Superselective transcatheter arterial embolization with ethanol and iodized oil for hepatocellular carcinoma.
OBJECTIVE
The effectiveness of superselective transcatheter arterial embolization with a mixture of ethanol and iodized oil was evaluated for hepatocellular carcinoma.


METHODS
The procedure was attempted in 14 male patients with hepatocellular carcinoma. The tumor was a single small (2-5 cm in diameter) hypervascular nodule in all patients, except in one patient with two nodules. Superselective catheterization was performed with use of coaxial technique into the third-order branch of the feeding hepatic artery. Under fluoroscopy, 1-4 mL of 75% ethanol mixed with iodized oil was infused.


RESULTS
Complete segmental or subsegmental devascularization of the feeding arteries and tumor vascularities occurred in all patients. Follow-up CT or angiography after 9-37 months revealed decrease of tumor in six of nine nonsurgical cases. Subsequent segmentectomy or tumorectomy in five patients revealed total or near-total necrosis of the tumor and thickening of capsules, explaining the halo seen around the tumor on CT scans and the relatively intact surrounding parenchyma seen microscopically.


CONCLUSIONS
Superselective transcatheter arterial embolization with ethanol and iodized oil is a safe method for treatment of small nodular hepatocellular carcinoma with a prominent feeding artery.
Department of Radiology, Seoul National University Hospital, Chongno-Gu, Korea.
J H
JH
Park
J K
JK
Han
J W
JW
Chung
B I
BI
Choi
M C
MC
Han
Y I
YI
Kim
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods; D000431:Ethanol / Q000008:administration & dosage*; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional
D000431:Ethanol; D007459:Iodized Oil