ABSTRACT
OBJECTIVE: We wanted to investigate the prevalence and causative factors of extrahepatic arterial blood supply to hepatocellular carcinoma (HCC) at its initial presentation and during chemoembolization. MATERIALS AND METHODS: Between February 1998 and April 2000, consecutive 479 patients with newly diagnosed HCC were prospectively enrolled into this study. A total of 1629 sessions of transcatheter arterial chemoembolization (TACE) were performed in these patients (range: 1-15 sessions; mean: 3.4 sessions) until April 2004. For each TACE procedure, we determined the potential extrahepatic collateral arteries (ExCAs) depending on the location of the tumor, and we performed selective angiography of all suspected collaterals that could supply the tumor. The prevalence of ExCAs and the causative factors were analyzed. RESULTS: At initial presentation, 82 (17%) of these 479 patients showed 108 ExCAs supplying tumors. Univariate analysis showed that tumor size (p or = 5 cm) was significantly higher than that for those patients with a small tumor (< 5 cm) (p < 0.01). CONCLUSION: The presence of ExCAs supplying HCC is rather common, and the tumor size is a significant causative factor for the development of these collateral arteries.
Subject(s)
Middle Aged , Male , Humans , Female , Aged, 80 and over , Aged , Adult , Neovascularization, Pathologic/etiology , Logistic Models , Liver Neoplasms/physiopathology , Collateral Circulation/drug effects , Chemoembolization, Therapeutic/methods , Carcinoma, Hepatocellular/physiopathology , AngiographyABSTRACT
Em 8 cäes anestesiados, foram estabelecidas preparaçöes coraçäo-pulmäo isoladas, mantendo-se a resistência periférica para assegurar pressäo arterial média constante (PA) de 80 mmHg. A artéria coronária descendente anterior (DA) foi ligada e um cateter introduzido distalmente. Foram controlados fluxo sistêmico (FS), EGG e fluxo colateral (FCCo), medido pelo cateter na DA. Estas variáveis foram estudadas antes e 5, 15 e 30 min depois da injeçäo de 10mg de dipiridamol. Os resultados obtidos demonstram que, mantendo-se a PA em 80 mmHg, o fluxo coronário permanece constante (p < 0,01) mesmo na vigência de variaçöes do fluxo sistêmico de 30 a 50% do controle. Na presente investigaçäo, näo foi possível constatar o fenômeno "steal effect" descrito para o dipiridamol