Experience of Using Microcatheter in Transcatheter Arterial Chemoembolization Therapy (TACE) for Hepatocellular Carcinoma

The purposes of this study were: 1. To evaluate therapeutic results of transcatheter hepatic arterial chemoembolization (TACE) using a microcatheter against hepatocellular carcinoma (HCC). 2. To describe the experience and technique of using a microcatheter. 3. To analyze the causes of difficult catheterization of tumor-feeding arteries and the indications for using a microcatheter. TACE with microcatheter was performed in 20 patients with HCC accompanied by difficult catheterization of tumor-feeding arteries. Emulsions of Lipiodol and an anticancer agent, an antibiotic, and Gelfoam particles were used as embolic materials. Change in tumor size was evaluated by CT scan, sonography, and angiography. Survival times, patient conditions, and changes in serum alphafetoprotein (AFP) were evaluated. The reasons for using a microcatheter were analyzed. Reduction of more than 50% in tumor size occurred in 8 patients, from 25% to 50% in one, less than 25% in 3, and no change in 8 patients. Reduction of serum AFP was noted in 80% of patients. The indications for using a microcatheter include: atherosclerotic change and rigid vessel in 9 patients, tortuous vessel in 11 patients, stenotic or small vessel in 10 patients, vessel compressed and displaced by large tumor in 5 patients, acute vessel angle in 4 patients, elongated celiac trunk in 5 cases, vasospasm in 3 cases, and iatrogenic intimal injury in 1 case. Transcatheter arterial chemoembolization therapy with a microcatheter was proven to be a useful treatment for hepatocellular carcinoma accompanied by difficult catheterization of tumor-feeding arteries.