title: Clinical usefulness of the triaxial system in super-selective transcatheter arterial chemoembolization for hepatocellular carcinoma.
abstract: BACKGROUND
  Transcatheter arterial chemoembolization (TACE) has been widely performed for inoperable hepatocellular carcinoma (HCC). Super-selective TACE is preferable to non-selective therapy and it is important to advance the catheter tip as close to the tumor as possible in the feeding artery. A new microcatheter with a 1.9-Fr non-tapered tip has recently become available and this new microcatheter can be inserted into a 2.7-Fr. microcatheter. It is called the triple co-axial (triaxial) system.
  
  
  OBJECTIVE
  To evaluate the clinical usefulness of super-selective TACE for HCC using the triaxial system.
  
  
  METHODS
  We evaluated 63 HCCs that underwent super-selective TACE. Requirements for inclusion in this study were: (a) HCCs 3 cm or less in diameter; (b) TACE performed by a single operator; and (c) no additional treatment in the absence of local progression. All patients were followed for more than 1 year after TACE. The median follow-up period for surviving patients was 20 months (range, 17-31 months). The conventional system was used in 35 HCCs (control group), and the triaxial system was used in 28 (triaxial group). We reviewed angiographies at TACE and follow-up CT, and then evaluated local tumor status in the two groups.
  
  
  RESULTS
  Local tumor control rates at 3, 6, and 18 months were 64%, 36%, and 29%, respectively, in the triaxial group, and 40%, 14%, and 8.6%, respectively, in the control group (P = 0.0086). There were no major complications in either group.
  
  
  CONCLUSIONS
  The triaxial system appears to be useful for super-selective TACE and may contribute to achieving higher local control rates for HCC.
authors: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. mshimohira@gmail.com
authors: Masashi
authors: M
authors: Shimohira
authors: Hiroyuki
authors: H
authors: Ogino
authors: Tatsuya
authors: T
authors: Kawai
authors: Keita
authors: K
authors: Sakurai
authors: Motoo
authors: M
authors: Nakagawa
authors: Yuta
authors: Y
authors: Shibamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D005334:Fever / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D016896:Treatment Outcome