[肝外 collateral 动脉参与肝细胞癌的血供：血管造影显示及经导管动脉化疗栓塞术] （注：这里“collateral”不太明确准确中文意思，可能是“侧支”之类，需结合更专业背景确定准确译法）
[Extrahepatic collateral arteries are involved in the blood supply to hepatocellular carcinoma: angiographic demonstration and transcatheter arterial chemoembolization].
作者信息
Li Qiang, Yang Ren-jie, Zhu Xu, Zhu Lin-zhong, Wang Mao-qiang, Duan Feng
机构信息
Department of Radiology the 309th Hospital of Chinese People's Liberation Army, Beijing 100091, China.
出版信息
Zhonghua Zhong Liu Za Zhi. 2013 Aug;35(8):613-7.
OBJECTIVE
To evaluate the incidence of extrahepatic collateral arteries involved in the blood supply to hepatocellular carcinoma (HCC) and to assess the technical success rates and complications of transcatheter arterial chemoembolization (TACE) through the collaterals.
METHODS
1356 TACE procedures were performed in 874 consecutive patients through extrahepatic collateral pathways to HCC between August 2006 and August 2010 in our department. The extrahepatic collateral pathways to HCC revealed on angiography were retrospectively evaluated. TACE through extrahepatic collaterals using iodized oil and gelatin sponge particles was performed when a catheter was advanced into the feeding branch to avoid nontarget embolization.
RESULTS
Incidences of collateral source to HCC were 76.3% from the right inferior phrenic artery (RIPA), 2.4% from the left inferior phrenic artery (LIPA), 6.9% from the right and 0.4% from the left internal mammary arteries (RIMA, LIMA), 2.9% from the right intercostal artery (RICA), 2.0% from the omental artery, 0.8% from the right or middle colic artery, 2.3% from the cystic artery, 1.3% from the left and 1.1% from the right gastric arteries (LGA, RGA), 3.5% from the right renal capsular artery (RRCA), right middle adrenal artery (RMAA) and right inferior adrenal artery (IAA). Technical success rates of TACE were 95.9% in the RIPA, 93.8% in the LIPA, 100.0% in the RIMA and LIMA, 55.0% in the RICA, 77.8% in the omental artery, 63.6% in the colic artery, 67.7% in the cystic artery, 76.5% in the LGA, 73.3% in the RGA and 95.8% in the RRCA, RMAA, and RIAA. Complications included skin erythema and necrosis after TACE through the RIMA, skin erythema after TACE through the RICA, cholecystitis after TACE through the cystic artery (n = 1), and pleural effusion, basal atelectasis and hiccup after TACE through the IPA.
CONCLUSION
TACE through extrahepatic collaterals is safe and feasible, and with a high success rate in the treatment of hepatocellular carcinoma.
目的
评估参与肝细胞癌（HCC）血供的肝外 collateral 动脉的发生率，并评估经 collateral 动脉进行经导管动脉化疗栓塞术（TACE）的技术成功率和并发症。
方法
2006年8月至2010年8月期间，我科对874例连续患者通过肝外 collateral 途径对 HCC 进行了1356例 TACE 手术。对血管造影显示的 HCC 的肝外 collateral 途径进行回顾性评估。当导管进入供血分支时，使用碘化油和明胶海绵颗粒通过肝外 collateral 进行 TACE，以避免非靶栓塞。
结果
HCC 的 collateral 来源发生率分别为：右膈下动脉（RIPA）76.3%，左膈下动脉（LIPA）2.4%，右、左乳内动脉（RIMA、LIMA）分别为6.9%和0.4%，右肋间动脉（RICA）2.9%，网膜动脉2.0%，右或中结肠动脉0.8%，胆囊动脉2.3%，左、右胃动脉（LGA、RGA）分别为1.3%和1.1%，右肾包膜动脉（RRCA）、右中肾上腺动脉（RMAA）和右肾上腺下动脉（IAA）3.5%。TACE 的技术成功率在 RIPA 中为95.9%，在 LIPA 中为93.8%，在 RIMA 和 LIMA 中为100.0%，在 RICA 中为55.0%，在网膜动脉中为77.8%，在结肠动脉中为63.6%，在胆囊动脉中为67.7%，在 LGA 中为76.5%，在 RGA 中为73.3%，在 RRCA、RMAA 和 RIAA 中为95.8%。并发症包括经 RIMA 进行 TACE 后的皮肤红斑和坏死，经 RICA 进行 TACE 后的皮肤红斑，经胆囊动脉进行 TACE 后的胆囊炎（n = 1），以及经 IPA 进行 TACE 后的胸腔积液、基底肺不张和呃逆。
结论
经肝外 collateral 进行 TACE 是安全可行的，在肝细胞癌的治疗中成功率较高。
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