Complications of Hepatic Chemoembolization

Clark, Timothy W.I.

doi:10.1055/s-2006-941442

Cited by 130 publications

(106 citation statements)

References 31 publications

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“…The incidence of major complications is described in the literature as 2% to 7% 5,8 and the risk of death is approximately 1%. 8 We had one death among all the procedures (563), which corresponds to a mortality rate of 0.18%. It occurred in a patient who developed hepatic and perihepatic abscesses and sepsis after the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…6 It is thought to result from therapeutic cytotoxity, tumor ischemia and resulting intrahepatic and extrahepatic inflammation 7 and is manifested by fever, malaise, right upper quadrant pain, nausea and vomiting. 8 Its reported incidences vary widely in the literature and it has been described in as many as 60%-80% of patients. 6,9 The symptoms usually develop 24 -72 hours after the procedure and PES is generally self-limited and can be treated conservatively.…”

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Risk Factors for the Development of Postembolization Syndrome after Transarterial Chemoembolization for Hepatocellular Carcinoma Treatment

et al. 2018

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RESUMOIntrodução: A quimioembolização hepática é uma técnica amplamente usada para o tratamento do carcinoma hepatocelular. A principal complicação deste procedimento é a síndrome pós-quimioembolização. O principal objetivo deste estudo foi determinar fatores de risco para síndrome pós-quimioembolização. Material e Métodos: Análise retrospetiva unicêntrica de 563 procedimentos de quimioembolização hepática efetuados entre 1/1/2014-31/12/2015. A quimioembolização hepática foi efetuada com ½ -2 ampolas de microesferas 100 -300 μm carregadas com doxorrubicina. Os pacientes que desenvolveram síndrome pós-quimioembolização foram identificados pelo prolongamento do internamento por dor, febre, náuseas e/ou vómitos. Um grupo controlo com os pacientes que não desenvolveram síndrome pós-quimioembolização foi criado de forma randomizada (três controlos para um caso). Foi realizada análise descritiva e regressão logística multivariada. Resultados: A prevalência global de síndrome pós-quimioembolização foi 6,2%. Quimioembolização hepática com dose de doxorrubicina superior a 75 mg (mais de uma ampola), o tamanho do nódulo maior e o género feminino demonstraram relação estatisticamente significativa com o desenvolvimento de síndrome pós-quimioembolização (p = 0,030, p = 0,046 e p = 0,037, respetivamente , 2015. Hepatic transarterial chemoembolization was performed with ½ -2 vials of 100 -300 μm microspheres loaded with doxorubicin. Patients who experienced postembolization syndrome were identified based on prolongation of hospitalization due to pain, fever, nausea and/or vomiting. A control group with the patients who did not have postembolization syndrome was randomly created (three controls for one case). Descriptive analysis and multivariate logistic regression were performed. Results: The overall prevalence of postembolization syndrome was 6.2%. Hepatic transarterial chemoembolization with doxorubicin dosage above 75 mg (more than one vial), the size of the largest nodule and female gender had statistically significant relation with development of postembolization syndrome (p = 0.030, p = 0.046 and p = 0.037, respectively). Discussion: Doxorrubicin dosage above 75 mg is associated with a higher risk of postembolization syndrome. This result can be helpful for decision-making in clinical practice, whenever it is possible to avoid a higher dose without compromising the efficacy of the treatment. The size of the largest nodule and female gender also constitute risk factors for postembolization syndrome. The other variables studied were not related to the development of postembolization syndrome. Conclusion:The dose of doxorrubicin, the size of the largest nodule treated and female gender are potential risk factors for the development of postembolization syndrome after hepatic transarterial chemoembolization for hepatocellular carcinoma.

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Section: Discussionmentioning

confidence: 99%

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Risk Factors for the Development of Postembolization Syndrome after Transarterial Chemoembolization for Hepatocellular Carcinoma Treatment

et al. 2018

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“…However, since the contrast material is injected with the beads, there have been reports of a slightly increased density on post-procedure non-contrast CT performed within 12 h of the procedure that may allow assessment of the injection accuracy in relation to the lesion (Golowa et al 2012 ). After the procedure, most patients (90 %) suffer from a post-embolization syndrome, which is diagnosed clinically (Clark 2006 ). It is a combination of fatigue, abdominal pain, nausea, vomiting, anorexia, fever, and cachexia.…”

Section: Hepatic Complications Due To Transarterial Chemoembolizationmentioning

confidence: 99%

“…In the hepaticobiliary system, it can be seen in the gallbladder, when Lipiodol is inadvertently injected into the cystic artery and is deposited in the gallbladder wall. In some cases (Clark 2006 ;Wagnetz et al 2010 ), acute ischemic or chemical cholecystitis may develop due to obstruction of the cystic artery by the embolization material. Clinically there is right upper quadrant pain, and radiologically, the fi ndings are similar to those of acalculous cholecystitis (Barie and Eachempati 2010 ), with gallbladder wall edema evident at imaging as wall thickening with a lucent layer in the gallbladder wall, pericholecystic fl uid, pericholecystic fat stranding on CT, and infrequently gallbladder distension.…”

Section: Abbreviationsmentioning

confidence: 99%

Female Pelvis: Genital Organs

Forstner

Cunha²

2015

Imaging of Complications and Toxicity Following Tumor Therapy

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Medical Radiology-Diagnostic Imaging is a unique series that aims to document the most innovative technologies in all fi elds within diagnostic imaging and interventional radiology, thereby informing the physician in practice of the latest advances in diagnostic imaging and percutaneous imageguided minimally invasive procedures. Th e contents are intended to cover all organs, and all modern imaging techniques and image-guided treatment modalities, with special emphasis on applications in clinical practice. Each volume is a comprehensive reference book on a topical theme, and the editors are always experts of high international standing. Contributions are included from both clinicians and researchers, ensuring wide appeal. Medical Radiology -Radiation Oncology is a unique series that aims to document the most innovative technologies in all fi elds within radiology, thereby informing the physician in practice of the latest advances in diagnostic and treatment techniques. Th e contents range from contemporary statements relating to management for various disease sites to explanations of the newest techniques for tumor identifi cation and of mechanisms for the enhancement of radiation eff ects, with the emphasis on maximizing cure and minimizing complications. Each volume is a comprehensive reference book on a topical theme, and the editors are always experts of high international standing. Contributions are included from both clinicians and researchers, ensuring wide appeal. This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. AbstractA precise knowledge of antineoplastic drugs is an indispensable basis for the care of patients with cancer. The mechanisms of action and resistance, cross-resistance patterns, pharmacodynamics and pharmacokinetics, pharmacological interaction, and last but not least potential adverse effects should be part of this knowledge. As contemporary cancer care requires interdisciplinary and multiprofessional structures, the radiologist is an important a...

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“…Less frequently, ischemic liver failure may occur in patients with partial portal vein thrombosis or if TACE has not been selectively performed. [1][2][3][4] Various complications of TACE have been reported, however, acute biliary obstruction due to migration of a tumor fragment after TACE is rare.…”

Section: Introductionmentioning

confidence: 99%

Acute Obstructive Cholangitis Complicated by Tumor Migration after Transarterial Chemoembolization: A Case Report and Literature Review

Park

Chung

et al. 2014

Korean J Gastroenterol

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Intraductal tumor invasion of hepatocellular carcinoma (HCC) is considered rare. Transarterial chemoembolization (TACE) is effective for tumor thrombus of HCC in the bile duct. However, a few cases of obstructive jaundice caused by migration of a tumor fragment after TACE have recently been reported. The aim of this study was to identify factors that affect tumor migration after TACE. At this writing, a review of the medical literature disclosed seven reported cases of biliary obstruction caused by migration of a necrotic tumor cast after TACE. We, herein, report on an additional case of acute obstructive cholangitis complicated by migration of a necrotic tumor cast after TACE for intrabile duct invasion of HCC, in a 71-year-old man. The tumor cast in the common bile duct was removed successfully using a basket during ERCP and was pathologically confirmed to be a completely necrotic fragment of HCC. The patient's symptoms showed dramatic improvement. In summary, physicians should be aware of acute obstructive cholangitis complicated by tumor migration in a patient undergoing TACE. We suggest that an intrabile duct invasion would be a major predisposing factor of tumor migration after TACE and drainage procedures such as ERCP or percutaneous transbiliary drainage could be effective treatment modalities in these patients. (Korean J Gastroenterol 2014;63:171-175)

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Complications of Hepatic Chemoembolization

Cited by 130 publications

References 31 publications

Risk Factors for the Development of Postembolization Syndrome after Transarterial Chemoembolization for Hepatocellular Carcinoma Treatment

Risk Factors for the Development of Postembolization Syndrome after Transarterial Chemoembolization for Hepatocellular Carcinoma Treatment

Female Pelvis: Genital Organs

Acute Obstructive Cholangitis Complicated by Tumor Migration after Transarterial Chemoembolization: A Case Report and Literature Review

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