Interventional radiology treatment of liver cancer

By | April 18, 2012

Interventional radiology treatment of liver cancer is a new technology developed in recent years, it has greatly enriched the clinical treatment of liver cancer and prolong survival and improve quality of life of late, but also those who can not get two surgical resection opportunities.
1. Indications and contraindications
(1) Where the indication can not be surgically resected, and no severe jaundice, ascites, and ALT was elevated, may line intervention, according to the manner in which the disease may be. When the white blood cells and platelets decreased significantly, they can not or little use of chemotherapy drugs, only for simple hepatic artery embolization, and partial splenic embolization supplemented.
Interventional radiology treatment of hepatocellular carcinoma (2) an absolute contraindication contraindication for serious heart, liver dysfunction, severe bleeding tendency and who was cachexia. Although the portal vein tumor thrombus in patients with poor prognosis, but the portal vein is rich in collateral circulation, embolization of the line, especially the super-selective hepatic lobe, hepatic artery embolization generally does not occur, or liver failure, liver necrosis, on the contrary, positive, timely and appropriate treatment of complex embolization can greatly improve the survival rate.
2. Intubation and chasing shadows
Catheter in the imaging of the aortic arch with 5FRH after forming pulled at T12 – L1 plane, find the internal rotation after abdominal artery dry down, and more able to enter the hepatic artery, when necessary, with the guide wire tie.
3. Transcatheter hepatic artery infusion chemotherapy and embolization (TAI / TAE)
TAl the chemotherapy drugs are injected by catheter into the tumor feeding arteries, which greatly improve the local drug concentration to overcome these shortcomings, improve the outcome. Interventional treatment of liver cancer in many ways, the most commonly used to TAI + TAE and convenience, but also the most effective in advanced liver cancer treatment. TAI / TAE of the physiological basis of the blood supply of hepatocellular carcinoma 95% – 99% from the hepatic artery, and liver cancer is about 95% of multi-vessel type, only very small part of the portal blood supply; and the blood of normal liver for only 20% – 30% from the hepatic artery, 70% – 80% to hepatic veins. Therefore, hepatic artery embolization can reduce the blood supply of hepatocellular carcinoma is about 90%, resulting in hypoxic ischemic necrosis of the tumor, while the non-cancerous liver tissue less affected areas.
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