The interventional evaluation and management of arteriovenous fistulae in patients with hepatic cancer / 介入放射学杂志

ABSTRACT

Objective To analyze the DSA manifestations of arteriovenous fistulae in hepatic cancer and to discuss the appropriate method for obstructing the fistulae in order to improve the therapeutic results for hepatic cancer associated with arteriovenous fistulae. Methods The imaging findings in 183 patients of hepatic cancer with urteriovenous fistulae, which were. selected from 637 patients with liver cancer, were retrospectively analyzed. For cases with mild arteriovenous fistulae (n = 89) the tumor-feeding arteries were embolized after iodized oil embolization procedure, while for cases with moderate and severe aneriovenous fistulae (n = 94) the abnormal shunts were obstructed before performing chemoembolization of the tumor in order to ensure that the effective infusion of the drug into the lesion and the sufficient deposit of iodized oil in the tumor could be obtained. Results The tumor-feeding arteries were successfully embolized in all 89 patients with mild arteriovenous fistulae. Of 94 cases with moderate and severe arteriovenous fistulae,excellent deposit of iodized oil was seen in 64 (68.1%), incomplete embolization in 13 (14.83%), poor oil deposit due to over-embolization in 11 (11.7%) and failure to block the fistulae as the fistulae were too large or too diffuse in 6 (6.4%). No serious complications occurred. Conclusion The arteriovenous fistulae accompanied with hepatic cancer can be effectively obstructed in most patients, with resultant clinical improvement of the patients' condition. This therapeutic technique is safe and reliable.