title: Adverse effects of irreversible electroporation of malignant liver tumors under CT fluoroscopic guidance: a single-center experience.
abstract: OBJECTIVE
  We aimed to describe the frequency of adverse events after computed tomography (CT) fluoroscopy-guided irreversible electroporation (IRE) of malignant hepatic tumors and their risk factors.
  
  
  METHODS
  We retrospectively analyzed 85 IRE ablation procedures of 114 malignant liver tumors (52 primary and 62 secondary) not suitable for resection or thermal ablation in 56 patients (42 men and 14 women; median age, 61 years) with regard to mortality and treatment-related complications. Complications were evaluated according to the standardized grading system of the Society of Interventional Radiology. Factors influencing the occurrence of major and minor complications were investigated.
  
  
  RESULTS
  No IRE-related death occurred. Major complications occurred in 7.1% of IRE procedures (6/85), while minor complications occurred in 18.8% (16/85). The most frequent major complication was postablative abscess (4.7%, 4/85) which affected patients with bilioenteric anastomosis significantly more often than patients without this condition (43% vs. 1.3%, P = 0.010). Bilioenteric anastomosis was additionally identified as a risk factor for major complications in general (P = 0.002). Minor complications mainly consisted of hemorrhage and portal vein branch thrombosis.
  
  
  CONCLUSIONS
  The current study suggests that CT fluoroscopy-guided IRE ablation of malignant liver tumors may be a relatively low-risk procedure. However, patients with bilioenteric anastomosis seem to have an increased risk of postablative abscess formation.
authors.affiliation: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany. marco.dollinger@ukr.de.
authors.forename: Marco
authors.initials: M
authors.lastname: Dollinger
authors.forename: Lukas Philipp
authors.initials: LP
authors.lastname: Beyer
authors.forename: Michael
authors.initials: M
authors.lastname: Haimerl
authors.forename: Christoph
authors.initials: C
authors.lastname: Niessen
authors.forename: Ernst Michael
authors.initials: EM
authors.lastname: Jung
authors.forename: Florian
authors.initials: F
authors.lastname: Zeman
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: Philipp
authors.initials: P
authors.lastname: Wiggermann
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects* / Q000379:methods; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D018274:Electroporation / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult