Superselective Conventional Transarterial Chemoembolization for Hepatocellular Carcinoma: Rationale, Technique, and Outcome

Chemoembolization related to good survival for selected patients with hepatocellular carcinoma invading segmental portal vein

“…Further to this, the major complication rate after TACE was 5.4% in our present series, rather lower than the 10% expected in patients with HCC without PVTT . With the development of the better techniques and devices, TACE can now be performed safely even in high‐risk patients, using superselective or ultraselective approaches . However, we found that the extent of the tumour and the patient's performance status (ECOG) were significantly related to the occurrence of major complications.…”

“…The dose of iodized oil depended on the tumour size and was 3‐20 mL. The emulsion of iodized oil and cisplatin was slowly injected until the accumulation of the emulsion in the tumour and the visualization of the PV branches near the tumour . If there was a significant arterioportal shunt, embolization with a Gelfoam slurry was first performed to occlude the shunt, after which the iodized oil/cisplatin emulsion was infused and embolization with a Gelfoam slurry was performed …”

New intermediate‐stage subclassification for patients with hepatocellular carcinoma treated with transarterial chemoembolization

“…With the development of the TACE technique and devices related to TACE (especially, sophisticated microcatheters with a very small diameter), the incidence of TACE‐related mortality has tended to decrease yearly . TACE can now be performed safely and effectively even in patients with a poor underlying functional reserve, by using superselective or ultraselective techniques . Thus, we believe that decompensated patients with Child B liver function with minor tumour burden should be grouped separately from decompensated patients with Child B with major tumour burden when the BCLC B stage is subclassified in the patient population treated with TACE.…”

Evaluation of transarterial chemoembolization refractoriness in patients with hepatocellular carcinoma

“…The emulsion of iodized oil and cisplatin or adriamycin was slowly injected until the accumulation of the emulsion in the tumor and the visualization of the portal vein branches near the tumor. [12][13][14][15] If there was a significant arterioportal shunt, embolization with a Gelfoam slurry was first performed to occlude the shunt, after which the iodized oil/ cisplatin or adriamycin emulsion was infused and embolization with a Gelfoam slurry was performed. [12][13][14] This embolization was performed to minimize the ischemic toxicity of the non-targeted normal liver parenchyma and to minimize vascular complications due to the repeated endovascular procedures.…”