Tumor Endovascular Intervention

Endovascular interventional therapy for tumor is a very important part of interventional therapy, which can be divided into interventional therapy for benign tumors (e.g. hepatic cavernous hemangioma, uterine fibroids, etc.) and malignant tumors (e.g. hepatocellular carcinoma, lung carcinoma, renal carcinoma, musculoskeletal malignant tumors of limbs and metastatic tumors, etc.). As we all know, the growth of tumor needs nutrition and oxygen, and these nutrients are obtained through the blood supply. If the blood supply to the tumor is cut off, the tumor will stop growing due to “starvation”, then necrosis, shrinkage or even disappearance will occur, which is exactly the mechanism of endovascular interventional therapy for tumors. Benign tumors are usually treated with endovascular embolization to cut off the blood supply of the tumor. Take uterine fibroids embolization therapy as an example. Uterine fibroid is a very common benign tumor in modern women, which can cause abdominal discomfort, lumbar pain, heavy menstrual flow, prolonged menstrual period and so on, and in serious cases, it can cause anemia in women. Embolization of uterine fibroids is performed by puncturing the blood vessels with a very thin puncture needle at the root of the patient’s thigh, i.e., in the inguinal region, and then feeding a very thin special plastic tube (catheter), inserting the catheter into the uterine artery on one side under fluoroscopic vision, and injecting pre-prepared embolizing agent into the uterine artery under fluoroscopic vision to embolize the blood vessels on one side, and then inserting the catheter into the uterine artery on the other side (it is thought that the uterus is supplied with blood by blood vessels of both the right and left sides). The catheter is then inserted into the uterine artery of the other side (thinking that the uterus is supplied by blood vessels on both sides), and then embolized in the same way. After the embolization, the patient can go back to the ward for observation, and the patient may have reactions such as pain and fever; however, these reactions are generally mild and can be tolerated. The patient can get out of bed the next day and can be discharged after 3-5 days of observation. This treatment method is very traumatic, does not leave scars, the patient avoids surgery, can preserve the uterus, and can eliminate the symptoms, the therapeutic effect is very good. Endovascular interventional therapy for malignant tumors can be divided into several methods such as endovascular embolization, endovascular drug perfusion and endovascular chemoembolization. The method of endovascular embolization is the same as the embolization method of benign tumors mentioned above and will not be repeated. Intravascular drug perfusion, i.e. local chemotherapy, involves injecting prepared chemotherapeutic drugs into tumor blood vessels through the blood-supplying arteries of the tumor to achieve the effect of local chemotherapy. According to research findings, the effect of chemotherapeutic drugs in killing tumor cells is related to the local drug concentration and contact time, and the higher the local drug concentration, the better the killing effect. Compared with systemic intravenous chemotherapy, intravascular drug infusion can increase the local drug concentration more than ten times to dozens of times, which can obviously improve the effect of chemotherapy, at the same time, due to the injected chemotherapeutic drugs are firstly metabolized and absorbed by tumor tissues and then refluxed back to the whole body, so that it can obviously reduce the toxicity and side effects of chemotherapeutic drugs. Chemoembolization for malignant tumors is the most widely used interventional therapy technique for tumors. This method is to mix chemotherapeutic drugs with vascular embolizing agents (commonly used iodized oil or ultra-liquefied iodized oil), and inject them into the arteries supplying blood to the tumors through the catheter, which can play the dual effect of local chemotherapy and vascular embolization. Vascular embolization reduces or cuts off the blood supply to the tumors, and at the same time reduces the dilution and washout of chemotherapeutic drugs in the blood and extends the contact time between chemotherapeutic drugs and tumor cells, which can significantly improve the effect of chemotherapy. prolong the contact time between chemotherapeutic drugs and tumor cells, which can obviously improve the therapeutic effect. Chemoembolization of malignant tumors can be clinically used for interventional therapy of malignant tumors in many parts of the body, among which it is most applied in liver cancer and kidney cancer. After treatment, patients may have complications such as fever, pain, decreased appetite, nausea, etc., which usually disappear in 3-5 days after active treatment, and the patients can get out of bed on the second day of treatment, and they can carry on a normal life in 3-5 days after the treatment without There is no need for incision, very little trauma and fast recovery, so the intervention is a simple, safe, effective, less traumatic and fast recovery treatment.