Hepatic arterial chemoembolization via a coaxial microcatheter combined with radiofrequency ablation for the treatment of primary hepatocellular carcinoma

Objective To discuss the therapeutic efficacy of transcatheter arterial chemoembolization(TACE) via a coaxial microcatheter combined with radiofrequency ablation(RFA) for primary hepatocellular carcinoma(HCC).Methods The preoperative DSA and multi-slice CT findings in 1 000 patients with HCC,encountered from May1998 to May 2007,were retrospectively analyzed.In 179 cases,the lesion was limited in one hepatic segment,and super-selective catheterization TACE with a coaxial microcatheter was performed in these patients.Four weeks after TACE,dynamic enhanced CT and / or MR scanning was made to observe the results.In 40 cases,there was poor lipiodol deposit in the lesion,and CT-guided RFA was employed for these patients.Follow-up check was done one month after the treatment.Results DSA examination totally revealed 670 lesions with diameter larger than 3 cm,202 lesions with diameter smaller than 3 cm,400 satellite nodules,482 arteriovenous fistulae or arterio-portal shunts,430 abnormal blood-supplying vessels and 362 cancerous thrombosis in portal vein.Four weeks after microcatheter embolization,the local control rate of the tumor was 77.6%.RFA was carried out for patients with poorly-controlled tumors,and one month after RFA the local control rate of the tumor reached 97.5%.Conclusions DSA is the most powerful examination means in detecting lesions less than 3 cm,satellite nodules,tumor’s blood-supply,arteriov-enous fistulae and arterio-portal shunts.Therefore,DSA plays an important role in making the preoperative evaluation of HCC,undoubtedly,this role can not be substituted by any other equipment.RFA is an effective treatment for HCC as well as an ideal alternative for patients who show poor response to TACE.