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Objective To evaluate the short-term curative effect and the safety of transcatheter arterial chemoembolization (TACE) therapy by using microspheres and lipiodol for hepatocellular carcinoma (HCC).Methods A total of 87 patients with pathologically proved HCC were randomly divided into the study group (n=44,using embospheres of 100-300 μm in diameter together with lipiodol) and the control group (n=43,using gelfoam particles of 350-560 μm in diameter together with lipiodol).Postopertaive biochemical (liver function and AFP) findings and imaging (CT and/or MRI) manifestations were recorded,and the clinical efficacy and adverse reactions were analyzed.Results TACE was performed in all 87 patients.After the treatment,both the disease benefit rate and the postoperative reduction in AFP level in the study group were remarkably better than those in the control group (P＜0.05),but postoperative liver function indexes were not significantly different from the preoperative ones (P＞0.05).The average number of interventional therapy within the follow-up period of 6 months in the study group was smaller than that in the control group (P＜0.05).No statistically significant differences in 6-,12-and 18-month survival rates existed between the two groups (P＞0.05).Conclusion In treating HCC,TACE by combination use of microspheres and lipiodol is safe,its short-term curative effect is more obvious than TACE by combination use of gelfoam particles and lipiodol,and it can reduce the times of interventional procedure.Before TACE,careful planning of the pre-treatment of hepatic artery-portal vein fistula and the superselective catheterization with micro catheter should be taken into consideration.
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Objective Covered stents have been widely utilized in aortic dissections and aortic aneurysms since Parieli treated an abdominal aortic aneurysm with a stent-graft in 1991.Covered stents have also been reported for managing peripheral vascular diseases,including large or wide-neck aneurysm,pseudoaneurysm,vascular rupture/perforation and arteriovenous fistula.Encouraging achievements are also bringing in more than one decade,even in China.For transjugular intrahepatic portosystemic shunt creation,the primary patency rate at 1 year after covered stent grafting is statistically longer than that of bare stent.At present,it is worth studying randomly the covered stent versus bare stent in treating long segmental arterial stenosis and/or occlusion.Furthermore observation should be insisted upon for the long term patency of parent artery after implanting with covered stent.Deploying a covered stent into a tortuous vessel is still a challenge and tough problem.There would still be a long way in China for further development in basic research of improving the substantial property of stent-graft and better design of deploying device.The main target for all interventional radiologists in the foreseen future is how to develop new covered stents with independent knowledge property right and to expand new horizon for its application.
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Objective To investigate the clinical value of home-made self-expandable metallic stent therapy for benign or malignant segmental obstruction of inferior vena cava (IVC). Methods 48 patients, including 30 cases of benignancy and 18 of malignancy, were underwent the home-made self-expandable metallic stent endovascular implantation of IVC. Results Of 48 patients, the average obstructive length of IVC were 5.3?2.8 cm. The IVC pressure below the obstruction varied from 21.4?5.1 mmHg of preoperation to 8.4?3.3 mmHg of postoperation(P
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Objective To investigate the change on the extent of coagulated lesion under various interrupting methods of hepatic blood flow in vivo animal livers, and the clinical effect of combining tran scathcter arterial chernoembolization(TACE) with percutaneous microwave coagulation therapy (PMCT) for primary and metastatic hepatic tumors. Methods Using FORSEA MTC-3-500s microwave coagulator, we performed microwave tissue coagulation in vivo liver of 6 pigs at 60 W, 2 min and of 20 rabbits al 40 W, 2 min with or without the interruption of hepatic blood flow. 27 patients with primary hepatic carcinoma(30 nodules) and 8 patients with metastatic carcinoma( 12 nodules) underwent the combination therapy of 1 - 4 sessions of TACK followed by within 3-10 days by 1 - 3 sessions of PMCT guided by ultrasonography and/or CT. The 42 lesions measured from 2. 3 cm to 15.6 cm were taken place. Results In vivo liver, the greatest dimension of the lesions coagulated by microwave with the interruption of hepatic arterial and portal flow were 22.510.6 mm at 40 W, 2 min and 28. 6?1. 2 mm at 60 W, 2 min, which were markedly larger than those without the interruption (13.3?0.3; and 15.6?0.7 mm, P
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The incidence of vascular malformations is very low, and its clinical manifestations are infinite in variety, from an asymptomatic birthmark to life-threatening massive bleeding, even to congestive heart failure. The pathogenesis of vascular malformations is still unknown, therefore, its effective treatment is a real challenge. With the development of interventional technology and the accumulation of clinical experience in ethanol embolization, in local direct puncture injection and in endovascular embolization, the ethanol embolization will hopefully become the therapy of first choice for this kind of complicate and intractable disorders.
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Purpose: To investigate the security and clinical value of percutaneous intravascular home-made port-catheter-system(PCS) implatation. Materials and Methods: This technique was used to treat thoracic, abdominal and pecvic malignant tuwcors in 63 patients. Intra-arterial injection of anticancerous agents and lipiodol were regularly carried out Via PCS. Results: All PCS implatation were successful. The PCS catheter tips were all retained within target vessels. The related complications in- cluded local hemorrhage (5 cases, 7.9%), wound delaged healing or wound dehiscence (4 cases, 6. 3%), indwelling catheter blockage (4 cases, 6. 3%), migrating of catheter tip (1case, 1.5%), local infection (2cases, 3.1%). Most of these cases were recovered after appropriate management without any fatal and pevae sequelae. Conclusion: Percutaneous Intravascular home-made port-eatheter system implantation is safe and reliable. Home-made PCS is cheaper and more suitable for chinese than im- ported products.