Civalleri D, Scopinaro G, Simoni G, Claudiani F, Repetto M, DeCian F, Bonalumi U
Cancer. 1986 Nov 1;58(9):2151-5. doi: 10.1002/1097-0142(19861101)58:9<2151::aid-cncr2820580932>3.0.co;2-f.
In four patients with major anomalies of the hepatic artery undergoing intra-arterial chemotherapy, aberrant lobar vessels were ligated and catheters were inserted into the contralateral artery. Catheter perfusion scans performed early after ligation with 99mTc-macroaggregated albumin (MAA) showed a defective perfusion of the lobe supplied by the occluded artery (0.43, 0.23, 0.11, and 0.28, respectively, as compared to the contralateral lobe). Further MAA scans performed after catheter infusion of 90,000,000 parts of degradable starch microspheres (DSM) showed a near normal perfusion of the ischemic lobe (0.91, 0.96, 0.87, and 0.98). On the contrary, simple MAA scans performed in the first two patients 114 and 135 days after ligation showed a still defective arterial perfusion of the ischemic lobe (0.60, and 0.24). The DSM-induced redistribution of flow towards ischemic portions of the liver suggests a possible new role of DSM in regional treatment of liver tumors in cases with either occlusion of aberrant vessels or "hypovascular" tumors.
在4例接受动脉内化疗且肝动脉存在主要异常的患者中，结扎了异常的叶血管，并将导管插入对侧动脉。在结扎后早期用99mTc-大聚合白蛋白（MAA）进行的导管灌注扫描显示，由闭塞动脉供血的肝叶灌注不良（与对侧肝叶相比，分别为0.43、0.23、0.11和0.28）。在导管注入90000000个可降解淀粉微球（DSM）后进行的进一步MAA扫描显示，缺血肝叶灌注接近正常（0.91、0.96、0.87和0.98）。相反，在前两名患者结扎后114天和135天进行的单纯MAA扫描显示，缺血肝叶的动脉灌注仍然不良（0.60和0.24）。DSM诱导的血流重新分布至肝脏缺血部分，提示DSM在异常血管闭塞或“乏血管”肿瘤病例的肝肿瘤区域治疗中可能具有新作用。
