Clin Mol Hepatol.  2019 Dec;25(4):344-353. 10.3350/cmh.2019.0016.

Ultraselective conventional transarterial chemoembolization: When and how?

• Miyayama S

• KMID: 2467243
• DOI: http://doi.org/10.3350/cmh.2019.0016

Abstract

Ultraselective conventional transarterial chemoembolization (cTACE), defined as cTACE at the most distal portion of the subsubsegmental hepatic artery, is mainly performed for hepatocellular carcinoma (HCC) ≤5 cm. Distal advancement of a microcatheter enables injection of a larger volume of iodized oil into the portal vein in the limited area under non-physiological hemodynamics. As a result, the reversed portal flow into the tumor through the drainage route of the tumor that occurs when the hepatic artery is embolized is temporarily blocked. By adding gelatin sponge slurry embolization, both the hepatic artery and portal vein are embolized and not only complete necrosis of can be achieved. Ultraselective cTACE can cure small HCCs including less hypervascular tumor portions and replace surgical resection and radiofrequency ablation in selected patients.

Keyword

Chemoembolization, Therapeutic; Hepatocellular carcinoma; Iodized oil; Gelatin sponge, Absorbable; Conebeam computed tomography

MeSH Terms

Carcinoma, Hepatocellular
Catheter Ablation
Chemoembolization, Therapeutic
Drainage
Gelatin
Gelatin Sponge, Absorbable
Hemodynamics
Hepatic Artery
Humans
Iodized Oil
Necrosis
Porifera
Portal Vein
Gelatin
Iodized Oil