左膈下动脉供血在肝癌介入治疗中的价值

目的 探讨左膈下动脉(LIPA)对肝癌的供血及其介入性栓塞在肝癌治疗中的价值.评价经导管做LIPA栓塞化疗的安全性和效果.方法 对22例经血管造影确认有LIPA参与肝癌供血者进行动脉栓塞化疗(TACE).结节型20例,巨块型2例.术前行CT或MRI平扫及增强扫描,术中常规做腹腔动脉-肝动脉及膈下动脉造影,在确认供血范围后将导管超选择至供血支,先用碘油-抗癌乳剂栓塞肿瘤末梢血管,然后注入明胶海绵碎粒或PVA颗粒.观察术后临床经过、相关实验室检查和影像学表现,并与血管造影进行对照分析.结果 病灶位于肝左叶18例(81.8%):7例位于S3,7例位于S2,4例位于S4.病灶位于肝右叶(S5)4例(18.2%).22例患者左膈下动脉TACE全部成功.9例进行LIPA化疗栓塞时发现肝动脉完全阻塞.2例术后发生左下肺叶盘状肺不张和少量胸腔积液.结论 LIPA参与肝癌供血多见于多次行TACE的病人并且肿块位于肝左叶.栓塞左膈下动脉的安全性很高,并发症少且多为自限性.     

38例原发性肝癌动-静脉瘘介入治疗的疗效分析

目的回顾性评价超选择性动脉插管栓塞原发性肝癌合并动-静脉瘘的疗效,以期提高患者的生存质量和延长生存期。方法本院近2年实施经动脉插管栓塞化疗的原发性肝癌425例,其中合并动-静脉瘘38例,采用超选择性动脉插管分别对动-静脉瘘以无水乙醇或无水乙醇＋明胶海绵颗粒、对肿瘤病灶以无水乙醇＋碘油（1：1）或碘油＋2～3种化疗药物实施栓塞。观察术后的临床表现,并随访复发率与生存率。结果425例原发性肝癌合并动脉-门静脉瘘38例（8．9％）,其中,高流量型21例（55％）,低流量型17例（45％）,同时伴有肝动脉-肝静脉瘘8例（21％）。38例均成功实施动-静脉瘘及肿瘤病灶的超选择性动脉插管栓塞术,其中,35例经过2～3次治疗。术后肝功能好转23例（61％）;腹水消失13例（34％）,腹水明显减少20例（53％）;6个月生存率84％（32例）,1年生存率61％（23例）。结论超选择性动脉插管栓塞术治疗肝癌伴动-静脉瘘,能缓解其导致的门静脉高压及其严重后果,疗效肯定,并且为同期实施的肿瘤病灶栓塞治疗奠定了基础,该方法可明显提高患者的生存质量,延长生存期。     

肝动脉化疗加栓塞治疗晚期肝癌65例分析

1997～ 2 0 0 0年 ,我院应用肝动脉化疗加栓塞治疗晚期肝癌患者 65例现报告如下。临床资料 :本组男 5 7例 ,女 8例 ,年龄 5 2 .5± 11.3岁。其中原发性肝癌 5 8例 ,转移性肝癌 7例 ,均经 CT、B超、AFP确诊。癌肿≤ 10 cm者 2 8例 ;>10 cm者 3 7例。肝癌分期 : 期者17例 , 期者 4 5例 , 期者 3例。肿瘤类型 :巨块型 3 9例 ,结节弥漫型 2 6例。 AFP≥ 2 0 0 ng/ml者 4 1例 ,AFP<2 0 0 ng/ml者 2 4例。门静脉癌栓者 2 8例。方法 :采用 Seldingers方法 ,经股动脉穿刺 ,将肝动脉导管选择性插管到肝固有动脉以远 ,行血管造影术 ,然后灌注化…     

335例中晚期肝癌的肿瘤血供分析及临床应用价值的探讨

１．材料与方法：对３５５例经介入治疗的大肝癌进行回顾性分析,其中,男性２８５例,女性７０例,年龄２５—８０岁,肿瘤大小５—１５ｃｍ,以单一巨块型为多 ;１２５０ ｍＡ数字减影 Ｘ光机; ４Ｆ ＲＨ超滑导管、３Ｆ微导管及相应超导丝。介入术中,首先对肝动脉途径肿瘤供血进行完全栓塞;再观察栓后的肿瘤轮廓是否与ＣＴ、ＭＲＩ的影像相符。如不相符则提示非肝动脉途径的肿瘤供血存在;对于５ ｃｍ以上的肝癌,常规检查隔动脉、肾动脉、肠系膜上动脉等以便找到开放的侧支动脉;对已作过介入治疗的大肝癌则常规找寻侧支动脉。 ２．…     

动脉化疗栓塞术治疗126例原发性肝细胞肝癌的疗效观察

目的探讨原发性肝细胞肝癌(HCC)的非肝动脉供血规律及介入治疗技术。方法对解放军第305医院2000—2006年收集的126例HCC患者,常规行腹腔动脉、肝总动脉、肠系膜上动脉、胃左动脉和膈动脉造影,并行超选择性插管,同时进行肝动脉、非肝动脉双动脉化疗栓塞术。结果126例HCC患者中,111例为肝脏本身固有的寄生性供血,其余15例由肝动脉闭塞引起侧支动脉供血。非肝动脉供血与肝脏肿瘤的部位、大小密切相关。用肝动脉导管或Cobra导管配合SP导管行非肝动脉超选择性插管成功率达92%。随访74例,1年及2年存活率分别为61%和25%。结论在HCC介入治疗中,除了肝动脉以外,还要积极寻找非肝动脉供血支。对具有非肝动脉供血的HCC采取双动脉内化疗栓塞是治疗成功的关键。在介入治疗操作过程中,要尽量预防肝动脉闭塞,减少侧支供血形成。     

癌家族报道一例

本科收治1例原发性肝癌患者,通过家系调查,发现其家族中多个成员患恶性肿瘤.现报道如下.　先证者,男,48岁,于2005年2月16日入住我科.实验室检查：AFP＞1 000μg/L,HBsAg、HBeAg及HBcAb阳性.B超、CT示：肝右叶巨块型肝癌伴多发子灶,门静脉右支癌栓,腹膜后淋巴结转移,肝硬化,脾肿大.临床诊断为“原发性肝癌”,于2005年2月21日行经股动脉插管肝动脉化疗栓塞术治疗（TACE）,术后1周好转出院.患者家族有据可查的5代31人中,6人患原发性肝癌,1人患肺癌,1人同时患肩部硬化性脂肪肉瘤及纵隔神经源性肿瘤.     

原发性肝癌滋养血管的变化与肺动脉栓塞及化疗药物灌注术后生存期的关系

[目的]探讨肝癌滋养血管的变化与肺动脉栓塞及化疗药物灌注（TAE）术后患者生存期的关系,提高超选择性肝动脉插管的成功率,改善肝癌患者的生活质量,延长生存期。[方法]回顾性分析行TAE术治疗的92例肝癌患者数字减影血管造影术资料,结合患者的生存期,进行相关的统计分析。[结果]02例肝癌患者中,78例为规则型供血,14例肝癌滋养血管变异,肝癌滋养血管的变化与TAE术后生存期密切相关。[结论]正确认识原发性肝癌滋养血管的变化,对提高TAE术的疗效,前瞻性的预测TAE术后的生存期,规避治疗风险有重要的意义。     

肝动脉插管化疗和栓塞治疗原发性肝癌34例

1990～1997年底,我们采用肝动脉插管化疗和栓塞,治疗原发性肝癌34例。报告如下。 1 一般资料 34例均为我院住院病人,均经B超、CT证实有肝脏占位性病变。其中男33例,女1例。年龄24～66岁,平均49岁。病程平均6个月。肝动脉插管后注入化疗药物而未栓塞者2例,碘化油栓塞31例,明胶海绵栓塞1例。     

肝动脉-右膈下动脉介入治疗块状型肝癌17例临床分析

肝动脉化疗栓塞术(TACE)是目前肝癌的主要治疗手段之一。当肿瘤增大直接侵犯黏连邻近器官，肿瘤可直接从该器官供养动脉中获得血供。由于解剖上右肝后有一部分无腹膜覆盖，直接与膈粘附的肝裸区，因此最常见的非肝动脉供血是右膈下动脉。本文通过分析17例肝动脉-右膈下动脉血供的块状型肝癌的联合化疗栓塞，以探讨其治疗块状型肝癌的价值。     

肝动脉化疗栓塞术联合白细胞介素-2治疗原发性肝癌的疗效

对100例原发性肝癌患者行肝动脉化疗栓塞术(TACE)联合白细胞介素-2(IL-2)治疗的疗效进行观察。 1.资料与方法:原发性肝癌患者100例,男67例,女33例。平均年龄43.1岁。100例患者随机分为对照组和治疗组,各50例。用Seldinger技术,经股动脉穿刺,超选择性将导管插入肝固有动脉、肝左动脉或肝右动脉或肿瘤供血动脉,做造影进一步定位,经造影确实导管位置后,注入化疗药物,并根据患者Child分级、临床分期、病灶大小及有无门静脉癌栓等情况决定化疗方案及用药剂量。化疗药物选择羟基喜树碱20～40mg,     

Iodized oil accumulation in the hypovascular tumor portion of early-stage hepatocellular carcinoma after ultraselective transcatheter arterial chemoembolization

Purpose  We evaluated iodized oil accumulation in the hypovascular portion of early-stage hepatocellular carcinoma (HCC) after ultraselective transcatheter arterial embolization (TACE). Materials and methods  Forty-seven HCC lesions with hypovascular portions were treated by TACE at the distal level of the sub-subsegmental artery of the liver. Portal blood in the hypovascular portion was classed in two grades by computed tomography (CT) during arterial portography: decreased and preserved. Iodized oil accumulation was classed into three grades on CT obtained 1 week after TACE: (1) dense accumulation in the almost entire tumor, including the hypovascular portion (grade 2); (2) dense accumulation in hypervascular portions but sparse accumulation in hypovascular portion (grade 1); and (3) sparse accumulation or no accumulation (grade 0). Findings on serial follow-up CT images were also analyzed. Results  Portal blood in the hypovascular portion was decreased in 32 lesions, and preserved in 15 lesions. On CT 1 week after TACE, 32 tumors (68.1%)—23 with decreased portal blood and 9 with preserved portal blood—were classed as grade 2. Twelve tumors (25.5%), six with decreased portal blood and six with preserved portal blood, were classed as grade 1. Three tumors (6.4%) with decreased portal blood were classed into grade 0. In total, 25 tumors (53.2%), 22 in grade 2 and 3 in grade 1, were well controlled by ultraselective TACE during the mean follow-up of 15.8 months. Conclusions  Iodized oil accumulation and retention in the hypovascular portion of early-stage HCC was frequently observed after ultraselective TACE, mainly in the hypovascular portion with decreased portal blood.     

Efficacy of transcatheter embolization/chemoembolization （TAE/TACE） for the treatment of single hepatocellular carcinoma

AIM: To investigate the efficacy of transcatheter embolization/chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. METHODS: A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrast-enhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m(2), infused over 30 min using a peristaltic pump, and followed by Lipiodol and Gelfoam embolization. RESULTS: Patients characteristics were: mean age, 62 years; male/female 117/45; Child-Pugh score 6.2 +/- 1.1; MELD 8.7 +/- 2.3; mean HCC size, 3.6 (range 1.0-12.0) cm. HCC size class was 6.0 cm, n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 +/- 1.7). Complete tumor necrosis was obtained in 94 patients (58%), massive (90%-99%) necrosis in 16 patients (10%), partial (50%-89%) necrosis in 18 patients (11%) and poor (< 50%) necrosis in the remaining 34 patients (21%). The rate of complete necrosis according to the HCC size class was: 69%, 69%, 52%, 68%, 50% and, 13% for lesions of 6.0 cm, respectively. Kaplan-Mayer survival at 24-mo was 88%, 68%, 59%, 59%, 45%, and 53% for lesions of 6.0 cm, respectively. CONCLUSION: Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm, TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embolization agents or drug eluting beads may improve the effect on tumor necrosis.     

Influential factors and formation of extrahepatic collateral artery in unresectable hepatocellular carcinoma

AIM: To analyze the influence factors and formation of extrahepatic collateral arteries (ECAs) in unresectable hepatocellular carcinoma (HCC) with or without chemoe-mbolization. METHODS: Detailed histories of 35 patients with 39 ECAs of HCC and images including computerized tomography scan, digital subtraction angiography were reviewed carefully to identify ECAs of HCC, ECAs arising from, and anatomic location of tumors in liver. Tumor sizes were measured, and relations of ECAs with times of chemoemb-olization, tumor size, and the anatomic tumor location were analyzed. Complications were observed after chemoemb-olization through ECAs of HCC with different techniques. RESULTS: Influence factors of formation of ECAs of HCC included the times of repeated chemoembolization, the location of tumors in liver, the tumor size and the types of chemoembolization. ECAs in HCC appeared after 3-4 times of chemoembolization (17.9%), but a higher frequency of ECAs occurred after 5-6 times of chemoembolization (56.4%). ECAs presented easily in peripheral areas (71.8%) of liver abutting to the anterior, posterior abdominal walls, the top right of diaphragm and right kidney. ECAs also occurred easily after complete obstruction of the trunk arteries supplying HCCs or the branches of proper hepatic arteries. Extrahepatic collaterals of HCC originated from right internal thoracic (mammary) artery (RTTA, 5.1%), right intercostal artery (RICA, 7.7%), left gastric artery (LGA, 12.8%), right inferior phrenic artery (RIPA, 38.5%), omental artery (OTA, 2.6%), superior mesenteric artery (SMA, 23.1%), and right adrenal and renal capsule artery (RARCA, 10.3%), respectively. The complications after chemoembolization attributed to no super selective cathet-erization. CONCLUSION: The formation of ECAs in unresectable HCC is obviously correlated with multiple chemoembolization, tumor size, types of chemoembolization, anatomic location of tumors. Extrahepatic collaterals in HCC are corresponding to the tumor locations in liver.     

Cerebral lipiodol embolism after transarterial chemoembolization for hepatic carcinoma: a case report

We report a case of cerebral lipiodol embolism (CLE) after transarterial chemoembolization (TACE) for unresectable hepatic carcinoma (HCC). A 54-year-old man with unresectable HCC underwent TACE via the right hepatic artery and right inferior phrenic artery using a mixture of 40 mg pirarubicin and 30 mL lipiodol. His level of consciousness deteriorated after TACE, and non-contrast computed tomography revealed a CLE. The cerebral conditions improved after supportive therapy. The complication might have been due to hepatic arterio-pulmonary vein shunt caused by direct invasion of the tumor. Even though CLE is an uncommon complication of TACE, we should be aware of these rare complications in patients with high risk factors.     

Pulmonary complications of transcatheter arterial chemoembolization for hepatocellular carcinoma

Transcatheter arterial chemoembolization (TACE) is an effective palliative intervention that is widely accepted for the management of hepatocellular carcinoma (HCC). Post-TACE pulmonary complications resulting in acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) are rare events. Pulmonary complications after TACE are thought to be related to chemical injury subsequent to the migration of the infused ethiodized oil or chemotherapeutic agent to the lung vasculature, facilitated by arteriovenous (AV) shunts within the hyper-vascular HCC. We review herein the literature on pulmonary complications related to TACE for HCC. Post-TACE pulmonary complications have included pulmonary oil embolism, interstitial pneumonitis, chemical pneumonitis, ALI, ARDS, lipoid pneumonia, acute eosinophilic and neutrophilic pneumonia, bilious pleuritis, pulmonary abscess, pulmonary tumor embolism, and possibly pulmonary metastasis with HCC. The risk factors associated with post-TACE pulmonary complications identified in the literature include large hyper-vascular HCC with AV shunts, large-volume Lipiodol infusion, and embolization via the right inferior phrenic artery. However, the absence of known risk factors is not a guarantee against serious complications. An astute awareness of the potential post-TACE pulmonary complications should expedite appropriate therapeutic interventions and increase potential for early recovery.     

Therapeutic radiological interventional procedures in hepatocellular carcinoma.

BACKGROUND: To improve the survival rate of patients with hepatocellular carcinoma (HCC) in whom surgery is not possible, various methods have been developed employing angiographic and percutaneous techniques. We analyzed our experience with various percutaneous therapeutic interventional techniques done for HCC in our center. METHODS: Sixty-one patients with inoperable HCC (mean age 48.9 [SD 13.8] y; 47 men) were treated between January 1997 and December 2000 by transcatheter arterial chemoembolization (TACE) alone (22), TACE with percutaneous alcohol injection (PEI) (20), transcatheter arterial embolization (TAE) with steel coils and gel foam for gastrointestinal bleed (7), percutaneous radiofrequency ablation (1), percutaneous preoperative right portal vein embolization (3) and percutaneous preoperative tumor embolization to reduce blood loss at surgery (8). RESULTS: In 42 patients treated by TACE and PEI and TACE alone, tumor necrosis was scored; over 50% necrosis was seen only after six and nine months in both treatment groups. The survival rates after six and nine months and the median survival were similar in the two groups. Of 7 cases treated with TAE with steel coils and gel foam, the gastrointestinal bleeding stopped in four; in the other three, bleeding did not stop completely although less transfusion was required. In the patient treated by radiofrequency ablation, follow-up contrast-enhanced CT did not show enhancing tumor mass. We noted left lobe enlargement after percutaneous preoperative right portal vein embolization, prior to right hepatectomy. CONCLUSION: In patients with HCC not amenable to surgical intervention, a variety of percutaneous therapeutic interventional techniques may be used.     

Oily chemoembolization combined with degradable starch microspheres for HCC with cirrhosis

BACKGROUND/AIMS: To assess efficacy of transcatheter arterial chemoembolization (TACE) combined with degradable starch microspheres (DSM) for patients with liver cirrhosis and hepatocellular carcinoma (HCC). METHODOLOGY: Our studied population was 19 patients with unresectable HCC and liver dysfunction due to repeated TACE, in whom we were unable to selectively advance a microcatheter into the feeding arteries because of tortuous or complex feeding arteries to the HCC. To avoid embolization of an extended non-tumorous area, we conducted Lipiodol-TACE after DSM-embolization (TACE-DSM) of the tumor-free parenchyma. Embolization data and clinical parameters were prospectively assessed. RESULTS: TACE-DSM was performed 21 times in the 19 patients, and the overall technical success rate was 81%. The TACE-DSM method did not induce severe liver dysfunction. A favorable response involving necrosis of more than 80% or 50% of the tumor was seen in 62% and 90% of cases, respectively. In the follow-up period (8 to 36 months), complete necrosis of the targeted tumors was observed in 26% of cases. The 2-year survival rates calculated as starting from the date of TACE-DSM therapy was 32.6%. CONCLUSIONS: From these results we conclude that TACE-DSM therapy is useful for protecting liver function in patients with cirrhosis and unresectable HCC.     

Adjuvant percutaneous radiofrequency ablation of feeding artery of hepatocellular carcinoma before treatment

AIM： To evaluate the feasibility and efficacy of percutaneous radiofrequency ablation （RFA） of the feeding artery of hepatocellular carcinoma （HCC） in reducing the blood-flow-induced heat-sink effect of RFA.
METHODS： A total of 154 HCC patients with 177 pathologically confirmed hypervascular lesions participated in the study and were randomly assigned into two groups. Seventy-one patients with 75 HCCs （average tumor size, 4.3 ± 1.1 cm） were included in group A, in which the feeding artery of HCC was identified by color Doppler flow imaging, and were ablated with multiple small overlapping RFA foci [percutaneous ablation of feeding artery （PAA）] before routine RFA treatment of the tumor. Eighty-three patients with 102 HCC （average tumor size, 4.1 ± 1.0 cm） were included in group B, in which the tumors were treated routinely with RFA. Contrast-enhanced computed tomography was used as post-RFA imaging, when patients were followed-up for 1, 3 and 6 mo.
RESULTS： In group A, feeding arteries were blocked in 66 （88%） HCC lesions, and the size of arteries decreased in nine （12%）. The average number of punctures per HCC was 2.76 ± 1.12 in group A, and 3.36 ± 1.60 in group B （P = 0.01）. The tumor necrosis rate at 1 mo post-RFA was 90.67% （68/75 lesions） in group A and 90.20% （92/102 lesions） in group B. HCC recurrence rate at 6 mo post-RFA was 17.33% （13/75） in group A and 31.37% （32/102） in group B （P = 0.04）.
CONCLUSION： PAA blocked effectively the feeding artery of HCC. Combination of PAA and RFA significantly decreased post-RFA recurrence and provided an alternative treatment for hypervascular HCC.     

Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients

BACKGROUND & AIMS: To elucidate the survival of the patients with unresectable hepatocellular carcinoma (HCC) who underwent transcatheter arterial lipiodol chemoembolization (TACE) and to analyze the factors affecting the survivals. METHODS: During the last 8 years, a nationwide prospective cohort study was performed in 8510 patients with unresectable HCC who underwent TACE using emulsion of lipiodol and anticancer agents followed by gelatin sponge particles as an initial treatment. Exclusion criteria were extrahepatic metastases and/or any previous treatment prior to the present TACE. The primary end point was survival. The survival rates were calculated by the Kaplan-Meier method. The multivariate analyses for the factors affecting survival were evaluated by the Cox proportional hazard model. The mean follow-up period was 1.77 years. RESULTS: For overall survival rates by TACE, median and 1-, 3-, 5-, and 7-year survivals were 34 months, 82%, 47%, 26%, and 16%, respectively. Both the degree of liver damage and the tumor-node-metastasis (TNM) system proposed by the Liver Cancer Study Group of Japan demonstrated good stratification of survivals (P = .0001). The multivariate analyses showed significant difference in degree of liver damage (P = .0001), alpha-fetoprotein value (P = .0001), maximum tumor size (P = .0001), number of lesions (P = .0001), and portal vein invasion (P = .0001). The last 3 factors could be replaced by TNM stage. The TACE-related mortality rate after the initial therapy was .5%. CONCLUSIONS: TACE showed safe therapeutic modality with a 5-year survival of 26% for unresectable HCC patients. The degrees of liver damage, TNM stage, and alpha-fetoprotein values were independent risk factors for patient survival.     

肺结核中量及大量咯血患者非支气管动脉出血的影像改变和介入处理

目的　分析肺结核中量及大量咯血患者非支气管动脉出血动脉造影征象及介入治疗价值。方法 对214例肺结核中量及大量咯血患者,进行肋间动脉和锁骨下动脉造影,其中支气管动脉合并肋间动脉出血153例,合并胸廓内动脉出血3例,同时合并肋间动脉和胸廓内动脉出血4例,合并肋间动脉、胸廓内动脉、胸上动脉出血和胸外侧动脉出血2例,合并肋间动脉、胸廓内动脉和甲状颈干分支出血1例,合并肋间动脉和膈下动脉出血2例。对造影明确出血血管进行栓塞并观察其临床疗效和并发症。结果 DSA造影发现支气管动脉合并肋间动脉出血153例,共465支肋间动脉出血,10.9%(51/465)有造影剂外溢直接征象,96.9%(451/465)有异常网状血管,43.2%(201/465)有出血动脉-肺动脉瘘或出血动脉-肺静脉瘘,32.9%(153/465)动脉造影有侧枝交通与出血的支气管动脉或邻近的肋间动脉相通。10支胸廓内动脉出血,动脉造影有异常网状血管并有侧枝交通与出血的支气管动脉或肋间动脉相通,2支胸上动脉出血和2支胸外侧动脉出血,动脉造影有异常网状血管并有侧枝交通与出血的肋间动脉相通,1支甲状颈干分支2支膈下动脉出血,动脉造影有异常网状血管。单次栓塞治疗有效率84.2%,多次栓塞治疗有效率96.4%。并发症为胸闷、胸背痛、发热。结论 肋间动脉、胸廓内动脉动脉、胸上动脉、胸外侧动脉、甲状颈干分支和膈下动脉造影和栓塞治疗对肺结核中量及大量咯血有重要的临床意义,可提高疗效防止复发。