules alone or with coils. The tumors were further treated with percutaneous microwave coagulation therapy (PMCT) or percutaneous radiofrequency ablation therapy (PRFA) 3 days later. DSA and CT or MRI contrast enhancement examination were performed 2 months later to evaluate therapeutic effect.Results 43 HAPS were found in initial hepatic angiography in 25 patients. 21 of them were central-type HAPS, the others were peripheral-type. The HAPS and the tumor supplying arteries were totally embolized by Gelfoam granules alone or with coils. 18 and 9 tumors were treated respectively with PMCT and PRFA. 17 HAPS were recanalized (12 central-type and 5 peripheral-type) by angiography 2 months later. Totally necrosis occurred in 6 tumors and necrosis greater than 50% in area occurred in 19 tumors were depicted by CT or MRI contrast examination, the volume of tumors decreased greater than 50% in 8 tumors and 25%-50% in 10 tumors. The symptoms related with portal hypertension, such as abdominal distension, diarrhea, ascites, were improved or disappeared. No severe complications occurred in all patients.Conclusion Transcatheter arterial embolization combined with percutaneous local thermal therapy could safely and effectively treat hepatocellular carcinoma with hepatic arteriovenous shunts.
【CateGory Index】: R735.7
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