The management of arteriovenous shunting in hepatocellular carcinoma
LUO Pengfei, CHEN Xiaoming, ZHANG Liangming, ZHOU Zejian, FU Li, WEI Zhihua. Department of Oncology, Guangdong Provincial People′s Hospital, Guangzhou 510080, China
Objective To investigate the management of arteriovenous shunting (AVS) within the liver in interventional therapy for hepatocellular carcinoma (HCC). Methods Fifty cases with hepatic arteriovenous shunting(Group A)were treated with percutaneous ethanol ablation (PEI) near the orifice in the mode of multi-point repeated injection before the transcatheter arterial embolization (TAE). For the 26 cases with arterioportal venous shunting (APVS) (Group B), the TAE was done firstly while the tip of the microcatheter passed beyond the site of APVS and followed by the Cook-coil or ethanol to block the orifice. Results The shunting disappeared or marked reduced in 40 cases in Group A, and no change in 10 cases. Of the 38 cases, their iodized oil deposition was satisfactory after TAE. PEI was done more than 4 times in 37 casses. The APVS was controlled in all the 26 cases in Group B after embolization for 1-2 times. Of these patient, a good iodized oil deposition was achieved in 25 cases, the pressure of portal vein was markedly decreased with the reduction of ascites in 23 cases, and the bleeding of upper gastrointestine was ceased in 2 cases on the following day after the management. Conclusion The two methods used in the management of AVS can get a better iodized oil deposition in the tumor, reduce the risk of pulmonary oil embolism or the increase of pressure of portal vein, and improve the effect of the interventional therapy for HCC.
【CateGory Index】： R735.7