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[微导管和微线圈用于转移性骨与软组织肿瘤的动脉栓塞治疗]

[Arterial embolization therapy for metastatic bone and soft-tissue tumors with microcatheter and microcoils].

作者信息

Ishiguchi T, Itoh S, Fukatsu H, Itoh Y, Horikawa Y, Tadokoro M, Itoh K, Ishigaki T, Sakuma S

机构信息

Department of Radiology, Nagoya University School of Medicine.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1991 Mar 25;51(3):260-9.

PMID:2047201
Abstract

Transcatheter arterial embolization therapy was performed in fifteen patients with hypervascular metastatic bone and soft-tissue tumors (7 from renal carcinoma, 5 from hepatocellular carcinoma, and one each from breast, thyroid, and cholangiocarcinoma). Sites of metastasis were spine (7), pelvis (5), skull (2), paraspine (2), chest wall (1), and thigh (1). Five patients had not responded to previous radiation therapy and hyperthermia. Embolization of feeding arteries was performed superselectively with long tapered catheters or coaxial microcatheters. Emulsion of Lipiodol and anticancer agent, polyvinyl alcohol sponge, gelatin sponge, and microcoils were used as embolic materials in various combinations. Relief of pain was experienced in 14 of 15 patients. Two patients were operated following embolization with minimal blood loss. Change in tumor size was evaluated by CT or MRI in ten patients. Reduction of tumor size were more than 50% in five patients, from 25% to 50% in two, and no change in three patients. Especially, patients embolized with microcatheter and microcoils showed excellent long-term results. No serious complications were seen. In conclusion, superselective arterial embolization therapy with coaxial microcatheter and microcoils was proved to be an useful treatment for hypervascular metastatic bone and soft-tissue tumors.

摘要

对15例高血运性骨和软组织转移瘤患者实施了经导管动脉栓塞治疗(其中7例来自肾癌,5例来自肝细胞癌,1例来自乳腺癌、1例来自甲状腺癌、1例来自胆管癌)。转移部位为脊柱(7例)、骨盆(5例)、颅骨(2例)、椎旁(2例)、胸壁(1例)和大腿(1例)。5例患者对先前的放射治疗和热疗无反应。使用长锥形导管或同轴微导管对供血动脉进行超选择性栓塞。碘油与抗癌剂的乳剂、聚乙烯醇海绵、明胶海绵和微线圈以不同组合用作栓塞材料。15例患者中有14例疼痛缓解。2例患者在栓塞后接受手术,出血量极少。10例患者通过CT或MRI评估肿瘤大小变化。5例患者肿瘤大小缩小超过50%,2例缩小25%至50%,3例无变化。特别是,使用微导管和微线圈进行栓塞的患者显示出优异的长期效果。未观察到严重并发症。总之,同轴微导管和微线圈超选择性动脉栓塞治疗被证明是治疗高血运性骨和软组织转移瘤的一种有效方法。

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