Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization.
OBJECTIVE
To elucidate major complications and their predisposing factors in transcatheter oily chemoembolization (TOCE) for hepatic tumors.


METHODS
In a retrospective study of 351 patients (aged 26-82 years) with hepatic tumors, TOCE was performed 942 times with an emulsion of iodized oil (3-40 mL) and doxorubicin hydrochloride (20-60 mg). In 126 patients, TOCE was followed by absorbable gelatin sponge embolization.


RESULTS
Complications were severe postembolization syndrome (n = 53); hepatic insufficiency (n = 20), infarction (n = 1), or abscess (n = 1); intrahepatic biloma formation (n = 3); tumor rupture (n = 3); septicemia (n = 9); coagulopathy (n = 1); gastrointestinal bleeding (n = 10); gallbladder (n = 5) or splenic infarction (n = 4); pulmonary oil embolism (n = 6); and spinal cord injury (n = 1). Important predisposing factors were major portal vein obstruction, compromised hepatic functional reserve, biliary obstruction, previous biliary surgery, excessive amount (> 20 mL) of iodized oil, hepatic arterial occlusion after repeated TOCE, and nonselective embolization.


CONCLUSIONS
Most patients with major complications after TOCE had preexisting risk factors.
Chung
J W
JW
Department of Radiology, Seoul National University College of Medicine, Korea.
Park
J H
JH
Han
J K
JK
Choi
B I
BI
Han
M C
MC
Lee
H S
HS
Kim
C Y
CY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006499:Hepatic Artery; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors
D000903:Antibiotics, Antineoplastic; D007459:Iodized Oil; D004317:Doxorubicin