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Cai Z, Ran M, Song J, Zhen W, Li M. Imaging Diagnosis and Interventional Treatment for Hepatocellular Carcinoma Combined with Arteriovenous Fistula. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6651236. [PMID: 33747418 PMCID: PMC7952172 DOI: 10.1155/2021/6651236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/11/2021] [Accepted: 02/23/2021] [Indexed: 11/25/2022]
Abstract
In order to explore the imaging diagnosis methods and interventional treatment effects of hepatocellular carcinoma combined with hepatic arteriovenous fistula (HAVF), a total of 120 patients, who were diagnosed as hepatic carcinoma with arteriovenous shunting and underwent medical imaging diagnosis and interventional surgery therapy at a designated hospital by this study from December 2014 to December 2018, were chosen as study subjects. Digital subtraction angiography was performed to analyze the imaging features of hepatocellular carcinoma combined with HAVF in each patient; then, according to these imaging diagnosis results, gelatin sponge or coil was used to block the fistula; mitomycin, carboplatin powder, and lipiodol mixed emulsion was combined or separately utilized for hepatic tumor embolization, in which iodized oil embolization chemotherapy was used for patients with mild paralysis; gelatin sponge granule embolization chemotherapy was used for moderate paralysis patients at their first intervention, and, after about 1 month, if the sputum disappeared, iodized oil embolization was used again; and hepatic arterial infusion chemotherapy was used only for patients with severe paralysis. The results show that the central type of HAVF is characterized by early angiography of portal vein and large branches and tumor staining after portal vein's angiography; the peripheral type of HAVF is characterized by portal vein branching in hepatic tumor and double rail sign accompanied by the arterial branch; 112 cases of patients completed embolization chemotherapy; 8 cases of patients only received chemotherapy perfusion; in 109 cases of patients sputum disappeared or shunt decreased at first treatment; and in 113 cases of patients iodine oil was well deposited or the tumor was stably reduced; most of the symptoms of refractory ascites, diarrhea, and upper gastrointestinal bleeding were controlled or improved, and there were no complications such as pulmonary embolism and hepatic failure. Therefore, HAVF increases the difficulty of interventional therapy, but, as long as the positive and appropriate treatment measures are taken, it can still achieve better curative effect without serious complications, which can effectively alleviate the clinical symptoms of patients and improve the quality of life of patients. The results of this study provide a reference for the further researches on imaging diagnosis and interventional treatment for hepatocellular carcinoma combined with arteriovenous fistula.
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Affiliation(s)
- Zheng Cai
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China
| | - Maohui Ran
- Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China
| | - Jiantao Song
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China
| | - Wenrui Zhen
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China
| | - Mingjian Li
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China
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Yan GW, Li HW, Yang GQ, Bhetuwal A, Liu JP, Li Y, Fu QS, Zhao LW, Chen H, Hu N, Wu L, Yan J, Wang W, Shuang JY, Ge J. Iatrogenic arteriovenous fistula of the iliac artery after lumbar discectomy surgery: a systematic review of the last 18 years. Quant Imaging Med Surg 2019; 9:1163-1175. [PMID: 31367570 DOI: 10.21037/qims.2019.05.12] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Patients with iatrogenic iliac arteriovenous fistulas (IAVFs) after lumbar discectomy surgeries (LDSs) from our hospital and the published literature were reviewed in order to better understand this clinical phenomenon. Literature from databases about iatrogenic IAVFs after LDSs were retrieved and a patient from our hospital was reviewed with emphasis placed upon the patient's clinical data. From 31 publications and studies of 44 individuals' data, the study revealed L4-L5 and/or L5-S1 intervertebral space levels were mostly involved (62.0%). Most of the patients underwent computed tomography angiography (CTA) and/or digital subtraction angiography (DSA) examinations to confirm the potential diagnosis and rule out other differential diagnosis (86.4%). Most of the patients (63.6%) developed features of high output heart failure months to years after the LDSs, and the majority of them (88.6%) were treated with endovascular repairs. An iatrogenic IAVF after an LDS is a rare occurrence; however, more attention should be paid to it for the purpose of obtaining accurate diagnosis and proper treatment.
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Affiliation(s)
- Gao-Wu Yan
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Hong-Wei Li
- Department of Radiology, The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang 621000, China
| | - Guo-Qing Yang
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Anup Bhetuwal
- Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Jian-Ping Liu
- Department of Cardiovascular Surgery, Suining Central Hospital, Suining 629000, China
| | - Yong Li
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Quan-Shui Fu
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Lin-Wei Zhao
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Hong Chen
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Na Hu
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Lei Wu
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Jing Yan
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Wei Wang
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Jiao-Yue Shuang
- Department of Radiology, Suining Central Hospital, Suining 629000, China.,Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Jing Ge
- Department of Cardiovascular Surgery, Suining Central Hospital, Suining 629000, China
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