Chemo-arterial embolization (TACE) is considered an effective treatment in cases of HCC with no indication for radical treatment. In addition to materials for conventional plugging with Lipidol suspension combined with chemicals (Doxorubicin, Farmorubicin, Cisplatin…), there are also chemically attached spherical microparticles (DC bead, Hepasphere…) or by radioactive particles to help better kill tumor cells.
Together with advances in the diagnosis of early-stage tumor lesions, their small size, combined with advances in ultra-selective embolization techniques using small (2F) catheters, have resulted in increased efficiency. treatment outcome of TACE. Currently, with a new generation of angiography machines that can do cone-beam CT (CBCT), it helps a lot in general electro-optical interventions, including chemotherapy liver embolization.
What disease is this technique used for
?
Indications and contraindications
Specify:
Determination of angiogenesis in liver tumors.
Locate the vascular peduncles feeding the liver tumor.
Indications for cone beam dosing (CBCT): on digital subtraction angiography (DSA) no artery feeding the tumor is found or is not clear.
Contraindications:
Relative contraindications: Patient does not hold breath or cooperates poorly.
Coagulation disorders: Need to be corrected before intervention.
Technical advantages and disadvantages
Advantage:
Blocking the artery’s blood supply, preventing the cancer from being nourished. Hepatic embolization can be combined with chemotherapy or radiation therapy.
Watching: What is Tace
Execution Process
The interventional doctor carried out the intervention with the help of the nurse in the intervention room of the imaging department.
The emotionless method:
Local anesthetic.
Pre-anesthesia if needed
Insertion of an intravascular tube into an artery:
Usually right femoral artery.
A needle is inserted and a guide is inserted into the lumen of the artery, bringing the lead up to the aorta.
Withdraw the arterial puncture needle and insert the tube into the lumen following the guide wire.
See also: What is a Register?
To use the cone beam CT technique: usually applied in cases of finding the artery feeding the tumor and evaluating the results of embolization before the end of the intervention process. Depending on the purpose, it is possible to combine with this technique at different stages.
Find the artery that feeds the tumor
Perfusion scan of the liver parenchyma in the area containing the tumor
Angiography of the visceral body, superior mesenteric vessels, and some extrahepatic circulation (if in doubt), then ultraselectively threaded with a small catheter into the artery feeding the tumor and nod it with embolized materials.
The best concentration of Lipiodol in the tumor.
Normal expression after performing the technique
The patient lies on the bed, immobilizes the leg on the side of the puncture for at least 6 hours and monitors for bleeding at the puncture site.
In the case of increased angiogenesis can continue for a second time.
See also: what is rare
Things to keep in mind when doing this technique
Topic: Liver cancer Digestive Hepatobiliary Angioplasty for treatment of liver cancer Arterial chemotherapy
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