Predisposing Factors of Liver Necrosis after Transcatheter Arterial Chemoembolization in Liver Metastases from Neuroendocrine Tumor

Abstract

DEB > 300 μm in size, BDD, and PVT are responsible for increased rate of liver necrosis after TACE. Careful analysis of BDD or PVT on pretreatment images as well as images taken between two courses can help avoid TACE complications.

Idarubicin-Loaded ONCOZENE Drug-Eluting Embolic Agents for Chemoembolization of Hepatocellular Carcinoma: In Vitro Loading and Release and In Vivo Pharmacokinetics

“…In patients with unresectable HCC, it was also shown that 100-300 mm doxorubicin-eluting embolic agents were associated with significantly lower rates of postembolization syndrome and fatigue compared with the use of 300-500 mm doxorubicin-eluting embolic agents (8% vs 40% for postembolization syndrome, 36% vs 70% for fatigue) and a trend toward a higher frequency of European Association for the Study of the Liver complete response with 100-300 mm DEE agents (59% vs 36%; P ¼ .11) (19). Finally, it was demonstrated recently that DEE agents 4 300 mm increased the necrosis rate of nontumorous liver tissue after transarterial chemoembolization in neuroendocrine liver metastases (20). All these findings may be explained by the fact that smaller DEE agents provided more distal occlusion and denser packing of DEE agents in the territory that received embolization, maximizing the local delivery of the anticancer drug.…”

Transarterial Hepatic Chemoembolization with 70–150 µm Drug-Eluting Beads: Assessment of Clinical Safety and Liver Toxicity Profile

“…Despite the reported benefits, fundamental questions remain with respect to optimal particle size and type and chemotherapeutic dose for clinical use (3,4). Existing data regarding the use of particles sized 100–300 μm, 300–500 μm, and 500–700 μm show adverse event (AE) rates ranging from 10% to 58%, with fewer AEs occurring with the use of smaller particles (4–6). The introduction of a new class of DEBs with a nominal bead size of 70–150 μm (LC/DC Bead M1 ; Biocompatibles UK Ltd, Farnham, Surrey, United Kingdom) has increased the options for therapeutic drug delivery and raised the issue of how these smallest DEBs can be best incorporated into clinical practice.…”

Histologically-Proven Efficacy of Bland Embolization in a Patient with Net Liver Metastasis

“…However, recent literature [7,8] has highlighted the high risk of biliary injury and liver necrosis. Our specimens revealed only a very small quantity of microspheres distributed in some portal spaces of residual liver parenchyma without necrosis.…”