Endovascular treatment of primary hepatic tumours

First transcatheter embolization of hepatic artery has been materializing in 1974, in France, for unresectable hepatic tumours. Then, this treatment has become use enough in many countries, especially in Japan, where primary hepatic tumours are very frequent. In this article, we present procedures of interventional endovascular treatment for primary hepatic tumours: chemoembolization, intra–arterial chemotherapy. The study comprises patients with primary hepatic tumours investigated by hepatic–ultrasound and contrast–enhanced CT or MRI. DSA–hepatic angiography is very important to verify the accessory hepatic supply. It has been performed selective catheterization of right/left hepatic branches followed by cytostatics injection. Most of the patients have benefit by hepatic chemoembolization (cytostatics, Lipiodol and embolic materials). The selective intra–arterial chemotherapy (cytostatics without Lipiodol) was performing in cases with contraindications for Lipiodol or embolic materials injection (cirrhosis–Child C, thrombosis of portal vein, hepatic insufficiency). For treatment of primary hepatic tumours we use 5–F–Uracil, Farmarubicin and Mytomicin C. Less numbers of the reservoirs were placed because financial causes. Chemoembolization was better than procedures without Lipiodol or embolic materials. Lipiodol reached in tumoural tissue and the distribution of Lipiodol harmonises with degree of vascularisation. After the chemoembolization procedure, the diameter of tumours decreased gradually depending on the size of tumour. Effective alternative for unresectable primary hepatic tumours (big size, hepatic dysfunction, and other surgical risk factors) is endovascular interventional treatment.