The clinical value of treatment for hepatocellular carcinoma complicated with arterio-portal fistula wing N-butyl 2-cyanoacrylate

Abstract

Objective To evaluate the clinical application of embolization therapy using N-butyl 2-cyanoacrylate(NBCA)for hepatocellular carcinoma(HCC)complicated with arterio-portal fistula(APF).Methods Eighty patients with HCC and APF underwent embolothempy with NBCA(NBCA group,26 patients)or absolute alcohol(alcohol group,54 patients).The APF wag first treated with liquid embolic agent during the TACE procedure.We used NBCA-Lipiodol mixtures in concentration of 20%-50% according to tlle different circulation times of these APF in NBCA group,Absolute alcohol plus gelfoam or other materisis were used for embolization of APF in alcohol group.The pain reaction during the procedure,influence for liver function(X2 test).occlusive suceessfxil rate after single embolization(Fisher's exact test)and the survival rate of 1 year(log-rank analysis)between two groups were compared after the embolotherapy.Results Four patients in NBCA group and 52 patients in alcohol group felt painful during the pmcedures.There wag statistically significant difference between two groups(x2=58.86,P＜0.001).The APF disappeared after only sin~e embolization in 24(92.3%,24/26)cages of NBCA group and in 37(68.5%,37/54)patients of alcohol group.There wag also significant difference between two groups (P=0.024).There were no statistical ditierence in the post.embolization liver function change and 1 year survival rate between two groups.Conclusions The embolization therapy using NBCA for HCC complicated with APF is safe.effective and more accurate.It can be used as a new technique for these patients. Key words: Carcinoma,hepatocellular; Arteriovenous fistula; Radiology,interventional