Transaerterial Chemoembolization Flashcards
aka TACE
places chemotherapy and synthetic materials called embolic agents into a blood vessel feeding a cancerous tumor to cut off the tumor
‘
s blood supply and trap the
chemotherapy within the tumor.
most often used to treat liver cancer but may
also be used in patients whose cancer has
spread to other areas of the body
Chemoembolization may be used as a
standalone treatment or in combination with
surgery, ablation, chemotherapy, or radiation
therapy
TRANSARTERIAL
CHEMOEMBOLIZATION
Anatomy & Their Functions
Hepatic Ducts - drains bile
from both lobes
Hepatic Portal Vein - carries
blood to the liver from the
intestines, spleen, pancreas,
and gallbladder
Hepatic Artery - delivers
oxygenated blood
Spleen - controls the level of
white blood cells, red blood
cells and platelets
Gallbladder - stores and
concentrates bile from the liver
Cystic Duct - carries bile from
the gall bladder
Common bile duct - carries
bile from the liver and gallbladder,
through the pancreas, and into the small intestine
Clinical Indications
Unresectable hepatocellular
carcinoma
Selective Metastatic disease
Cholangiocarcinoma
decreasing liver function
patient’s daily activity
performance capabilities
lack of microvascular invasion
limited extrahepatic disease
isolated or hepatic dominant
metastatic deposits
Approach of Tace
TRANS-FEMORAL ROUTE
(Hepatic Artery Approach)
The hepatic artery and the portal vein, two separate blood vessels that supply the liver, make it distinct from other organs.
Only 25% of the blood that the normal liver receives is through the hepatic artery and 75% is through the portal vein.
When a tumor develops in the liver, the hepatic artery provides practically all of its blood supply.
Devices/Equipment Used
Begins with a superior mesenteric
artery & celiac axis arteriogram
Cannulation of hepatic artery using 5F
celiac catheter & 0.035’ J-tip Terumo
guidewire
Chemotherapy drug (doxorubicin 50
mg, cisplatin 100 mg, 10 ml iodinated
non-ionic CM, 20 ml liopodol; this
amount of emulsion is ideal for lesions
larger than 5 cm
Complications
Generalized abdominal discomfort
Low-grade fever
Nausea
Malaise
Hepatic Insufficiency
Abscess
Biliary necrosis
Tumor rupture
Cholecystitis
