PURPOSE: The effectiveness of superselective transcatheter arterial embolization with a mixture of ethanol and iodized oil was evaluated for hepatocellular carcinoma. PATIENTS AND METHODS: The procedure was attempted in 14 male patients with hepatocellular carcinoma. The tumor was a single small (2-5 cm in diameter) hypervascular nodule in all patients, except in one patient with two nodules. Superselective catheterization was performed with use of coaxial technique into the third-order branch of the feeding hepatic artery. Under fluoroscopy, 1-4 mL of 75% ethanol mixed with iodized oil was infused. RESULTS: Complete segmental or subsegmental devascularization of the feeding arteries and tumor vascularities occurred in all patients. Follow-up CT or angiography after 9-37 months revealed decrease of tumor in six of nine nonsurgical cases. Subsequent segmentectomy or tumorectomy in five patients revealed total or near-total necrosis of the tumor and thickening of capsules, explaining the halo seen around the tumor on CT scans and the relatively intact surrounding parenchyma seen microscopically. CONCLUSION: Superselective transcatheter arterial embolization with ethanol and iodized oil is a safe method for treatment of small nodular hepatocellular carcinoma with a prominent feeding artery.
PURPOSE: The effectiveness of superselective transcatheter arterial embolization with a mixture of ethanol and iodized oil was evaluated for hepatocellular carcinoma. PATIENTS AND METHODS: The procedure was attempted in 14 male patients with hepatocellular carcinoma. The tumor was a single small (2-5 cm in diameter) hypervascular nodule in all patients, except in one patient with two nodules. Superselective catheterization was performed with use of coaxial technique into the third-order branch of the feeding hepatic artery. Under fluoroscopy, 1-4 mL of 75% ethanol mixed with iodized oil was infused. RESULTS: Complete segmental or subsegmental devascularization of the feeding arteries and tumor vascularities occurred in all patients. Follow-up CT or angiography after 9-37 months revealed decrease of tumor in six of nine nonsurgical cases. Subsequent segmentectomy or tumorectomy in five patients revealed total or near-total necrosis of the tumor and thickening of capsules, explaining the halo seen around the tumor on CT scans and the relatively intact surrounding parenchyma seen microscopically. CONCLUSION: Superselective transcatheter arterial embolization with ethanol and iodized oil is a safe method for treatment of small nodular hepatocellular carcinoma with a prominent feeding artery.