Coussy Alexis, Jambon Eva, Le Bras Yann, Combe Christian, Chiche Laurence, Grenier Nicolas, Marcelin Clément
Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France.
Departement of Nephrology, Pellegrin Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France.
J Pers Med. 2022 Oct 1;12(10):1624. doi: 10.3390/jpm12101624.
Purpose: We investigated the long-term safety and efficacy of hepatic transarterial embolization (TAE) in patients with symptomatic polycystic liver disease (PLD). Materials and Methods: A total of 26 patients were included, mean age of 52.3 years (range: 33−78 years), undergoing 32 TAE procedures between January 2012 and December 2019 were included in this retrospective study. Distal embolization of the segmental hepatic artery was performed with 300−500 µm embolic microspheres associated with proximal embolization using microcoils. The primary endpoint was clinical efficacy, defined by an improvement in health-related quality of life using a modified Short Form-36 Health Survey and improvement in symptoms (digestive or respiratory symptoms and chronic abdominal pain), without invasive therapy during the follow-up period. Secondary endpoints were a decrease in total liver volume and treated liver volume and complications. Results: Hepatic embolization was performed successfully in 30 of 32 procedures with no major adverse events. Clinical efficacy was 73% (19/26). The mean reduction in hepatic volume was −12.6% at 3 months and −27.8% at the last follow-up 51 ± 15.2 months after TAE (range: 30−81 months; both ps < 0.01). The mean visual analog scale pain score was 5.4 ± 2.8 before TAE and decreased to 2.7 ± 1.9 after treatment. Three patients had minor adverse events, and one patient had an adverse event of moderate severity. Conclusion: Hepatic embolization using microspheres and microcoils is a safe and effective treatment for PLD that improves symptoms and reduces the volume of hepatic cysts.
我们研究了肝动脉栓塞术（TAE）治疗症状性多囊肝病（PLD）患者的长期安全性和疗效。材料与方法：本回顾性研究纳入了2012年1月至2019年12月期间共26例患者，平均年龄52.3岁（范围：33 - 78岁），接受了32次TAE手术。使用300 - 500 µm的栓塞微球进行节段性肝动脉远端栓塞，并使用微线圈进行近端栓塞。主要终点是临床疗效，通过改良的简短健康调查问卷36评估健康相关生活质量的改善以及症状（消化或呼吸症状和慢性腹痛）的改善来定义，且在随访期间无需侵入性治疗。次要终点是肝脏总体积和治疗肝体积的减少以及并发症。结果：32例手术中有30例成功进行了肝栓塞，无重大不良事件。临床疗效为73%（19/26）。TAE后3个月肝脏体积平均减少−12.6%，在最后一次随访（TAE后51±15.2个月，范围：30 - 81个月）时减少−27.8%（均p<0.01）。术前平均视觉模拟评分疼痛评分为5.4±2.8，治疗后降至2.7±1.9。3例患者出现轻微不良事件，1例患者出现中度严重程度的不良事件。结论：使用微球和微线圈进行肝栓塞是治疗PLD的一种安全有效的方法，可改善症状并减少肝囊肿体积。
