chemoembolization

A technique of injecting substances designed to decrease or stop tumor growth into the arteries that feed a tumor.
Injected substances include chemotherapy medication along with particles that decrease the supply of oxygen and nutrients to the tumor.

It is used to treat primary liver cancer or liver metastases.

Potential accessory arterial supplies to liver tumors:
• Right inferior phrenic artery
• Replaced or accessory left hepatic artery
• Right internal thoracic artery

It is not as effective as surgery, either transplant or partial hepatic resection. It is not considered to be a curative treatment but palliative.
It may downsize one or more tumors to qualify the patient for surgery to cure or provide complete permanent tumor necrosis.

(Procedure)
Gaining percutaneous transarterial access by the Seldinger technique to the hepatic artery with an arterial sheath, usually by puncturing the common femoral artery in the right groin and passing a catheter guided by a wire through the abdominal aorta, through the celiac trunk and common hepatic artery, and finally into the branch of the proper hepatic artery supplying the tumor.

(Adverse effects)
• Pseudoaneurysm at the site of puncture in the femoral artery.
• Allergic reaction to contrast media.
• Symptomatic hypothyroidism due to high retained iodine load of the contrast.
• Ulceration of the gut or cholecystitis in case that embolic agents are introduced into healthy surrounding tissue.