Microwave ablation for hepatocellular carcinoma associated with Budd-Chiari syndrome after transarterial chemoembolization: an analysis of ten cases.
To evaluate the feasibility, efficacy, and safety of microwave ablation (MWA) in the treatment of hepatocellular carcinoma associated with Budd-Chiari syndrome (BCS) after transarterial chemoembolization (TACE).



A total of 10 patients (mean 50.0 ± 7.5 years) with 15 BCS-associated HCC lesions were retrospectively evaluated. All patients received MWA treatment for residual tumors after 1 to 3 sessions of TACE. The diagnosis of residual tumors was confirmed by at least two types of enhanced imaging. CEUS images were performed to confirm the residual lesions and guide the placement of antenna before MWA. Thermal monitoring and artificial pleural effusion or ascites were used to guarantee ablative accuracy and safety for patients with tumors adjacent to vital structures. Technical success, technique efficacy, local tumor progression, survival rate, and the incidence of complications were comprehensively analyzed.



Technical success and technique effectiveness were achieved in all patients. Thirteen lesions achieved complete ablation for the first time, and 2 lesions needed two sessions. Thermal monitoring was used in 2 patients, artificial pleural effusion was used in 1 patient, and artificial ascites in 2 patients. In a median follow-up of 34.5 months (range 21-52 months), no LTP was founded in all patients. Intrahepatic recurrence was found in 5 patients. 1-, 2-, 3-, and 4-year survival rates were 100%, 100%, 74.1%, and 37.0%, respectively. No major or minor complications were observed.



Microwave ablation is a feasible and effective way to treat residual tumors after TACE treatment in patients with BCS-associated HCC.
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
Jian-Ping
JP
Dou
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
Jie
J
Yu
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
Zhi-Yu
ZY
Han
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
Fang-Yi
FY
Liu
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
Zhi-Gang
ZG
Cheng
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. liangping301@126.com.
Ping
P
Liang
D006502:Budd-Chiari Syndrome / Q000150:complications* / Q000000981:diagnostic imaging*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media; D003952:Diagnostic Imaging; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D018365:Neoplasm, Residual; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D003287:Contrast Media
Budd–Chiari syndrome; Hepatocellular carcinoma; Microwave ablation