Hepatic falciform artery: is prophylactic embolization needed before short-term hepatic arterial chemoinfusion?
Hepatic falciform artery: is prophylactic embolization needed before short-term hepatic arterial chemoinfusion?
复制标题
肝镰状动脉：短期肝动脉化疗前是否需要预防性栓塞？
DOI：
10.2214/ajr.172.6.10350296
复制
发表时间：
1999
期刊：
影响因子：
--
通讯作者：
K. Sung
中科院分区：
文献类型：
--
作者：
Dong Eun Kim;H. Yoon;G. Ko;Jin Sook Kwon;H. Song;K. Sung
目的
本研究的目的是评估是否需要对肝镰状动脉（HFA）进行预防性栓塞，以防止在短期肝动脉化疗灌注（伴或不伴后续栓塞）前出现脐上皮疹。
材料和方法
在1997年8月至1997年9月期间，对127例肝细胞癌患者进行了经导管动脉化疗灌注或化疗栓塞。分析肝动脉的解剖变异、肝动脉瘤的存在和起源等肝血管造影表现。术后随访35-143天，平均78天。脐上皮疹的发生率进行了评估两组患者，那些与HFA和那些没有。我们还评估了似乎与HFA存在密切相关的其他因素。
结果
127例患者中有16例（13%）发现HFA。每例HFA起源于肝左动脉（n = 14）或肝中动脉（n = 2）。在16例HFA患者中，血清胆红素水平显著高于无HFA患者（p <0.05），而血清白蛋白水平和凝血酶原时间显著低于无HFA患者（p <0.05）和延长（p = 0.02）。门静脉侧支血管在HFA患者（50%）中比在无HFA患者（31%）中更常见，但频率不显著（p = 0.157）。然而，在任何患者中均未观察到脐上皮疹。
结论
我们发现，在短期肝动脉化疗灌注（有或没有后续栓塞）之前，不需要对HFA进行预防性栓塞以预防脐上皮疹。
OBJECTIVE
The purpose of this study was to assess the need for prophylactic embolization of the hepatic falciform artery (HFA) to prevent supraumbilical skin rash before short-term hepatic arterial chemoinfusion with or without subsequent embolization.
MATERIALS AND METHODS
Transcatheter arterial chemoinfusions or chemoembolizations were performed on 127 consecutive patients with hepatocellular carcinoma between August 1997 and September 1997. Hepatic angiography findings regarding the anatomic variations of the hepatic artery and the presence and origin of the HFA were analyzed. The patients were followed up for 35-143 days (mean, 78 days). The incidence of supraumbilical skin rash was assessed for two groups of patients, those with an HFA and those without. We also evaluated other factors that seemed closely related to the presence of an HFA.
RESULTS
An HFA was identified in 16 (13%) of 127 patients. Each HFA originated either in the left hepatic artery (n = 14) or the middle hepatic artery (n = 2). In the 16 patients with an HFA, serum bilirubin levels were significantly higher than in patients without one (p < .05), whereas serum albumin levels and prothrombin times were significantly lower (p < .05) and more prolonged (p = .02) than in patients without one. Portal venous collateral vessels were more frequently seen in patients with an HFA (50%) than in those without one (31%), but the frequency was not significant (p = .157). However, supraumbilical skin rash was not seen in any patient.
CONCLUSION
We found no need for prophylactic embolization of the HFA to prevent supraumbilical skin rash before short-term hepatic arterial chemoinfusion with or without subsequent embolization.