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Radiology, Vol 198, 33-40, Copyright © 1996 by Radiological Society of North America


ARTICLES

Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization

JW Chung, JH Park, JK Han, BI Choi, MC Han, HS Lee and CY Kim
Department of Radiology, Seoul National University College of Medicine, Korea.

PURPOSE: To elucidate major complications and their predisposing factors in transcatheter oily chemoembolization (TOCE) for hepatic tumors. MATERIALS AND METHODS: In a retrospective study of 351 patients (aged 26-82 years) with hepatic tumors, TOCE was performed 942 times with an emulsion of iodized oil (3-40 mL) and doxorubicin hydrochloride (20-60 mg). In 126 patients, TOCE was followed by absorbable gelatin sponge embolization. RESULTS: Complications were severe postembolization syndrome (n = 53); hepatic insufficiency (n = 20), infarction (n = 1), or abscess (n = 1); intrahepatic biloma formation (n = 3); tumor rupture (n = 3); septicemia (n = 9); coagulopathy (n = 1); gastrointestinal bleeding (n = 10); gallbladder (n = 5) or splenic infarction (n = 4); pulmonary oil embolism (n = 6); and spinal cord injury (n = 1). Important predisposing factors were major portal vein obstruction, compromised hepatic functional reserve, biliary obstruction, previous biliary surgery, excessive amount (> 20 mL) of iodized oil, hepatic arterial occlusion after repeated TOCE, and nonselective embolization. CONCLUSION: Most patients with major complications after TOCE had preexisting risk factors.


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