Nasu K, Fujimoto H, Yamamoto S, Naitou H, Maekawa I, Yasuda S, Itou H
Department of Radiology, Inoue Memorial Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 1998 Apr;58(5):204-11.
To determine the best flow alternation in the internal iliac arteries for regional chemotherapy using a reservoir to treat pelvic malignancies, collateral arteries that arose after arterial flow alternation were evaluated on follow-up pelvic angiographies. Follow-up angiographies were obtained in 11 patients with 21 embolized arteries; six male and five female patients including three with urinary bladder cancer, two with prostate cancer, four with uterine cervical cancer and two with bone metastasis. The interval until follow-up angiography ranged from one to-28 months (mean 8.9 months). Three radiologists interpreted the angiographic results and evaluated collateral vessels. Among 21 embolized arteries, 19 were well occluded, while two were not blocked completely. The two arteries with incomplete embolization did not induce collaterals. Eight internal iliac arteries occluded at the proximal portion enhanced retrogradely via collaterals from the ipsilateral external iliac arteries. Collaterals between the bilateral internal iliac arteries were noted only in four of them. In conclusion, embolization at the proximal point of the internal iliac arteries usually induced collaterals from the ipsilateral external iliac arteries and did not always from collaterals between the bilateral internal iliac arteries, which were necessary for regional chemotherapy. This should be considered when pelvic malignancies are treated with reservoirs.
为了确定使用储液器进行盆腔恶性肿瘤区域化疗时髂内动脉的最佳血流交替方式，在随访盆腔血管造影中评估了动脉血流交替后出现的侧支动脉。对11例患者的21条栓塞动脉进行了随访血管造影；其中男性6例，女性5例，包括3例膀胱癌、2例前列腺癌、4例子宫颈癌和2例骨转移患者。随访血管造影的间隔时间为1至28个月（平均8.9个月）。3名放射科医生解读血管造影结果并评估侧支血管。在21条栓塞动脉中，19条栓塞良好，2条未完全阻塞。这两条栓塞不完全的动脉未诱导侧支形成。8条在近端闭塞的髂内动脉通过来自同侧髂外动脉的侧支逆行增强。双侧髂内动脉之间的侧支仅在其中4例中被发现。总之，髂内动脉近端的栓塞通常会诱导来自同侧髂外动脉的侧支形成，并不总是诱导双侧髂内动脉之间的侧支形成，而双侧髂内动脉之间的侧支对区域化疗是必要的。在用储液器治疗盆腔恶性肿瘤时应考虑到这一点。
