Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1-2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates. As a result, the rote of interventional radiology in the management of HCC has grown remarkably in the past decade. Transcatheter arterial chemoembolization (TACE), by far, is the most common technique used to treat unresectable HCC, that is usually performed with the selective arterial administration of ACA- lipiodol emulsion of iodized and gelatin sponge particles to occlude temporarily tumor feeding vessels. Arteriovenous shunt has been reported in HCC and is usually as a recognized contrain-dication of TACE. In this paper, a patient of HCC with intratumoral arteriovenous fistula was successfully embolized with the mixture of N-butyl-2-cyanoacrylate and ethiodol oil by us. (authors)