TACE combined with embolization of artery-portal venous fistula in treatment of advanced hepatocellular carcinoma
10.13929/j.1672-8475.201907023
- Author:
Shicai WANG
1
Author Information
1. Department of Medical Imaging, Shanxi Medical University
- Publication Type:Journal Article
- Keywords:
Arteriovenous fistula;
Chemoembolization, therapeutic;
Liver neoplasms;
Portal vein
- From:
Chinese Journal of Interventional Imaging and Therapy
2019;16(12):721-725
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the value of TACE combined with interventional embolization of hepatic arterio-portal fistula (HAPF) in treatment of primary hepatocellular carcinoma (PHC). Methods: Clinical data of 65 advanced PHC patients with HAPF were retrospectively analyzed. According to the time of portal vein appearance during hepatic artery angiography, there were 31 patients with low flow type HAPF (<1 s), 25 with medium flow type (1-3 s) and 9 with high flow type HAPF (>3 s). The patients were treated with TACE combined with embolization of the fistula. Then clinical efficacy and closure of fistula were evaluated 1 month after treatment, and the postoperative survival rates of 3, 6, 12 and 24 months were counted. Results: HAPF were successfully one-time embolized in 48 cases (73.85%, 48/65), including 26 cases (26/31, 83.87%) of low-flow type, 18 cases (18/25, 72.00%) with medium-flow type and 4 cases (4/9, 44.44%) with high-flow type HAPF (P=0.046). One month after treatment, tumor progression was observed in 11 patients, while stable in 19 and remission in 35 patients, respectively. Tumor progression, stable and remission was found in 2, 3 and 26 cases among patients with low-flow orifice fistula, 2, 14 and 9 cases among those with medium-flow type HAPF, 7, 2 and 0 case among high-flow type HAPF, respectively (P=0.001). The survival rate was 87.69% (57/65) 3 months, 67.69% (44/65) 6 months, 43.08% (28/65) 12 months and 6.15% (4/65) 24 months after treatment. The difference of survival rate among patients with low-, medium- and high-flow type HAPF was statistically significant (P<0.001). Conclusion: TACE combined with interventional embolization of HAPF has good therapeutic effect, especially for PHC patients with low-flow type HAPF.
