3:36 PM Abstract No. 326 Balloon-occluded transarterial chemoembolization (B-TACE): single-center U.S. experience

Abstract

Balloon-occluded transarterial chemoembolization (B-TACE) may be potentially advantageous in the treatment of liver malignancy. This technique alters flow-dynamics ideally allowing deeper penetration of therapeutic agents. We describe our single-center experience involving balloon occlusion for liver directed therapy. Retrospective analysis was performed from 9/2016 to 5/2017 in which 24 lesions in 22 patients (20 males, 2 females, age range 51-90) underwent liver directed therapy utilizing a balloon occluding microcatheter (Scepter C (Microvention) [n = 16] or Sniper (Embolx) [n = 8]) for therapeutic embolization of hepatocellular carcinoma. Patients underwent balloon occlusion for conventional TACE (50%) and DEB-TACE (50%). Target lesion response was evaluated using Modified Response Evaluation Criteria for Solid Tumors (mRECIST) using contrast enhance CT or MRI. Technical success, patient demographics, lesion characteristics, lab values and adverse events (AEs) were recorded. Technical success was 100%. Mean follow-up time was 4 months (range, of 1-17 months). Of patients who did not undergo subsequent thermal ablation (10/24), target lesions were analyzed utilizing mRECIST criteria. Mean lesion diameter was 2.7 cm (range1.1-5.9). Disease control rate was 100%. Objective response was 90%. 60% (6/10) demonstrated a complete response, 30% (3/10) demonstrated partial response, 10% (1/10) had stable disease on follow-up. No patients demonstrated progression of disease at follow-up. There were no intraprocedural AEs. At 4 weeks one patient had a 1.3 cm liver infarct and new portal vein thrombosis, Statistical analysis of serum biochemistry demonstrated no significant difference in pre- vs post-procedure parameters. B-TACE is a feasible technique with favorable safety profile. Our small subset of patients demonstrated good outcomes, but findings warrant further investigation with direct comparison to conventional therapies.