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目的研究腹腔干动脉狭窄后肝癌患者经侧枝循环行导管肝动脉化疗栓塞(TACE)治疗的方法和疗效。方法对11例腹腔干动脉狭窄后肝癌患者应用RH、Cobra配合微导管技术进行治疗。结果 2例经腹腔干插管至肝段水平行化疗栓塞。7例经肠系膜上动脉插管至肝段水平,并行化疗及栓塞治疗,插管成功率为77.8%(7/9);4～6周复查,CT显示肿瘤缩小,碘油沉积致密。2例插管至肝固有动脉行灌注化疗。结论腹腔干动脉狭窄后肝脏可形成丰富的侧枝循环,其中肠系膜上动脉供血尤为常见,应用RH、Cobra导管配合微导管技术,多能顺利插管至肝段水平对肝癌行TACE治疗。
Objective To study the method and effect of transcatheter hepatic arterial chemoembolization (TACE) in patients with liver cancer after celiac artery stenosis. Methods 11 cases of HCC after celiac artery stenosis were treated with RH, Cobra and microcatheter. Results 2 cases of transcatheter intraperitoneal cannulation to the level of the liver chemoembolization. In 7 cases, the success rate of intubation was 77.8% (7/9) after intubating superior mesenteric artery to the level of hepatic segment. The success rate of intubation was 4 weeks to 6 weeks. CT showed that the tumor was reduced and the density of lipiodol deposition was dense. 2 cases intubated to the hepatic artery perfusion chemotherapy. Conclusion The hepatic artery can form abundant collateral circulation after celiac artery stenosis. The superior mesenteric artery blood supply is especially common. Using RH and Cobra catheter combined with microcatheter technique, it can be successfully intubated to the level of hepatic segment for TACE treatment.