Nontarget Embolization Complicating Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma

ABSTRACT

Nontarget embolization during transarterial chemoembolization, although infrequent, can be a serious complication. The authors describe a case of nontarget gastric embolization to the stomach after transarterial chemoembolization and describe the published incidence of nontarget embolization to various organs, its diagnosis, treatment, and possible outcomes.

KEYWORDS

Chemoembolization - hepatocellular carcinoma

REFERENCES

• 1 Cammà C, Schepis F, Orlando A et al.. Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials.  Radiology. 2002;  224 (1) 47-54
• 2 Brown D B, Fundakowski C E, Lisker-Melman M et al.. Comparison of MELD and Child-Pugh scores to predict survival after chemoembolization for hepatocellular carcinoma.  J Vasc Interv Radiol. 2004;  15 (11) 1209-1218
• 3 Gates J, Hartnell G G, Stuart K E, Clouse M E. Chemoembolization of hepatic neoplasms: safety, complications, and when to worry.  Radiographics. 1999;  19 (2) 399-414
• 4 López-Benítez R, Radeleff B A, Barragán-Campos H M et al.. Acute pancreatitis after embolization of liver tumors: frequency and associated risk factors.  Pancreatology. 2007;  7 (1) 53-62
• 5 Su Y C, Chen L T, Jan C M et al.. Reappraisal of gastroduodenal lesions after transcatheter arterial chemoembolization of liver neoplasms—selective versus superselective method.  J Clin Gastroenterol. 1994;  18 (2) 118-121
• 6 Hirakawa M, Iida M, Aoyagi K, Matsui T, Akagi K, Fujishima M. Gastroduodenal lesions after transcatheter arterial chemo-embolization in patients with hepatocellular carcinoma.  Am J Gastroenterol. 1988;  83 (8) 837-840
• 7 Morante A, Romano M, Cuomo A et al.. Massive gastric ulceration after transarterial chemoembolization for hepatocellular carcinoma.  Gastrointest Endosc. 2006;  63 (4) 718-720
• 8 Toyoda H, Fukuda Y, Nakano I et al.. Massive bleeding from a gastric erosion after transcatheter arterial chemoembolization for hepatocellular carcinoma in a patient with mild haemophilia A.  Haemophilia. 2000;  6 (6) 688-692
• 9 Liu D M, Salem R, Bui J T et al.. Angiographic considerations in patients undergoing liver-directed therapy.  J Vasc Interv Radiol. 2005;  16 (7) 911-935
• 10 Song S Y, Chung J W, Lim H G, Park J H. Nonhepatic arteries originating from the hepatic arteries: angiographic analysis in 250 patients.  J Vasc Interv Radiol. 2006;  17 (3) 461-469
• 11 British Society of Gastroenterology Endoscopy Committee . Non-variceal upper gastrointestinal haemorrhage: guidelines.  Gut. 2002;  51 (Suppl 4) iv1-iv6
• 12 Leontiadis G I, Sharma V K, Howden C W. Proton pump inhibitor treatment for acute peptic ulcer bleeding.  Cochrane Database Syst Rev. 2006;  (1) CD002094