A quimioembolização hepática intra-arterial é um procedimento minimamente invasivo, que ganha a cada dia mais importância no tratamento das neoplasias hepáticas.
A quimioembolização atua combinando duas frentes de tratamento contra os tumores: a embolização e a aplicação intra- tumoral de quimioterápico. A embolização é a oclusão dos vasos sanguíneos que nutrem os tumores por micropartículas específicas, que ficam impactadas e obstruem permanentemente os microvasos dentro do tumor, levando à morte de suas células. Estas partículas são desenvolvidas para receberem as medicações quimioterápicas e as absorverem, liberando-as dentro do tumor com uma concentração até 20 vezes maior que pelas vias sistêmicas, assim diminui efetivamente a taxa de crescimento das células neoplásicas e evita os efeitos colaterais. O sucesso da técnica consiste na caraterística peculiar da circulação sanguínea hepática, que recebe sangue por duas vias, a artéria hepática e a veia porta. Desta maneira é possível ocluir as artérias que nutrem o tumor, mantendo a irrigação hepática para as células saudáveis.
Cuidados pós procedimento:
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Curativo no local de punção e observação clínica para monitorização de alterações devido à isquemia causada no fígado.
Como é realizado:
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O procedimento é realizado por equipe qualificada, e orientado por exames de imagem em ambiente especializado. Realiza-se uma punção arterial, com identificação das artérias que nutrem os tumores, seguido do cateterismo seletivo destes vasos e da injeção das micropartículas carreadas de quimioterápicos. Após o procedimento o paciente permanece em média 6 a 24 horas em observação, retornando em poucos dias às suas atividades cotidianas. Em torno de um mês após o procedimento já podemos avaliar os resultados por exames de controle e caso seja necessário é possível repeti-lo em busca de uma resposta completa.
Indicação:
É indicado para pacientes com neoplasias hepáticas primárias e para tumores de outras localizações que afetem secundariamente o fígado (metástases), podendo ser realizada em conjunto com quimioterapia sistêmica ou tratamento cirúrgico beneficiando um extenso grupo de pacientes.
A quimioembolização hepática segue crescendo sua atuação no tratamento das neoplasias no figado, isolada ou em conjunto com outros tratamentos e vem trazendo benefícios importantes aos pacientes no combate às neoplasias hepáticas.
Resultado/Objetivo:
O objetivo do procedimento é diminuir o tamanho dos tumores hepáticos ou limitar seu crescimento. Desta maneira proporciona aumento da sobrevida e da qualidade de vida, dimuinindo os sintomas e, em alguns casos, permitindo que o paciente seja submetido a uma cirurgia curativa com ressecção da lesão neoplásica.
Preparação:
Jejum de 8 horas e exame de imagem.
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