1.Interventional treatment of liver cancer The incidence rate of liver cancer ranks the third in the incidence rate of malignant tumors in China, and more than 100,000 patients die of liver cancer every year. Patients with liver cancer in China are often primary liver cancer secondary to liver cirrhosis, and most of them are in advanced stage when they are diagnosed. According to some data, the surgical resection rate of primary liver cancer in China is only 5.5-28% due to chronic hepatitis, cirrhosis, poor liver function, multifocal lesions and vascular invasion. Interventional therapy provides an effective treatment for patients with liver cancer that cannot be surgically resected. It has been widely used in the clinical non-surgical treatment of liver cancer in China, and has become the first choice for many advanced liver cancers that cannot be surgically resected. In the treatment of small hepatocellular carcinoma, long-term follow-up results show that interventional treatment can also achieve similar efficacy as surgery. (1) Endovascular interventions [A], transcatheter hepatic artery infusion chemotherapy (TAI) and transcatheter hepatic artery chemoembolization (TACE) TAI have been used for 30 years to treat hepatocellular carcinoma, and Watkin et al. first reported transcatheter hepatic artery chemotherapy for primary hepatocellular carcinoma in 1970. In 1986, Japanese scholars first reported the clinical application results of transhepatic arterial injection of iodine oil for the treatment of hepatocellular carcinoma. At present, TAI and TACE have been used as routine treatment for liver cancer at home and abroad. Hatanaka et al. reported that the survival rates of 1, 3 and 5 years after TACE for large liver cancer were 69.3%, 35.1% and 19.6%, respectively; the survival rates of 1, 3 and 5 years after TACE plus surgery for large liver cancer could reach 80.0%, 55.3% and 23.0%, all of which were significantly better than the surgery group. The survival rates at 1, 3 and 5 years after TACE plus surgery for large hepatocellular carcinoma can reach 80.0%, 55.3% and 23.0%, all of which are significantly better than the surgical group. Usually, the femoral artery is punctured by Seldinger’s method, and diagnostic hepatic arteriogram is performed first after success to clarify the location, size, number and blood supply of the tumor, and then super-selective cannulation is performed by guidewire catheter method or coaxial catheter method to the intrinsic hepatic artery or the blood supply artery of the tumor. Chemotherapeutic drugs are mixed with iodine oil or gelatin sponge particles and injected into the target area for chemoembolization. At present, most domestic and foreign countries adopt the “sandwich bread” injection method, i.e., first embolize the end tumor vessels with chemotherapeutic drug-iodine oil emulsion, and then inject a large amount of chemotherapeutic drug. Finally, a gelatin sponge is used to embolize the proximal end of the tumor supplying artery in order to prolong the duration of chemotherapy. The administration method of TAI or TACE is divided into two types: one-shot method and leave-tube infusion method. In the one-impact method, after the catheter is inserted into the target vessel, a larger dose of chemotherapeutic drug is administered within 20-30 min, and then the catheter is removed; the treatment is repeated at intervals of about one month. This method has high local drug concentration in a short period of time, simple technical operation and postoperative care, and low incidence of complications such as infection and thrombosis. In this method, the catheter is placed in the tumor blood supply artery and the chemotherapeutic drug is injected continuously by perfusion pump every day, and the treatment is repeated every 4-6 weeks. Subcutaneous implantable cartridge system (PCS) is currently the most widely used arterial perfusion pump. The cartridge is made of hard plastic or titanium, with a silicone rubber membrane in the center of the cartridge for puncture drug injection. In the past, the cassette was mostly inserted and implanted by surgeons under direct vision of dissection, but with the development of interventional medicine, it is now mostly placed by interventionalists under fluoroscopy by percutaneous puncture of the left subclavian or femoral artery. [B], combined hepatic artery-portal vein embolization (TAPVE) It is generally believed that more than 90% of the blood supply for hepatocellular carcinoma comes from the hepatic artery. The rest comes from the portal vein, but more and more data show that portal blood supply plays an important role in the growth of hepatocellular carcinoma, especially in small hepatocellular carcinoma, which is shown to be oligovascular by hepatic arteriography and the peripheral part of hepatocellular carcinoma. In addition, there are extensive physiological and pathological anastomoses and traffic between hepatic artery and portal vein, and extensive hepatic artery collateral pathways will be formed in the liver after simple TACE, so that the peripheral part of the tumor remains after simple TACE, which is also the reason why TACE is prone to recurrence and the basis of double embolization. Since the 1980s, domestic and foreign scholars began to try to treat hepatocellular carcinoma with the double embolization method of percutaneous hepatic penetration portal vein embolization (PVE) at the same time of TACE, and achieved certain efficacy, but this method requires portal vein puncture cannulation, which is a complicated operation technique and has great damage, so it has not been promoted so far. [In recent years, the improvement of hepatic angiography technology and the development of cannulation technology have made super-selective segmental (regional) or sub-segmental cannulation possible, and for cases in which the tumor is located in a single or a few liver segments and cannot withstand conventional hepatic artery TACE due to severely impaired liver function, super-selective tumor For cases in which the tumor is located in a single or a few segments of the liver and cannot withstand conventional hepatic artery TACE due to impaired liver function, permanent embolic agents such as Gelfoam powder or propionic acid can be applied on the basis of super-selective tumor donor artery cannulation to achieve better embolic effects. At the same time, due to the precise site of drug administration, less damage and mild side effects to non-hepatocellular carcinoma tissues, similar to surgical procedures, also known as arterial partial hepatectomy (TransarterialPartialHepatectomy). [D], hepatic artery chemoembolization after temporary blockage of hepatic artery or hepatic vein by balloon (TACE-THAO or TACE-THVO) The retention time of TACE drugs in the target area is short in the one-impact method, in order to further increase the local drug concentration in the tumor, prolong the action time, and achieve the effect of double embolization of hepatic artery-portal vein, balloon can be used before TACE. TACE-THAO can avoid the premature removal of chemotherapeutic agent and embolic agent by hepatic artery blood flow and prevent ectopic embolism caused by embolic agent reflux; after blocking the hepatic vein, TACE-THAO can make the chemoembolic agent injected from hepatic artery reflux to portal vein to achieve the effect of TAPVE, and After blocking the hepatic vein, the local arterial perfusion increases, which is conducive to increasing the local drug concentration in the tumor and prolonging the drug action time. (2) Percutaneous percutaneous ablation therapy TACE is a precise and effective method, but the pathological results show that simple TACE often fails to achieve complete necrosis of tumor. In recent years, various percutaneous puncture tumor ablation techniques have emerged and matured gradually, which can achieve obvious efficacy alone or with TACE. 2.Interventional treatment of gastric cancer Gastric cancer is a common tumor in China, and the early treatment effect is better. For advanced stage patients, there is no ideal treatment yet. Gastric intravascular infusion chemotherapy (GAI) can significantly improve patients’ quality of life and prolong their survival, which has been widely reported at home and abroad. Gastric artery embolization (GAE), which has been reported less frequently and with limited experience. Routine gastric left artery cannulation, a single injection of chemotherapeutic agents, embolizer iodine oil at the usual dose per kilogram for adults. both GAI and GAE have damage to gastric tissue, but this damage is reversible. gastric tissue damage during GAI treatment is mild and often recovers within a week; the recovery period after GAE takes 30 to 45 days. Pathological results show that the damage caused by GAE is mainly located in the mucosa or submucosa and rarely involves the muscular layer, so the possibility of serious complications such as gastrointestinal hemorrhage and gastric perforation after GAE is small. Nevertheless, one week after GAE, fluid or intravenous nutritional support should be performed to protect the gastric mucosa. Interventional treatment of pancreatic cancer Interventional radiology was first applied to the diagnosis of pancreatic tumors, and then with the promotion of TAI for hepatocellular carcinoma, transarterial perfusion chemotherapy for pancreatic tumors also gradually aroused people’s interest. The blood supply of the pancreas is complex, and a certain part of pancreatic tumor is often supplied by multiple arteries, which suggests us that if the cannula is too selective during perfusion chemotherapy, some tumor supplying arteries may be missed sometimes. Therefore, when perfusion chemotherapy for pancreatic cancer is administered, the catheter tip placed in the abdominal artery is sufficient, and chemotherapy drugs alone are used without embolic agents. In addition, after local chemotherapy, there is a short-term increase of amylase in patients. 4.Interventional treatment for kidney and adrenal tumors Kidney cancer accounts for about 2% of all malignant tumors and 83% of kidney tumors. As early as 1969, Lalli et al. reported transcatheter renal cancer embolization; in 1971, Lang et al. embolized renal cancer with Au pellets and shrunk the mass; in 1973, Almgard et al. reported that embolization of renal cancer with autologous muscle tissue was successful. Now, embolization of renal and adrenal tumors has become a routine treatment before surgical procedures. Studies have shown that preoperative embolization of renal and adrenal tumors significantly reduces intraoperative bleeding; in patients with inoperable renal or adrenal tumors, intra-arterial chemoembolization significantly reduces painful symptoms and prolongs their lives. The results of studies in recent years have shown that the embolic effect of permanent liquid embolization with iodine oil and other embolic agents that have both embolic and tracer effects is identical or even better than when used alone. For patients with inoperable renal cancer, chemoembolization with iodine oil plus chemotherapeutic agents can also be used, but the application of drugs that are more toxic to the kidney, such as CDDP, should be avoided. Preoperative embolization of adrenal t-cell tumor should be done with caution, and if performed, receptor blockers should be given before embolization and intraoperative blood pressure changes should be monitored. 5.Interventional treatment of bladder cancer Among the urological tumors in China, bladder cancer is the most common. At present, surgical resection is still the first choice of bladder cancer treatment. The significance of interventional treatment for bladder cancer is that: preoperative infusion chemotherapy or embolization makes the tumor smaller and easier to resect, reduces intraoperative bleeding, decreases the difficulty of surgery, and increases the surgical resection rate. Postoperative infusion chemotherapy helps to eliminate residual cancer foci and early metastases; for unresectable tumors, it can also prolong patients’ lives. 6.Interventional treatment of gynecological tumors Gynecological tumors mainly include cervical cancer, uterine body cancer, choriocarcinoma, ovarian cancer, etc. The effect of surgery on early tumors is better. However, in China, due to limited medical condition and low awareness of health care, tumors have already developed to advanced stage when patients are seen, and it is not uncommon to lose the chance of surgery. Although some patients received surgical treatment, it is difficult to remove the primary foci and pelvic metastases completely during surgery, resulting in recurrence within a short time after surgery. As early as in the early 1980s, scholars at home and abroad began to try to treat uterine cancer with drug delivery via the common skeletal artery, but it was not promoted because of the low selectivity of the drug delivery method and low local drug concentration. With the development of catheterization technology, it is now convenient to perform super-selective cannulation of bilateral uterine arteries or ovarian arteries through unilateral puncture, and then embolization after one high-dose drug administration. The PCS system can be applied to patients who have been left with a tube, and the drugs can be administered regularly for a long time. The patient’s pain and economic burden are less than that of previous femoral artery left-tube chemotherapy. It is worth mentioning that in recent years, the treatment of uterine fibroid bleeding through uterine artery embolization has achieved efficacy comparable to that of surgical treatment; at the same time, the physiological and psychological problems associated with surgical removal of the uterus have been avoided. It is estimated that in the near future, interventional therapy is expected to replace surgery as the treatment of choice for uterine fibroids.