Ischemic complications of transcatheter arterial chemoembolization in liver malignancies

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 tvas 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.