Embolisation of the right gastric artery in patients undergoing hepatic arterial infusion chemotherapy using two possible approach routes
Embolisation of the right gastric artery in patients undergoing hepatic arterial infusion chemotherapy using two possible approach routes
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DOI：
10.1259/bjr/51736762
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发表时间：
2010-07-01
影响因子：
2.6
通讯作者：
Nishimura, T.
中科院分区：
文献类型：
--
作者：
Yamagami, T.;Terayama, K.;Nishimura, T.
我们采用回顾性非随机研究来研究在使用端口导管系统进行肝动脉灌注化疗（HAIC）之前选择性栓塞胃右动脉的临床效果。我们评估了肝动脉或胃左动脉是否是选择胃右动脉的更好方法。共有 367 名无法切除的晚期肝癌患者（244 名男性和 123 名女性；平均年龄 64.1 岁）接受了经皮植入端口导管系统。在其中 294 名患者中，在放置端口导管系统之前尝试用微弹簧圈进行右胃动脉栓塞，以防止胃粘膜损伤。方法是通过肝动脉（175 名患者）或通过胃左动脉（119 名患者），胃右动脉置管的成功率分别为 78.3% 和 77.3%。如果尝试不成功，导管将被重定向到替代方法，这将最终成功率提高到 96.3%。内窥镜检查显示，HAIC 后仅 7 名患者出现胃十二指肠粘膜急性病变。胃右动脉栓塞是一种可行的手术，可以减少与 HAIC 相关的胃粘膜病变的发生率。通过肝动脉或胃左动脉的方法同样可以接受。
We used a retrospective non-randomised study to investigate the clinical effect of selective embolisation of the right gastric artery before hepatic arterial infusion chemotherapy (HAIC) using a port-catheter system. We evaluated whether the hepatic artery or the left gastric artery is the better approach for selecting the right gastric artery. A total of 367 patients (244 men and 123 women; mean age, 64.1 years) with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system. In 294 of these patients, right gastric arterial embolisation with microcoils was attempted before placement of the port-catheter system to prevent gastric mucosal lesions. Approach was either through the hepatic artery (175 patients) or through the left gastric artery (119 patients), with success rates in catheterising the right gastric artery of 78.3% and 77.3%, respectively. If the attempt was unsuccessful, the catheter was redirected to the alternative approach, which increased the final success rate to 96.3%. Only seven patients experienced gastroduodenal mucosal lesions acutely after HAIC, as revealed by endoscopy. Embolisation of the right gastric artery is a feasible procedure that can reduce the incidence of gastric mucosal lesions associated with HAIC. Approach through either the hepatic artery or the left gastric artery is equally acceptable.