Curative observation of ultrasound-guided microwave ablation therapy for hepatocellular carcinoma combined with arterio-venous fistula

Abstract

Objective To observe the curative effect of the microwave ablation (MWA) therapy for hepatocellular carcinoma(HCC) with arterio-venous fistula(AVF) in patients with intervention and operative contraindication, and to observe the clinical effect. Methods MWA therapy was offered to 24 patients with HCC combined with AVF accompanied with intervention and operative contraindication. The complete ablation rates, volume changes of tumors before and after treatment were observed. Color Doppler ultrasonography was performed to evaluate the peak flow rate and resistance index(RI)of AVF, width and flow rate change of portal vein. The lifetime of patients were also observed. Results All patients were treated with double needle therapy. The first time complete ablation was 75.0%(18/24). Then they were followed up after 6 months. The volume of tumors was (72.9±23.8)cm3 and (57.6±19.8)cm3(P<0.01) before and after treatment. The AVF disappeared in 20 cases, while flow rates of fistula orifice decreases obviously in the rest of them. The widths of portal veins decreased from (1.4±0.9)cm to (1.3±0.1)cm, while the flow rate of that increased from (7.5±3.9)cm/s to (20.1±2.9)cm/s. The survival rates of patients for one, two and three years were 66.6%(16/24), 37.5%(9/24) and 20.8%(5/24), respectively. Conclusions Most AVF disappeared after MWA therapy in HCC combined with AVF. The therapy can relieve portal hypertension symptom effectively and improve survival time and life quality of patients. So it is a good treatment for patients with HCC combined with AVF while with intervention and operative contraindication. Key words: Ultrasonography; Carcinoma, hepatocellular; Arteriovenous Fistula; Microwaves/therapeutic use