How to do the interventional treatment for liver cancer?

  The main physiological basis of hepatocellular intervention is that the blood supply of normal hepatocytes is 20%-25% from the hepatic artery and 75%-85% from the portal vein. In primary hepatocellular carcinoma, 90%-95% of the blood supply comes from the hepatic artery, which provides the anatomical basis for vascular intervention for hepatocellular carcinoma.  This provides the anatomical basis for vascular interventional treatment of hepatocellular carcinoma. It is the least invasive treatment method to treat the lesion locally under the guidance of DSA through the original blood vessels of human body without incision to expose the lesion. Vascular interventions are the most clinically used. The main treatments are selective hepatic artery perfusion therapy, selective hepatic artery embolization, and selective hepatic artery chemoembolization. The specific technical methods are the same for all three, that is, a small incision of about 3-5 mm is punctured on the skin, a tube is inserted from the artery to the blood supplying artery of hepatocellular carcinoma, and the drug is administered through the catheter, the difference lies in the different drugs administered.  Selective hepatic artery chemoembolization (TACE) is to give both chemotherapeutic drugs and embolic agents through catheter, often mixing chemotherapeutic drugs and iodine oil in vitro to make a kind of emulsifier, and then hitting the blood vessels to destroy tumor through two ways. The important thing is that the blood supply arteries of tumors are often multi-vessel blood supply, so we should try our best to achieve super-selection for each vessel, so as to have good effect, little side effect and little liver damage.  Selective hepatic arterial infusion (TAI) therapy is the intra-arterial infusion of drugs through a catheter at a dose equal to or less than that administered intravenously. This results in higher local drug concentrations in the target cells and prolonged drug contact time with the lesion, and reduces the total systemic drug dose, achieving improved efficacy and reduced side effects. The efficacy of chemotherapeutic drugs is positively correlated with the effective blood concentration of the drug at the tumor site and the time of drug-tumor contact.  Selective hepatic artery embolization (TAE) is to selectively inject embolic agents into tumor blood vessels and tumor blood supply arteries through catheters to block tumor blood supply and close tumor blood vessel beds, thus inhibiting tumor growth. This is equivalent to “starving” the tumor to death.  The commonly used embolic agents for hepatic artery chemoembolization and hepatic artery embolization are gelatin sponge, super liquefied iodine oil, sodium alginate microspheres, PVA pellets, tripropylene microspheres, etc.