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Hepatic artery embolization

General

The cells of the liver receive blood partly from the hepatic artery and partly from the hepatic portal vein. The cancer cells receive blood mainly from the hepatic artery. By embolizing the arteries to the tumor with small particles, it is possible to stop blood supply to the tumor tissue. By doing this, all or parts of the tumor becomes necrotic  . The normal cells in the area survive since they also receive blood from the hepatic portal vein. This treatment is appropriate if there are many large metastases in the liver. Generally, only one liver flap is embolized at a time. 

Liver embolization is also used for patients without serious symptomology since the procedure can be repeated, but the effect diminishes with repeated embolizations of the same lobe. This is mainly due colateral formation of arteries making effective embolization of arterial supply difficult for later procedures. 

The procedure is carried out by an interventional radiologist.

The treatment may be appropriate at an early stage to reduce tumor size, or later when liver metastases increase in size despite treatment. The treatment often relieves symptoms, especially for those with hormonal symptoms such as flushing and diarrhea. A life-prolonging effect can also be attained with this treatment.


Indications

  • Multiple liver metastases
  • Symptom-causing disease despite other treatment

Contraindications

Absolute:

  • Central port vein thrombosis

Relative:

  • Poor general health status
  • Enterobiliar anastomosis (increased risk for infection)
  • Little remaining liver parenchyme (risk of hepatic failure)

Goal

  • Relieve symptoms
  • Reduce amount of tumor tissue in the liver

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