Analysis of rare and severe complications of transcatheter arterial chemoembolization for primary hepatic carcinoma

GUOYong-tuan; ZHU Xiao-li; TANG Jie; ZOU Jian-wei; JIN Yong-hai; LIUYi-zhi; NI Cai-fang

Abstract：Objective To analyze the factors that result in rare and severe complications after transcatheter arterial che-moembolization (TACE) for primary hepatic carcinoma (PHC) ,thus to reduce the occurrence rate of these kind of compli-cations .Methods A retrospective study of a consecutive group of 351 patients with PHC who underwent TACE proce-dures was performed from January 2010 to October 2013 .Imaging and clinical records of rare and severe complications were reviewed to find possible causes and underlying factors in order to find the preventive methods which can reduce the occurrence rate .Results 3 patients had spontaneous hepatic rupture after TACE procedures ,one was cured after conser-vative management ,two was died of hemorrhagic shock .Two patients got liver abscess ,one was cured after adequate drainage and anti-infective therapy ,another was died of septic shock .One patient experienced esophageal and gastric vari-ces bleeding and recovered after 11 days symptomatic treatment .One patients experienced acute cholecystitis and was cured after symptomatic treatment .Three patients were died of cerebral lipiodol embolism ,pulmonary oil embolism and delay femoral artery bleeding respectively .Conclusion Severe complications of TACE for PHC are rare in clinic ,but can result in serious injury even death to patients .Thus ,strictly following the guideline of diagnosis and treatment of PHC , cautious selection the indications ,reasonable control the dose of chemotherapeutics and the embolic degree ,and focus on the dispose of perioperative period are important measures to reduce occurrence rate of these kinds of complications .