[Evaluation of interventional therapy for hepatocellular carcinoma with arteriovenous fistulas: an analysis of 38 cases].

OBJECTIVE

To evaluate the therapeutical effects and techniques of superselective arterial embolization in hepatocellular carcinoma (HCC) patients with arteriovenous fistulas (AVFs).

METHODS

Data from 425 cases of HCC patients treated with transcatheter arterial chemoembolization (TACE) in our hospital during the last 2 years were analyzed. Ethanol and/or ethanol and gelfoam (into AVFs), ethanol and/or lipiodol (1:1) or lipiodol and 2 to 3 other kinds of chemodrugs (into tumors) were used to do the transcatheter superselective arterial embolization.

RESULTS

AVFs were found in 38 of our 425 HCC cases (8.9%). Among those 38 cases, 21 (55%) had high flux APFs and 17(45%) had low flux APFs. Eight patients (21% of the 38) had both AVFs and hepatic artery-hepatic venous fistulas. AVFs and tumors of the 38 cases were successfully superselectively embolized, but 35 of the 38 cases had 2-3 procedures. After treatment, hepatic functions improved in 23 cases (61%), ascites disappeared in 13 cases (32%) and ascites decreased in 20 cases (53%). The survival rates at 6 months and 1 year were 84% (32/38) and 61% (23/38).

CONCLUSION

Superselective embolization procedure is beneficial in relieving portal high pressure and its serious consequences in HCC patients with APFs; it is also a foundation for TACE. The procedure can improve the quality of life and the survival rate of the patients.