intravascular interventional diagnosis and treatment2

the level of the first lumbar vertebra
above the renal artery . And inferior mesenteric artery arises between the L2-L3 and L3-L4
disc spaces .
IV
Interventional
embolization with lipiodol can reduce the tumor mass and HCC patients receiving TAI,TAE may survive longer than untreated patients .
Transcatheter embolization
injection will conform the catheter position .
Selective catheterization of the left gastric artery is performed by ,
either straightening the curved tip of thd of the
5. a delay of the contrast in capillary
emptying (tumor dyeing)
Transcatheter hepatic artery infusion and
embolization(TAI,TAE) for HCC
Blood supply of the liver :20-25% from hepatic artery, 80-75%from the portal vein . HCC are vascular with an arterial supply. Hepatic artery infusion with antitumor drugs and
Arteriography in HCC 1. arteries irregular in caliber
2. arteriovenous anastomoses of HCC
3. the hepatic veins filling early 4. retrograde filling of the portal veins
The abdominal arteriography
The RH catheter is inserted into the
aorta and the tip is rotated anteriorly and
gently withdrawn .As the catheter flicks into the celiac orifice ,a small contrast
Angioplasty
for any stenosis or short occlusion using balloon dilatation and stent placement .A wire guide is passed across the stenosis or occlusion and the angioplasty catheter positioned in the narrowed segment .Then an occluded segment will be dilated
veins is the best way for BCS .
therapeutic techniques
Hepatic arterial chemoembolization hepatic arteriography
diagnosing HCC
assessing the efficacy of tumor chemoembolization
infusion of antitumor agents
control of hemorrhage
reduction of arterial supply
palliation of tumors obliteration of arterio-venous fistula embolization materials sponge cotton
steel coils, absolute alcohol, lipiodol
using the balloon slowly .Don’t withdraw an
inflated balloon from the artery or vein .
Angioplasty for BCS Both obstruction from the inferior vena cava at the posterior hepatic segments and /or hepatic vein obstruction . Catheterization of IVC or percutaneous transhepatic hepatovenography can establish the diagnosis of BCS .Balloon angioplasty and placement of metallic stents in IVC and hepatic
wire guide or by reforming a loop catheter in the hepatic artery and
engaging the left gastric artery .
The orifice of the superior mesenteric artery is usually found at