J Korean Radiol Soc.  1992 Jun;28(3):419-423.

Superselective transcather arterial embolization for hepatocellular carcinoma with a mixture of ethanol and lipiodol

• Park JH
• Han JK
• Choi BI
• Han MC

Abstract

To evaluate the effectiveness of superselective transcatheter arterial embolization (STAE) for hepatocelluar carcinoma (HCC) with a mixture of ethanol and Lipiodol, STAE was done in 12 male patients with HCC. Three were diagnosed clinically with angiographic findings and elevated alphafetprotein levels and three were recurrent tumors after surgery. Sono-guided aspiration biopsy proved the diagnosis of hepatocellular carcinoma in another six patients. The tumor was a small single nodule (2-5cm in diameter) in 11 patients. In one patient, two nodules were found. Superselective catheterization was done using 3F Tracker catheter(Target Therapeutics USA) coaxially through 6F catheter into the feeding hepatic artery, usually the third order branch. One to four cc of 75% ethanol mixed with Lipiodol was infused under fluoroscopy immediately after imjection of 2% lidocaine. Immediate angiography and CT after 2 weeks were undertaken. Complete segmental or subsegmental devascularization including feeding arteries and tumor vascularities occurred in all patients. Follow-up angiography after 6 to 15 months revealed the tumor opacified by Lipiodol. The tumor decreased in 5 cases and recurrence was found in three patients. CT taken 2 weeks after STAE showed low density halo around the tumor in 5 cases. Subsequest segmentectomy in four patients revealed total or near total necrosis of the tumor and no evidence of damage in surrounding parenchyme. STAE for HCC with a mixture of ethanol and Lipiodol is an effective and safe measure for small HCC.

MeSH Terms

Angiography
Arteries
Biopsy, Needle
Carcinoma, Hepatocellular*
Catheterization
Catheters
Diagnosis
Ethanol*
Ethiodized Oil*
Fluoroscopy
Follow-Up Studies
Hepatic Artery
Humans
Lidocaine
Male
Mastectomy, Segmental
Necrosis
Recurrence
Ethanol
Ethiodized Oil
Lidocaine