Ischemic complications of transcatheter arterial chemoembolization in liver malignancies

Abstract

Objective: To determine the frequency, character, methods of treatment, and outcome of ischemic complications after transcatheter hepatic artery chemoembolization (TACE). Material and Methods: Between 1985 and 1998, 827 sessions of TACE with Doxorubicin mixed with iodized oil, and gelatin sponge particles were performed in 282 patients with primary and metastatic liver cancer. Post-TACE monitoring included clinical observation, US and CT. Results: Ischemic complications appeared in 13 (4.6%) and included the following: hepatic (n=6) and splenic abscess (n=1), cholecystitis (n=3), and bile duct necrosis (n=3). The treatment was US-guided drainage in 12 cases and systemic antibacterial therapy in 1. No negative influence of these complications on survival of patients was detected. Conclusion: Serious ischemic complications of TACE occur in about 5% of patients and can be successfully managed without open surgery. These complications do not worsen the survival of patients.