Safety and feasibility of outpatient transcatheter hepatic arterial embolization for hepatocellular carcinoma.
OBJECTIVE
To evaluate the feasibility and safety of performing image-guided bland embolization and chemoembolization as an outpatient-based procedure in selected patients with hepatocellular carcinoma (HCC).


METHODS
This is a retrospective review of the authors' experience with outpatient embolization and chemoembolization from January 2005 to June 2006. Patients with nonresectable HCC not eligible for liver transplantation were enrolled. Patients with Child-Pugh class A and early class B liver disease were treated by using the outpatient protocol, patients with Child-Pugh class C and late class B liver disease and those with elevated bilirubin or creatinine levels were excluded and treated as inpatients or denied embolization therapy. One hundred thirty-three bland embolizations or chemoembolizations were performed in 77 patients on an outpatient basis during the study period.


RESULTS
Patients were discharged home on the same day after 131 of the 133 procedures (99%; 95% confidence interval [CI]: +/-2%), in two cases (2%, 95% CI: +/-2%), patients were admitted the day of the procedure. In two of the 131 cases (2%, 95% CI: +/-2%), patients discharged home returned to the emergency department 1-6 days after the procedure. One hundred twenty-nine of the 133 cases (97%, 95% CI: +/-3%) were successfully treated by using the outpatient embolization or chemoembolization protocol, with subsequent hospitalization needed in only four of 133 cases (3%, 95% CI: +/-3%).


CONCLUSIONS
Image-guided hepatic bland embolization and chemoembolization performed with an outpatient protocol in carefully selected patients with HCC with aggressive follow-up is safe, with relatively few complications and few requirements for admission or revisitation to the emergency department.
Mitchell
Jason W
JW
Department of Radiology, University Hospital, UMDNJ-New Jersey Medical School, 150 Bergen St, Ste C-318, Newark, NJ 07103, USA.
O'Connell
William G
WG
Kisza
Piotr
P
Klyde
David P
DP
Gonzalez
Sharon F
SF
Maldjian
Pierre
P
Bahramipour
Philip
P
Contractor
Sohail G
SG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects / Q000379:methods; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D016896:Treatment Outcome