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.
Department of Radiology, Seoul National University College of Medicine, Korea.
J W
JW
Chung
J H
JH
Park
J K
JK
Han
B I
BI
Choi
M C
MC
Han
H S
HS
Lee
C Y
CY
Kim
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