Severe complications associated with transcatheter hepatic arterial chemoembolization / 介入放射学杂志

ABSTRACT

Transcatheter hepatic arterial chemoembolization (THACE)has been widely used in the treatment of advanced primary hepatic carcinoma (PHC)and metastatic hepatic carcinoma (MHC). Although the incidence of severe complications associated with THACE is unusual (0% ～ 5% ),its prognosis is generally worse and mortality is higher than that of postembolization syndrome.Therefore,to minimize the risk associated with THACE has to be achieved through the understanding of these severe complications related to the selection of indication,the use of chemoembolic agents and manipulation of a cathether or guide wire,etc. In this paper,according to the involved anatomic organs,these severe complications are divided into six categories as follows(1)complications of the liver,including acute hepatic failure,liver infarction (necrosis),liver abcess and liver (or tumor)ruptrure;(2)complications of the celiac artery and its branches,included of iatrogenic dissection,stricture or occlusion,perforation or pseudoaneurysm and multiple intrahepatic aneurysms; (3)complications of intrahepatic biliary system,included of cholecystitis and gallbladder infarction,bile duct necrosis and intrahepatic biloma formation; (4)complications of extrahepatic structures,included of nontarget embolism or infarction of the brain,spinal cord,lung,spleen,gastroduodenum and pancreas; (5)bleeding of upper digestive tract; (6)the orthers. And the incidence,pathogenesis,predisposing factors,clinical and imaging manifestations of these complications are also discussed in detail,it may be of great advantage to its correct diagnosis promptly and appropriate management.