이 작품은 푸단대학 중산병원(2016ZSLC17)의 임상연구 특별기금에 의해 지원되었다. 저자는 푸단 대학의 중산 병원의 샹글린 후 박사에게 영어 글쓰기에 대한 그의 매우 전문적인 제안에 매우 감사드립니다.

이 단일 센터 회고전 연구는 푸단 대학 중산 병원의 지역 기관 검토 위원회에 의해 승인되었습니다.
1. 정보에 입각한 동의를 얻습니다.
<ol><li>TRA 개입 전에, 중재 방사선 학자 (IR)가 환자에게 TRA의 이점및 잠재적 인 합병증을 설명합니다.</li>
</ol>2. 환자 평가
<ol><li>정보에 입각한 동의를 얻은 후, 천자 및 캐니치의 타당성에 대한 RA를 평가합니다.</li>
	<li>환자의 병력에 대한 포괄적인 검토를 수행하십시오. 환자가 심한 혈관 투환, 심한 말초 혈관 질환, 투석 누공 또는 RA 투석 수술을위한 준비를했는지 확인합니다. 이들은 TRA 내정간섭을 수신하는 환자를 위한 상대적인 금기입니다.</li>
	<li>RA의 가시성을 평가합니다.<ol>
<li>맥박 산소측정을 사용하여 Barbeau 테스트를 수행하여 손 담보 동맥이 개입11전에 얼마나 보이는지 평가한다. Barbeau D 파형은 RA 캐넌트에 대한 절대적인 금기 사항으로 간주됩니다.</li>
		<li>Barbeau C 파형으로 테스트된 환자의 경우 도플러 초음파 검사를 적용하여 팔뚝과 손의 부수적 순환 양에 대한 보다 신뢰할 수 있는 정보를 제공합니다. 2mm보다 작은 내지름은 금기 사항으로 간주됩니다. 참고: 병력 평가 및 RA 평가 후, 금기 사항이 있는 환자는 ipsilateral RA를 통해 펑크에서 기권해야 합니다. 반대로 RA는 Barbeau 시험 평가를 통해 특허로 밝혀지면 이상적인 공급이 될 수 있습니다. 왼쪽 RA는 처음에 기본 액세스 경로로 선택됩니다. 왼쪽 RA가 적합하지 않은 것으로 판명되면 오른쪽 RA가 대안이 될 수 있습니다.</li>
	</ol>
</li>
</ol>3. 방사형 동맥 접근
<ol><li>혈관 조영술 표에 환자를 척추 위치에 놓습니다. 그런 다음 왼쪽 팔을 환자의 신체에 평행하게 배치하고 왼쪽 허리에 가깝게 배치하여 카테터와 와이어를 쉽게 배치할 수 있으며 TFA와 비교할 수 있는 작업자위치를 가능하게 합니다.</li>
	<li>심Pation에 의해 탈단 RA 펄스를 표시합니다. 10% 포비도네-요오드 수술 스크럽 용액으로 피부 표면을 청소하고 용액이 공기 건조하도록 합니다. 수술 용 커튼으로 왼쪽 팔을 덮습니다.<ol>
<li>잠재적인 왼쪽 RA 천자 고장의 경우, 오른쪽 팔 또는 오른쪽 인기구를 살균하고 드레이핑하여 대체 액세스 경로를 준비합니다.</li>
	</ol>
</li>
	<li>국소 마취 적용(즉, 리도카인 2mL 1mL) 왼쪽 RA의 가장 강력한 맥동축축을 따라 스타일로이드 공정에 근접한다.</li>
	<li>변형된 셀딩거 기술을 사용하여 손목을 확장하고 20G 바늘로 RA를 펑크합니다. 맥동 동맥 혈액 반환이 관찰되면 0.025 인치 친수 성 가이드 와이어를 소개합니다.<ol>
<li>가이드 와이어를 철회하고 저항이 발생하면 바늘을 재조정하십시오. 가이드와이어의 삽입을 강제로 사용하지 마십시오. 디지털 감산 혈관 조영술 (DSA)의 도움으로, RA를 강조하고 친수 성 가이드 와이어를 삽입하는 데 도움이 대비의 약 1 ~ 2 mL을 주입합니다.</li>
	</ol>
</li>
	<li>일단 접근이 얻어지면 바늘을 제거하고 가이드 와이어로 4-프랑스 친수성 칼집을 소개합니다. 칼집 삽입 후, 소량의 동맥 혈액을 주사기로 부드럽게 펌핑하여 칼집 끝이 용기 내에 있는지 확인합니다.</li>
</ol>4. 항응고 및 혈관 팽창
<ol><li>혈관 확장 칵테일 용액 10mL(3,000IU의 굴절되지 않은 헤파린, 0.1 mg의 니트로글리세린, 리도카인 20 mg)를 준비하십시오.</li>
	<li>0.5 mL/s(도1)의속도로 칼집을 통해 혈관 확장 칵테일 용액 8mL를 관리한다. 참고: 중등도 또는 높은 출혈 위험이 있는 환자를 위해 헤파린의 복용량을 줄이거나 중단하십시오.</li>
</ol>5. 카테터 선택
<ol><li>4-프랑스어, 125cm 커먼 카테터 및 표준 0.035 인치 x 180cm 친수 성 와이어를 사용하여 서브 클라비아 동맥을 통과하고 내림차순 대동맥을 참여시다. DSA 형광법을 사용하여 암 내 탐색 중에 근위 축동맥을 시각화하여 동맥 루프 또는 혈관 강수증에 대한 잠재적병변을 피하십시오. 참고 : 서브 클라비아 동맥에는 많은 동맥 가지가 있습니다. 혈관 학지침은 보좌식 카테터가 역행 카테터화 중에 부수적인 선박에 유입되는 것을 방지합니다. 몇몇 케이스에는 방사형 동맥에 동맥 루프가 있습니다. 표준 와이어가 루프를 통과할 수 없는 경우 마이크로카테터와 각진 0.016 인치 또는 0.018 인치 마이크로 와이어를 사용하는 것이 좋습니다.</li>
	<li>표준 0.035인치 와이어와 함께 4-프랑스어, 125cm 공통 카테터를 사용하여 가이드와이어를 내림차순 대오르타쪽으로 지시합니다. 참고: 대동맥과 좌아파안 동맥 사이의 각도가 매우 심각한 경우, 코브라 2자 형 카테터(예: 시몬스 I 또는 시몬스 II 카테터)가 이 턴을 수행하는 것이 좋습니다.</li>
	<li>내림차순 대어의 카테터화 후 동축 기술을 통해 일반적인 카테터를 교체하십시오. 일반적인 카테터가 내림차장내로 삽입되면, DSA 불소 검사의 지도 하에 체강 트렁크의 카테터 삽입을 위해 카테터 팁을 환기시게 한다. 대부분의 경우 체강 트렁크, 간 동맥 및 우수한 장막 동맥의 혈관 조영술을 쉽게 카테터화하고 수행할 수 있습니다. 참고: 체강 동맥과 내림차순 대동맥 사이의 각도가 매우 심각한 경우 코브라 카테터를 사용하여 절차를 완료하십시오.</li>
	<li>간 색전화 절차의 경우, 동축 기술을 사용하여 초선택적 카테터삽입 및 화학색전화를 수행하고 종양을 공급하는 간 동맥의 표적 지점에 2.8-프랑스어 150cm 마이크로카테터를 배치한다(도2). 질병과 환자 선호도의 부담에 따라 TACE를 수행합니다.</li>
	<li>적절한 색전화를 확인하기 위해 고압 인젝터를 사용하여 일반적인 카테터를 통해 혈관 전도를 수행합니다. 카테터 팁은 일반적으로 일반적인 간 동맥에 위치합니다. -15s의 형광 시동으로, s당 3-4mL의 속도로 조영제의 9-12mL을 주입한다. 그런 다음 RA의 손상을 피하기 위해 가이드 와이어를 통해 카테터를 제거합니다.</li>
</ol>6. 방사형 동맥 헤모스타시스
참고: 비옥정성 헤모스티스는 RA 가혈을 유지하기 위해 특수 지혈대를 사용하여수행됩니다(그림 3).
<ol><li>RA 칼집을 통해 혈관 확장 칵테일 솔루션(섹션 4)의 나머지 2mL을 관리한다. 직후 약 5cm의 칼집을 회수하십시오.</li>
	<li>왼쪽 손목의 방사형 액세스 사이트에 지혈대를 놓고 함께 제공되는 주사기를 사용하여 공기로 지혈대 에어백을 적절하게 팽창시다. 그런 다음 칼집을 완전히 제거하고 에어백을 천천히 수축시합니다. 액세스 사이트에서 누출이 관찰되면 커프에 공기 1mL을 다시 추가합니다. 일반적으로 10~15mL의 공기가 에어백에 첨가되어 혈전증을 유지합니다.</li>
	<li>출혈이나 누출이 없는지 확인합니다. 동시에, 말단 방사형 동맥 펄스가 hemostasis 동안 만져볼 수 있는지 확인하십시오. 펄스 산소계 파형을 사용하여 왼쪽 엄지 손가락의 동맥 파형을 확인합니다.</li>
	<li>공기 주머니를 ~2mL마다 2시간마다 6h 이하로 천천히 팽창시다. 지혈대가 작동 후 6 h를 제거하면 hemostasis가 수행된다는 것을 다시 확인합니다. 참고: 디플레이션 중에 천자 부위에서 출혈이나 누출이 관찰되면 공기가 공기 낭에 다시 30분 동안 추가되고 프로세스가 반복됩니다.</li>
	<li>퇴원하기 전에 Barbeau 테스트를 실시하여 RA의 가부장제를 확인하고 방사형 동맥 폐색 환자를 기록하고 면밀히 후속 조치를 취하십시오.</li>
</ol>7. 후속 조치
<ol><li>개입 후 약 1 개월, TRA 환자에게 왼쪽 손목 검사 및 맥박 검사를 포함하여 철저한 신체 검사를 제공합니다. 잠재적으로 폐색된 RA를 가진 환자를 위해, 팔뚝 도플러 초음파 또는 맥박 산소측정을 사용하여 손 혈액 공급의 후속 평가를 수행합니다.</li>
	<li>TACE 후 모든 환자를 밀접하게 추적합니다. 새로운 종양 결절CT 검사에 분명 하고 초기 병변이 회전하는 것처럼 보였다면, 또 다른 TACE 처리를 수행하십시오.</li>
</ol>

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P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+cardiac+catheterization+in+elderly+patients.">Transradial cardiac catheterization in elderly patients.</a> Catheterization and Cardiovascular Interventions. 51 (3), 287-290 (2000).</li><li>Cox, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+the+risk+of+vascular+complications+associated+with+femoral+and+radial+access+coronary+catheterization+procedures+in+obese+versus+nonobese+patients.">Comparison of the risk of vascular complications associated with femoral and radial access coronary catheterization procedures in obese versus nonobese patients.</a> American Journal of Cardiology. 94 (9), 1174-1177 (2004).</li><li>Titano, J. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+and+Feasibility+of+Transradial+Access+for+Visceral+Interventions+in+Patients+with+Thrombocytopenia.">Safety and Feasibility of Transradial Access for Visceral Interventions in Patients with Thrombocytopenia.</a> Cardiovascular and Interventional Radiology. 39 (5), 676-682 (2016).</li><li>Mortensen, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prospective+Study+on+Total+Fluoroscopic+Time+in+Patients+Undergoing+Uterine+Artery+Embolization:+Comparing+Transradial+and+Transfemoral+Approaches.">Prospective Study on Total Fluoroscopic Time in Patients Undergoing Uterine Artery Embolization: Comparing Transradial and Transfemoral Approaches.</a> Cardiovascular and Interventional Radiology. 42 (3), 441-447 (2019).</li><li>Iezzi, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Operator+learning+curve+for+transradial+liver+cancer+embolization:+implications+for+the+initiation+of+a+transradial+access+program.">Operator learning curve for transradial liver cancer embolization: implications for the initiation of a transradial access program.</a> Diagnostic and Interventional Radiology. 25 (5), 368-374 (2019).</li><li>Mounsey, C. A., Mawhinney, J. A., Werner, R. S., Taggart, D. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Does+Previous+Transradial+Catheterization+Preclude+Use+of+the+Radial+Artery+as+a+Conduit+in+Coronary+Artery+Bypass+Surgery.">Does Previous Transradial Catheterization Preclude Use of the Radial Artery as a Conduit in Coronary Artery Bypass Surgery.</a> Circulation. 134 (9), 681-688 (2016).</li><li>Hibbert, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+versus+transfemoral+artery+approach+for+coronary+angiography+and+percutaneous+coronary+intervention+in+the+extremely+obese.">Transradial versus transfemoral artery approach for coronary angiography and percutaneous coronary intervention in the extremely obese.</a> JACC: Cardiovascular Interventions. 5 (8), 819-826 (2012).</li><li>Fischman, A. M., Swinburne, N. C., Patel, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Technical+Guide+Describing+the+Use+of+Transradial+Access+Technique+for+Endovascular+Interventions.">A Technical Guide Describing the Use of Transradial Access Technique for Endovascular Interventions.</a> Techniques in Vascular and Interventional Radiology. 18 (2), 58-65 (2015).</li><li>Caputo, R. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+arterial+access+for+coronary+and+peripheral+procedures:+executive+summary+by+the+Transradial+Committee+of+the+SCAI.">Transradial arterial access for coronary and peripheral procedures: executive summary by the Transradial Committee of the SCAI.</a> Catheterization and Cardiovascular Interventions. 78 (6), 823-839 (2011).</li><li>Shiozawa, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+approach+for+transcatheter+arterial+chemoembolization+in+patients+with+hepatocellular+carcinoma+-+Comparison+with+conventional+transfemoral+approach.">Transradial approach for transcatheter arterial chemoembolization in patients with hepatocellular carcinoma - Comparison with conventional transfemoral approach.</a> Journal of Clinical Gastroenterology. 37 (5), 412-417 (2003).</li><li>Mitchell, M. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systematic+review+and+cost-benefit+analysis+of+radial+artery+access+for+coronary+angiography+and+intervention.">Systematic review and cost-benefit analysis of radial artery access for coronary angiography and intervention.</a> Circulation: Cardiovascular Quality and Outcomes. 5 (4), 454-462 (2012).</li><li>Shoji, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stroke+After+Percutaneous+Coronary+Intervention+in+the+Era+of+Transradial+Intervention.">Stroke After Percutaneous Coronary Intervention in the Era of Transradial Intervention.</a> Circulation: Cardiovascular Interventions. 11 (12), 006761 (2018).</li><li>Jurga, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cerebral+microembolism+during+coronary+angiography:+a+randomized+comparison+between+femoral+and+radial+arterial+access.">Cerebral microembolism during coronary angiography: a randomized comparison between femoral and radial arterial access.</a> Stroke. 42 (5), 1475-1477 (2011).</li><li>Bishay, V. 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WZ 및 ZPY에 의해 개념과 디자인을 연구; ND, ZHZ 및 MJY에 의한 데이터 수집; ZPY에 의해 자금을 획득. 저자는 관련 재무 공시가 없습니다.

TRA 중재 치료는 최근 몇 년 동안 전 세계적으로 크게 성장했다, 특히 진단 및 중재 심장 절차에서 12. 더욱이, 말초 혈관 질환 개입에 대한 관심이 증가하고 있다. 절차적 성공률을 손상시키지 않으면서, TRA에서 심장 내정간섭은 TFA13,14에비해 출혈과 혈관 합병증의 비율을 효과적으로 감소시킬 수 있다. TFA와 비교하여, TRA는 시술 후 모니...

간세포 암 (HCC)은 전 세계적으로 여섯 번째로 높은 부각 율을 가진 매우 흔한 악성 종양입니다. 또한 전 세계 암 사망률의 두 번째 주요원인1. 환자의 5%-20%만이 치료 치료를 받을 수 있기 때문에, 간질 화학물질(TACE)은 절제할 수 없는 HCC2환자를 위한 가장 인기 있는 완화 치료법이다. TACE는 중간단계 3에서HCC 환자를 위한 가장 일반적으로 이용되고 효과적인 치료 접근법으로 인식되고 있다. TACE4에대한 가장 일반적인 접근 방식인 TFA(Femoembolization) 화학물질화. 그러나 액세스 사이트에서 출혈과 주요 혈관 합병증5를포함하여 TFA 개입과 관련된 위험이 있습니다. 이러한 합병증은 장기간 입원과 비용 증가로 이어집니다. 더욱이, TFA는 환자에 대한 불편과 불만을 증가 적어도 6 h에 대한 고정을 필요로한다.
경외 접근(TRA)은 2년 이상 경피관상 동맥 개입(PCI)에서 사용되어 온 대체접근법5,6이다. TRA PCI는 몇 가지 장점이 있습니다 : 증가 절차 편안함, 액세스 사이트 관련 출혈 감소, 주요 혈관 합병증 감소, 사망률 감소7,8. 방사형 동맥 (RA)은 피상적 인 위치7으로인해 접근및 펑크가 쉽습니다. Hemostasis는 개입 후 수행하기 쉽고 엄격한 immoblization9가없습니다. 심장 카테터화에 있는 TRA 내정간섭을 위한 격려적인 기록에도 불구하고, 현재까지 말초 질병 내정간섭에 있는 TRA를 이용한 몇몇 연구 결과. 악성 간 종양에 대 한 TRA 개입도 드문. 여기서, TRA 간 색전화의 임상 타당성 및 안전성을 분석한다. 제공된 단계별 TRA 프로토콜에 대한 한 기관의 경험도 설명되어 있습니다.

<table border="0" cellpadding="0" cellspacing="0" style="width:553px;" width="553">
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			<td height="21" style="height:21px;width:141px;">Reagents</td>
			<td style="width:127px;"></td>
			<td style="width:123px;"></td>
			<td style="width:163px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Embosphere</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">20173776165</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Gelfoam</td>
			<td style="width:127px;">Alicon</td>
			<td style="width:123px;">20143771056</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Heparin</td>
			<td style="width:127px;">Hepatunn</td>
			<td style="width:123px;">H51021209</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Injection syringe</td>
			<td style="width:127px;">KDL</td>
			<td style="width:123px;">20163150518</td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:141px;">Iodinated oil</td>
			<td style="width:127px;">Yantai Luyin Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H37022398</td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:141px;">Lidocaine</td>
			<td style="width:127px;">Shandong Hualu Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H37022147</td>
			<td></td>
		</tr>
		<tr height="84">
			<td height="84" style="height:84px;width:141px;">Lobaplatin</td>
			<td style="width:127px;">Hainan Changan International Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H20050308</td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:141px;">Nitroglycerin</td>
			<td style="width:127px;">Brijing Yimin Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H11020289</td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:141px;">Normal saline</td>
			<td style="width:127px;">Anhui Shuanghe Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H34023609</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Pharmorubicin</td>
			<td style="width:127px;">Pfizer</td>
			<td style="width:123px;">H20000496</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Ultravist 370</td>
			<td style="width:127px;">Bayer</td>
			<td style="width:123px;">H20171333</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Material</td>
			<td></td>
			<td></td>
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		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:141px;">Hydrophilic Guide Wire</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">LWSTDA38180</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Injection syringe</td>
			<td style="width:127px;">KDL</td>
			<td style="width:123px;">20163150518</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:141px;">Maestro Microcatheter</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">28MC24150SN</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">MPA1 (I) catheter</td>
			<td style="width:127px;">Cordis</td>
			<td style="width:123px;">451-406P0</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Sheath Introducer</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">PSI-4F-11-035</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Steerable Guidewire</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">TNR2411</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">TR Band</td>
			<td style="width:127px;">Terumo</td>
			<td style="width:123px;">XX*RF06</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Equipment</td>
			<td></td>
			<td></td>
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		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">DSA</td>
			<td style="width:127px;">Toshiba</td>
			<td style="width:123px;">INFX-9000V</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Ultrasonic machine</td>
			<td style="width:127px;">SonoScape</td>
			<td style="width:123px;">20172231180</td>
			<td></td>
		</tr>
	</tbody>
</table>

transradial access chemoembolization for hepatocellular carcinoma patients

간질 화학 물질화 (TACE)는 중간 단계에서 간세포 암 (HCC)의 치료를위한 가장 일반적인 양상이다. TACE는 일반적으로 TFA(fefemoral access)를 통해 수행됩니다. 그러나, 경전 접근 (TRA)은 감소된 합병증 및 사망으로 인한 관상 동맥 내정간섭에서 선호됩니다. TRA의 장점을 TACE에 적용할 수 있는지 여부는 조사가 필요합니다.
단일 센터에서 TRA TACE를 받는 환자는 소급하여 연구를 위해 등록되었습니다. 절차적 세부 사항, 기술적 성공, 방사형 동맥 폐색(RAO) 속도 및 접근 현장 관련 출혈 합병증이 평가되었다. 2017년 10월부터 2018년 10월까지 112명의 환자가 160개의 TRA TACE 절차를 거쳤습니다. 전체 기술 성공률은 95.0%(152/160)였습니다. TRA에서 TFA까지의 크로스오버 비율은 1.9%였습니다. 어떤 경우에도 액세스 사이트 관련 출혈 합병증이 발견되지 않았습니다. 무증상 RA 폐색은 3명의 환자(2.7%)에서 발생했습니다. TFA와 비교하여 TRA는 접근성 사이트 관련 출혈 합병증을 줄이면서 안전성과 환자 만족도를 높일 수 있습니다. 더욱이, TRA 내정간섭은 고령, 비만, 또는 출혈 합병증의 고위험환자를 유익할 수 있습니다.

2017년 10월부터 2018년 10월까지 112명의 환자가 160개의 TRA TACE 절차를 거쳤으며, 전체 기술 성공률은 95.0%(152/160)였습니다. 8건의 사례가 기술적 실패로 충족되었습니다. 이 중 5건은 왼쪽 RA 천지 실패로 인해 발생했으며, 이후 오른쪽 RA 액세스로 성공적인 TACE를 받았습니다. 다른 세 가지 경우는 통조림 실패로 인해 발생했으며, 오른쪽 FA 액세스에 크로스 오버하여 후속 성공적인 개입을 겪었습니다. F...

Watch this Scientific Journal Video about Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients at JoVE.com

Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients

간질 화학 물질화(TACE)는 간세포 암의 중간 단계에서 환자를 위한 표준 요법이며 일반적으로 대퇴동맥 접근을 통해 수행됩니다. 경피성 접근과 비교하여, 경질 접근 (TRA)은 출혈 합병증의 비율을 감소시키고 참을성 있는 내성을 향상할 수 있습니다. 방사형 동맥 접근을 통해 간질 화학 색전화를 수행하는 방법이 여기에 제시된다.

간세포 암종 환자를 위한 경질 접근 화학색전성

Transarterial chemoembolization (TACE) is the most common modality for treatment of hepatocellular carcinoma (HCC) at the intermediate stage. TACE is ...

transradial-access-chemoembolization-for-hepatocellular-carcinoma

Research

JoVE Journal

Cancer Research

5.3K 조회수.  Fudan University. 간질 화학 물질화(TACE)는 간세포 암의 중간 단계에서 환자를 위한 표준 요법이며 일반적으로 대퇴동맥 접근을 통해 수행됩니다. 경피성 접근과 비교하여, 경질 접근 (TRA)은 출혈 합병증의 비율을 감소시키고 참을성 있는 내성을 향상할 수 있습니다. 방사형 동맥 접근을 통해 간질 화학 색전화를 수행하는 방법이 여기에 제시된다.

비디오: Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients

Study of Viral Vectors in a Three-dimensional Liver Model Repopulated with the Human Hepatocellular Carcinoma Cell Line HepG2

This protocol describes the generation of a three-dimensional (3D) ex vivo liver model and its application to the study and development of viral vector systems. The model is obtained by repopulating the extracellular matrix of a decellularized rat liver with a human hepatocyte cell line. The model permits studies in a vascularized 3D cell system, replacing potentially harmful experiments with living animals. Another advantage is the humanized nature of the model, which is closer to human physiology than animal models.
In this study, we demonstrate the transduction of this liver model with a viral vector derived from adeno-associated viruses (AAV vector). The perfusion circuit that supplies the 3D liver model with media provides an easy means to apply the vector. The system permits monitoring of the major metabolic parameters of the liver. For final analysis, tissue samples can be taken to determine the extent of recellularization by histological techniques. Distribution of the virus vector and expression of the delivered transgene can be analyzed by quantitative PCR (qPCR), Western blotting and immunohistochemistry. Numerous applications of the vector model in basic research and in the development of gene therapeutic applications can be envisioned, including the development of novel antiviral therapeutics, cancer research, and the study of viral vectors and their potential side effects.

The recellularized extracellular matrix of a decellularized rat liver can be used as a humanized, three-dimensional ex vivo model to study the distribution and transgene expression of a virus or viral vector.

인간의 간세포 암 세포주 인 HepG2와 3 차원 간 모델 다시 채워에서 바이러스 성 벡터의 연구

This protocol describes the generation of a three-dimensional (3D) ex vivo liver model and its application to the study and development of viral vector ...

연구

암 연구학

A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma

Perineural invasion (PNI) is found in approximately 40% of head and neck squamous cell carcinomas (HNSCC). Despite multimodal treatment with surgery, radiation, and chemotherapy, locoregional recurrences and distant metastases occur at higher rates, and overall survival is decreased by 40% compared to HNSCC without PNI. In vitro studies of the pathways involved in HNSCC PNI have historically been challenging given the lack of a consistent, reproducible assay. Described here is the adaptation of the dorsal root ganglion (DRG) assay for the examination of PNI in HNSCC. In this model, DRG are harvested from the spinal column of a sacrificed nude mouse and placed within a semisolid matrix. Over the subsequent days, neurites are generated and grow in a radial pattern from the cell bodies of the DRG. HNSCC cell lines are then placed peripherally around the matrix and invade preferentially along the neurites toward the DRG. This method allows for rapid evaluation of multiple treatment conditions, with very high assay success rates and reproducibility.

Perineural invasion (PNI) is a common feature of head and neck squamous cell carcinoma (HNSCC), conferring lower survival rates. Its mechanisms are poorly understood. Utilizing neurites generated from murine dorsal root ganglia confined to a semisolid matrix, the pathways involved in the PNI of HNSCC cell lines can be investigated.

머리와 목 편평 ​​세포 암에서 신경초 침략을위한 모델

Perineural invasion (PNI) is found in approximately 40% of head and neck squamous cell carcinomas (HNSCC). Despite multimodal treatment with surgery, ...

Multidimensional Coculture System to Model Lung Squamous Carcinoma Progression

Tumor-stroma interactions play a critical role in the development of lung squamous carcinoma (LUSC). However, understanding how these dynamic interactions contribute to tissue architectural changes observed during tumorigenesis remains challenging due to the lack of appropriate models. In this protocol, we describe the generation of a 3D coculture model using a LUSC primary cell culture known as TUM622. TUM622 cells were established from a LUSC patient-derived xenograft (PDX) and have the unique property to form acinar-like structures when seeded in a basement membrane matrix. We demonstrate that TUM622 acini in 3D coculture recapitulate key features of tissue architecture during LUSC progression as well as the dynamic interactions between LUSC cells and components of the tumor microenvironment (TME), including the extracellular matrix (ECM) and cancer-associated fibroblasts (CAFs). We further adapt our principal 3D culturing protocol to demonstrate how this system could be utilized for various downstream analyses. Overall, this organoid model creates a biologically rich and adaptable platform that enables one to gain insight into the cell-intrinsic and extrinsic mechanisms that promote the disruption of epithelial architectures during carcinoma progression and will aid the search for new therapeutic targets and diagnostic markers.

An in vitro model system was developed to capture tissue architectural changes during lung squamous carcinoma (LUSC) progression in a 3-dimensional (3D) co-culture with cancer-associated fibroblasts (CAFs). This organoid system provides a unique platform to investigate the roles of diverse tumor cell-intrinsic and extrinsic changes that modulate the tumor phenotype.

폐 편평상피암 진행을 모델링하는 다차원 동문화 시스템

Tumor-stroma interactions play a critical role in the development of lung squamous carcinoma (LUSC). However, understanding how these dynamic interactions ...

Analysis of Liver Microenvironment During Early Progression of Non-Alcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma in Zebrafish

Liver cancer is currently the third&#160;leading cause of cancer related death worldwide, and Hepatocellular Carcinoma (HCC) accounts for 75-90% of all liver cancer cases. With the introduction of effective treatments to prevent and treat hepatitis B/C, non-alcoholic fatty liver disease (NAFLD), and the more aggressive form know as non-alcoholic steatohepatitis (NASH), are quickly becoming the number one risk factors to develop HCC in modern societies. To better understand the role NASH has on the development of HCC we designed a NASH-associated HCC zebrafish. The optical clarity and genetic tractability of the zebrafish larvae make them an appealing and powerful model to study the liver microenvironment and immune cell composition using non-invasive fluorescent live imaging. This protocol describes how to use a NASH-associated HCC zebrafish model to investigate the effect of cholesterol surplus in the liver microenvironment and its impact on immune cell composition at early stages of the disease. First, we feed HCC larvae (s704Tg), which express hepatocyte-specific activated beta-catenin, with a 10% high cholesterol diet for 8 days to develop a NASH-associated HCC model. Here we describe how to make use of different transgenic lines to evaluate several early malignancy features in the liver by non-invasive confocal microscopy, such as liver area, cell, and nuclear morphology (hepatocytes area, nuclear area, nuclear:cytoplasmic ratio (N:C ratio), nuclear circularity, micronuclei/nuclear herniation scoring) and angiogenesis. Then, using transgenic lines with tagged immune cells (neutrophils, macrophages, and T cells) we show how to analyze liver immune cell composition in NASH-associated HCC larvae. The described techniques are useful to evaluate liver microenvironment and immune cell composition at early hepatocarcinogenesis stages, but they can also be modified to study such features in other liver disease models.

Here, we present how to generate a non-alcoholic fatty liver disease (NAFLD)-associated Hepatocellular Carcinoma (HCC) zebrafish model to study the impact of cholesterol surplus on liver microenvironment and immune cell landscape.

제브라피쉬에서 비알코올성 지방간 질환 관련 간세포암의 초기 진행 중 간 미세환경 분석

Liver cancer is currently the third&#160;leading cause of cancer related death worldwide, and Hepatocellular Carcinoma (HCC) accounts for 75-90% of all ...

A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma

The aggressiveness and lack of well-tolerated and widely effective treatments for advanced hepatocellular carcinoma (HCC), the predominant form of liver cancer, rationalize its rank as the second most common cause of cancer-related death. Preclinical models need to be adapted to recapitulate the human conditions to select the best therapeutic candidates for clinical development and aid the delivery of personalized medicine. Three-dimensional (3D) cellular spheroid models show promise as an emerging in vitro alternative to two-dimensional (2D) monolayer cultures. Here, we describe a 3D tumor spheroid&#160;model which exploits the ability of individual cells to aggregate when maintained in hanging droplets, and is more representative of an in vivo environment than standard monolayers. Furthermore, 3D spheroids can be produced by combining homotypic or heterotypic cells, more reflective of the cellular heterogeneity in vivo, potentially enabling the study of environmental interactions that can influence progression and treatment responses. The current research optimized the cell density to form 3D homotypic and heterotypic tumor spheroids by immobilizing cell suspensions on the lids of standard 10 cm3 Petri dishes. Longitudinal analysis was performed to generate growth curves for homotypic versus heterotypic tumor/fibroblasts spheroids. Finally, the proliferative impact of fibroblasts (COS7 cells) and liver myofibroblasts (LX2) on homotypic tumor (Hep3B) spheroids was investigated. A seeding density of 3,000 cells (in 20 &#181;L media) successfully yielded Huh7/COS7 heterotypic spheroids, which displayed a steady increase in size up to culture day 8, followed by growth retardation. This finding was corroborated using Hep3B homotypic spheroids cultured in LX2 (human hepatic stellate cell line) conditioned medium (CM). LX2 CM triggered the proliferation of Hep3B spheroids compared to control tumor spheroids. In conclusion, this protocol has shown that 3D tumor spheroids can be used as a simple, economical, and prescreen in vitro tool to study tumor-stromal interactions more comprehensively.

Comprehensive in vitro models that faithfully recapitulate the relevant human disease are lacking. The current study presents three-dimensional (3D) tumor spheroid creation and culture, a reliable in vitro tool to study the tumor-stromal interaction in human hepatocellular carcinoma.

간세포 암에서 종양-기질 상호 작용을 조사하는 3차원 스페로이드 모델

The aggressiveness and lack of well-tolerated and widely effective treatments for advanced hepatocellular carcinoma (HCC), the predominant form of liver ...

Non-Invasive PET/MR Imaging in an Orthotopic Mouse Model of Hepatocellular Carcinoma

Preclinical experimental models of hepatocellular carcinoma (HCC) that recapitulate human disease represent an important tool to study tumorigenesis and evaluate novel therapeutic approaches. Non-invasive whole-body imaging using positron emission tomography (PET) provides critical insights into the in vivo characteristics of tissues at the molecular level in real-time. We present here a protocol for orthotopic HCC xenograft creation with and without hepatic artery ligation (HAL) to induce tumor hypoxia and the assessment of their tumor metabolism in vivo using [18F]Fluoromisonidazole ([18F]FMISO) and [18F]Fluorodeoxyglucose ([18F]FDG) PET/magnetic resonance (MR) imaging. Tumor hypoxia could be readily visualized using the hypoxia marker [18F]FMISO, and it was found that the [18F]FMISO uptake was higher in HCC mice that underwent HAL than in the non-HAL group, whereas [18F]FDG could not distinguish tumor hypoxia between the two groups. HAL tumors also displayed a higher level of hypoxia-inducible factor (HIF)-1&#945; expression in response to hypoxia. Quantification of HAL tumors showed a 2.3-fold increase in [18F]FMISO uptake based on the standardized value uptake (SUV) approach.

Here, we present a protocol to create orthotopic hepatocellular carcinoma xenografts with and without hepatic artery ligation and perform non-invasive positron emission tomography (PET) imaging of tumor hypoxia using [18F]Fluoromisonidazole ([18F]FMISO) and [18F]Fluorodeoxyglucose ([18F]FDG).

간세포 암종의 동소 마우스 모델에서 비침습적 PET/MR 이미징

Preclinical experimental models of hepatocellular carcinoma (HCC) that recapitulate human disease represent an important tool to study tumorigenesis and ...

Establishment and Characterization of Patient-Derived Xenograft Models of Anaplastic Thyroid Carcinoma and Head and Neck Squamous Cell Carcinoma

Patient-derived xenograft (PDX) models faithfully preserve the histological and genetic characteristics of the primary tumor and maintain its heterogeneity. Pharmacodynamic results based on PDX models are highly correlated with clinical practice. Anaplastic thyroid carcinoma (ATC) is the most malignant subtype of thyroid cancer, with strong invasiveness, poor prognosis, and limited treatment. Although the incidence rate of ATC accounts for only 2%-5% of thyroid cancer, its mortality rate is as high as 15%-50%. Head and neck squamous cell carcinoma (HNSCC) is one of the most common head and neck malignancies, with over 600,000 new cases worldwide each year. Herein, detailed protocols are presented to establish PDX models of ATC and HNSCC. In this work, the key factors influencing the success rate of model construction were analyzed, and the histopathological features were compared between the PDX model and the primary tumor. Furthermore, the clinical relevance of the model was validated by evaluating the in vivo therapeutic efficacy of representative clinically used drugs in the successfully constructed PDX models.

The present protocol establishes and characterizes a patient-derived xenograft (PDX) model of anaplastic thyroid carcinoma (ATC) and head and neck squamous cell carcinoma (HNSCC), as PDX models are rapidly becoming the standard in the field of translational oncology.

역형성 갑상선 암종 및 두경부 편평 세포 암종의 환자 유래 이종 이식 모델의 확립 및 특성화

Patient-derived xenograft (PDX) models faithfully preserve the histological and genetic characteristics of the primary tumor and maintain its ...

표적 식별 및 약물 개발을 위한 HCC 오가노이드 형성 최적화

Development and Optimization of A Human Hepatocellular Carcinoma Patient-Derived Organoid Model for Potential Target Identification and Drug Discovery

Hepatocellular carcinoma (HCC) is a highly prevalent and lethal tumor worldwide and its late discovery and lack of effective specific therapeutic agents necessitate further research into its pathogenesis and treatment. Organoids, a novel model that closely resembles native tumor tissue and can be cultured in vitro, have garnered significant interest in recent years, with numerous reports on the development of organoid models for liver cancer. In this study, we have successfully optimized the procedure and established a culture protocol that enables the formation of larger-sized HCC organoids with stable passaging and culture conditions. We have comprehensively outlined each step of the procedure, covering the entire process of HCC tissue dissociation, organoid plating, culture, passaging, cryopreservation, and resuscitation, and provided detailed precautions in this paper. These organoids exhibit genetic similarity to the original HCC tissues and can be utilized for diverse applications, including the identification of potential therapeutic targets for tumors and subsequent drug development.

저자 스포트라이트: 환자 유래 오가노이드를 사용한 간암 발병 기전 조사 

We provide a comprehensive overview and refinement of existing protocols for hepatocellular carcinoma (HCC) organoid formation, encompassing all stages of organoid cultivation. This system serves as a valuable model for the identification of potential therapeutic targets and the assessment of drug candidate effectiveness.

잠재적 표적 식별 및 약물 발견을 위한 인간 간세포 암종 환자 유래 오가노이드 모델의 개발 및 최적화

Hepatocellular carcinoma (HCC) is a highly prevalent and lethal tumor worldwide and its late discovery and lack of effective specific therapeutic agents ...