title: Transcatheter arterial chemoembolization for hepatocellular carcinoma in cirrhosis: influence on portal hypertension.
abstract: BACKGROUND
  Transcatheter arterial chemoembolization (TACE) is a routine treatment for hepatocellular carcinoma in cirrhotic patients. Whether TACE influences the degree of portal hypertension remains uncertain. AIM AND PATIENTS: We retrospectively analyzed the clinical course of 283 TACE to investigate the incidence of variceal bleeding and ascites after the procedure. We also prospectively evaluated portal pressure by hepatic venous portal gradient (HVPG) before and within 3 days by TACE in a group of 15 patients.
  
  
  RESULTS
  Before TACE, esophageal varices were present in 125 patients. Variceal bleeding occurred in three (1.5%) and ascites in two (1%) patients during the follow-up post-TACE. Patients with variceal bleeding were significantly older (P=0.019). In 15 patients who underwent portal pressure measurement before and within 3 days by TACE, HVPG was unchanged (mean 13.1 vs. 12.8 mmHg, P>0.05).
  
  
  CONCLUSIONS
  In our series portal hypertension-related complications after TACE were rare and did not result in higher mortality. As TACE did not influence HVPG, the preventive ligation of esophageal varices before TACE does not seem justified.
authors.affiliation: Department of Gastrohepatology, San Giovanni Battista Hospital, Corso Bramante 88, Turin, Italy. eliachiara@gmail.com
authors.forename: Chiara
authors.initials: C
authors.lastname: Elia
authors.forename: Wilma Debernardi
authors.initials: WD
authors.lastname: Venon
authors.forename: Davide
authors.initials: D
authors.lastname: Stradella
authors.forename: Silvia
authors.initials: S
authors.lastname: Martini
authors.forename: Franco
authors.initials: F
authors.lastname: Brunello
authors.forename: Alfredo
authors.initials: A
authors.lastname: Marzano
authors.forename: Giorgio
authors.initials: G
authors.lastname: Saracco
authors.forename: Mario
authors.initials: M
authors.lastname: Rizzetto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D004932:Esophageal and Gastric Varices / Q000139:chemically induced; D004998:Ethiodized Oil / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000139:chemically induced*; D008103:Liver Cirrhosis / Q000188:drug therapy*; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000970:Antineoplastic Agents; D004998:Ethiodized Oil; D004317:Doxorubicin; D002945:Cisplatin