- 期刊
- OpenAccess
Experience of Using Microcatheter in Transcatheter Arterial Chemoembolization Therapy (TACE) for Hepatocellular Carcinoma
使用微小導管做肝癌栓塞治療之經驗
摘要
目的：1．評估使用微小導管做肝癌栓塞治療的效果。2．描述使用微小導管的經驗與技術。3．分析腫瘤血管不易放入導管的原因，以及使用微小導管的適應症。20例肝癌病人，因為腫瘤血管不易放入導管，因而使用微小導管來做化學栓塞治療。抗癌藥與油性對比劑Lipiodol、抗生素混合，注入腫瘤血管。隨後並以泡棉Gelfoam將血管塞住。腫瘤縮小一半以上的有8例，縮小四分之一到一半的有一例，縮小不到四分之一的有3例，不變的有8例。血清甲型胎兒蛋白AFP數值下降的佔80%。使用微小導管的適應症包括：動脈粥狀硬化及血管僵硬的有9例，血管扭曲的有11例，血管狹窄或血管很小的有10例，血管被大腫瘤擠壓移位的有5例，血管以大角度分枝的有4例，腹腔大動脈幹過長的有5例，血管攣縮的有3例，醫源性動脈內層傷害的有1例。對於血管不易放入導管的肝癌病人，使用微小導管來做化學栓塞治療，證明是有效的方法。
並列摘要
The purposes of this study were: 1. To evaluate therapeutic results of transcatheter hepatic arterial chemoembolization (TACE) using a microcatheter against hepatocellular carcinoma (HCC). 2. To describe the experience and technique of using a microcatheter. 3. To analyze the causes of difficult catheterization of tumor-feeding arteries and the indications for using a microcatheter. TACE with microcatheter was performed in 20 patients with HCC accompanied by difficult catheterization of tumor-feeding arteries. Emulsions of Lipiodol and an anticancer agent, an antibiotic, and Gelfoam particles were used as embolic materials. Change in tumor size was evaluated by CT scan, sonography, and angiography. Survival times, patient conditions, and changes in serum alphafetoprotein (AFP) were evaluated. The reasons for using a microcatheter were analyzed. Reduction of more than 50% in tumor size occurred in 8 patients, from 25% to 50% in one, less than 25% in 3, and no change in 8 patients. Reduction of serum AFP was noted in 80% of patients. The indications for using a microcatheter include: atherosclerotic change and rigid vessel in 9 patients, tortuous vessel in 11 patients, stenotic or small vessel in 10 patients, vessel compressed and displaced by large tumor in 5 patients, acute vessel angle in 4 patients, elongated celiac trunk in 5 cases, vasospasm in 3 cases, and iatrogenic intimal injury in 1 case. Transcatheter arterial chemoembolization therapy with a microcatheter was proven to be a useful treatment for hepatocellular carcinoma accompanied by difficult catheterization of tumor-feeding arteries.
延伸閱讀
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