title: The incidence and outcome of major complication following conventional TAE/TACE for hepatocellular carcinoma.
abstract: To investigate the incidence and outcome of major complication following conventional transarterial embolization/chemoembolization (TAE/TACE) therapy for hepatocellular carcinoma (HCC).From May 2010 to May 2016, all patients with major complication following conventional TAE/TACE for HCC were included. Major complication was defined as admission to a hospital for therapy, an unplanned increase in the level of care, prolonged hospitalization, permanent adverse sequelae, or death after conventional TAE/TACE therapy by Society of Interventional Radiology.During the study period, a total of 2863 TAE/TACE procedures were performed among 1120 patients, and a total of 24 patients (21 male and 3 female) developed major complication with the incidence of 2.1% (24/1120) per patient and 0.84% (24/2863) per TAE/TACE procedure. The major complications were liver rupture (n = 6), liver abscess (n = 5), femoral artery pseudoaneurysm (n = 3), cholecystitis (n = 2), biloma (n = 2), pulmonary embolism (n = 2), and 1 each of the following: cerebral lipiodol embolism, tumor lysis syndrome, partial intestinal obstruction, gallbladder perforation. The mean interval from last TAE/TACE procedure to the diagnosis of major complication was 11.1 ± 7.7 days. The treatments of the complications were conservative treatment (n = 12), conservative treatment plus percutaneous drainage (n = 3), ultrasound-guided thrombin injection (n = 3), conservative treatment plus TAE (n = 2), and conservative treatment plus surgery (n = 2). Of the 24 patients, 20 patients were recovered, and remaining 4 patients were died of major complications; therefore, the mortality rate of major complication was 16.7% (4/24).Major complication following conventional TAE/TACE therapy is uncommon; the outcomes are benign of most major complications, but some are mortality.
authors.affiliation: Department of Radiology and Interventional Radiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Department of Interventional Radiology, The Second People's Hospital of Changzhou, Nanjing Medical University, Changzhou, China.
authors.forename: Jianfei
authors.initials: J
authors.lastname: Tu
authors.forename: Zhongzhi
authors.initials: Z
authors.lastname: Jia
authors.forename: Xihui
authors.initials: X
authors.lastname: Ying
authors.forename: Dengke
authors.initials: D
authors.lastname: Zhang
authors.forename: Shaoqin
authors.initials: S
authors.lastname: Li
authors.forename: Feng
authors.initials: F
authors.lastname: Tian
authors.forename: Guomin
authors.initials: G
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000209:etiology / Q000503:physiopathology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000009:adverse effects* / Q000379:methods; D007902:Length of Stay; D008099:Liver / Q000293:injuries*; D008100:Liver Abscess / Q000209:etiology / Q000503:physiopathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011655:Pulmonary Embolism / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012422:Rupture, Spontaneous / Q000209:etiology / Q000503:physiopathology; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult