Imaging Changes and Clinical Complications After Drug-Eluting Bead Versus Conventional Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: Multicenter Study

Zhang, Lei; Sun, Jun‐Hui; Ji, Jiansong; Zhong, Bin-Yan; Zhou, Gengui; Shen, Jingjing; Hou, Zhong-Heng; Huang, Peng; Zhang, Shen; Li, Zhi; Zhu, Xiaoli; Chen, Ni

doi:10.2214/ajr.20.24708

Cited by 25 publications

(23 citation statements)

References 42 publications

(51 reference statements)

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“…In this sense, DEB–TACE is different than conventional TACE, as the previously described two-part process (cTACE) is exchanged for a single-step modality (DEB–TACE). In randomized trials comparing cTACE and DEB–TACE, the major difference were less post-procedural pain and shorter hospital admission in DEB–TACE, this finding can be explained by the deeper penetration of chemoembolic material into the liver capsule and peritumoral portal venous system with cTACE [ 109 ].…”

Section: Mechanism Of Action Of Transarterial Therapiesmentioning

confidence: 99%

Intraarterial Therapies for the Management of Hepatocellular Carcinoma

Garg

Shrigiriwar

Habibollahi

et al. 2022

Cancers

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Image-guided locoregional therapies play a crucial role in the management of patients with hepatocellular carcinoma (HCC). Transarterial therapies consist of a group of catheter-based treatments where embolic agents are delivered directly into the tumor via their supplying arteries. Some of the transarterial therapies available include bland embolization (TAE), transarterial chemoembolization (TACE), drug-eluting beads–transarterial chemoembolization (DEBs–TACE), selective internal radioembolization therapy (SIRT), and hepatic artery infusion (HAI). This article provides a review of pre-procedural, intra-procedural, and post-procedural aspects of each therapy, along with a review of the literature. Newer embolotherapy options and future directions are also briefly discussed.

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Section: Mechanism Of Action Of Transarterial Therapiesmentioning

confidence: 99%

Intraarterial Therapies for the Management of Hepatocellular Carcinoma

Garg

Shrigiriwar

Habibollahi

et al. 2022

Cancers

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“…Recently, Zhang et al. showed that DEB-TACE caused more hepatobiliary injuries and severe abdominal pain ( 38 ).…”

Section: Tacementioning

confidence: 99%

Transarterial Chemoembolization Combined With Tyrosine Kinase Inhibitors for Intermediate‐Stage Hepatocellular Carcinoma, What Else Can We Do?

Deng

Wen

2022

Front. Oncol.

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Transarterial chemoembolization (TACE) has been considered the standard treatment for intermediate-stage hepatocellular carcinoma (HCC). However, intermediate‐stage HCC is highly heterogeneous with a broad population with varying tumour burdens, liver function. This suggests that TACE monotherapy treatment might not be suitable for all patients with intermediate‐stage HCC. The administration of tyrosine kinase inhibitors (TKIs) has become an important treatment option for improving the prognosis of patients with advanced HCC. Over the years, several trials have been conducted to explore the effects of TACE combined with TKIs for intermediate-stage HCC. However, the clinical efficacy is still controversial, and its potential clinical utility needs to be confirmed. This review will focus on the recent progress of TACE combined TKIs for intermediate-stage HCC.

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“…Intrahepatic biloma and global hepatic damage associated with DEB-TACE has been hypothesized to result from the combination of chemotherapy-induced arteriosclerosis and ischemia. [8][9][10] Biliary strictures, particularly postsurgical anastomotic strictures, often present the diagnostic dilemma of whether the obstruction results from ischemia/scar or recurrent tumor.…”

Section: Cause Of Obstructionmentioning

confidence: 99%

Treatment of Malignant Bile Duct Obstruction: What the Interventional Radiologist Needs to Know

Camacho

Brody

Covey

2021

Semin intervent Radiol

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Management of malignant bile duct obstruction is both a clinically important and technically challenging aspect of caring for patients with advanced malignancy. Bile duct obstruction can be caused by extrinsic compression, intrinsic tumor/stone/debris, or by biliary ischemia, inflammation, and sclerosis. Common indications for biliary intervention include lowering the serum bilirubin level for chemotherapy, ameliorating pruritus, treating cholangitis or bile leak, and providing access for bile duct biopsy or other adjuvant therapies. In some institutions, biliary drainage may also be considered prior to hepatic or pancreatic resection. Prior to undertaking biliary intervention, it is essential to have high-quality cross-sectional imaging to determine the level of obstruction, the presence of filling defects or atrophy, and status of the portal vein. High bile duct obstruction, which we consider to be obstruction above, at, or just below the confluence (Bismuth classifications IV, III, II, and some I), is optimally managed percutaneously rather than endoscopically because interventional radiologists can target specific ducts for drainage and can typically avoid introducing enteric contents into isolated undrained bile ducts. Options for biliary drainage include external or internal/external catheters and stents. In the setting of high obstruction, placement of a catheter or stent above the ampulla, preserving the function of the sphincter of Oddi, may lower the risk of future cholangitis by preventing enteric contamination of the biliary tree. Placement of a primary suprapapillary stent without a catheter, when possible, is the procedure most likely to keep the biliary tree sterile.

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Imaging Changes and Clinical Complications After Drug-Eluting Bead Versus Conventional Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: Multicenter Study

Cited by 25 publications

References 42 publications

Intraarterial Therapies for the Management of Hepatocellular Carcinoma

Intraarterial Therapies for the Management of Hepatocellular Carcinoma

Transarterial Chemoembolization Combined With Tyrosine Kinase Inhibitors for Intermediate‐Stage Hepatocellular Carcinoma, What Else Can We Do?

Treatment of Malignant Bile Duct Obstruction: What the Interventional Radiologist Needs to Know

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