title: Repeated bland-TAE using small microspheres injected via an implantable port-catheter system for liver metastases: an initial experience.
abstract: OBJECTIVE
  The purpose of this pilot study was to assess the effectiveness of repeated bland-TAE using small-size microspheres for liver metastases. To date, there have been no publications as to whether bland-TAE could be effective for nonhypervascular liver tumors.
  
  
  METHODS
  Bland-TAE with 100-μm, calibrated microspheres was performed in two chemoresistant patients: one with colorectal metastases and the other with gastric metastases. Both patients had multiple tumors in the entire liver. An implantable port-catheter system was placed in the hepatic artery to conduct repeated embolizations, thereby achieving enough efficacies. Microspheres were injected via the port until the disappearance of the tumor stains. Angiographies via the port were conducted 1, 3, 7, and 14 days after bland-TAE to evaluate the patency of the hepatic artery.
  
  
  RESULTS
  The hepatic artery started to recanalize 1 day after TAE and tumor stains appeared again during the 14 days. In both patients, bland-TAE was repeated four times in intervals of 14-21 days. The enhanced CTs showed necrotic changes and the decrease in size of the tumors. The serum CEA level decreased from 2,989 to 70 ng/ml and from 174 to 48 ng/ml, respectively. Bilomas and a liver abscess developed as complications.
  
  
  CONCLUSIONS
  Repeated bland-TAE using 100-μm microspheres injected via an implantable port-catheter system could be effective for liver metastases, although the caution of biliary injury is needed.
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan, toshihir@bf6.so-net.ne.jp.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nishiofuku
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Maeda
authors.forename: Testuya
authors.initials: T
authors.lastname: Masada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Anai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
mesh_terms: D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010865:Pilot Projects; D015641:Radiography, Interventional; D012494:Sampling Studies; D016896:Treatment Outcome; D062666:Vascular Access Devices