Abstract No. 410 - Safety of chemoembolization with drug-eluting microspheres (DEB-TACE) in patients with pre-existing transjugular intrahepatic portosystemic shunt (TIPS)

Abstract

Purpose To assess the safety of DEB-TACE for inoperable hepatocellular carcinoma (HCC) in patients with pre-existing TIPS. Materials and Methods In this retrospective IRB approved study, we reviewed medical records of patients with a functioning TIPS who underwent DEB-TACE with doxorubicin (100mg) loaded LC beads for inoperable HCC between 2005 and 2011. Patient demographics, number of procedures, type of embolization (lobar, segmental), and post-procedure complications were recorded. The incidence of post-procedure liver failure, renal failure, duration of in-hospital stay, 30-day mortality and Grade 3 and 4 toxicity (NCCN V.3) were recorded. Results During this period, five patients (3Men, Mean age 64y) with a functioning TIPS underwent DEB-TACE for inoperable HCC. The number of procedures per patient ranged from 1-4, with a median of 1. Three patients had lobar embolization and the rest, segmental arterial embolization. Post-op stay ranged from 1-20days. During the 8 procedures, two procedures (in two different patients), two patients required prolonged admission to (max 20 days) for pain and edema. Both of them had lobar embolization. Grade 3 toxicity of AST, ALT, Bilirubin was seen in one patient. There were no deaths within 30 days of the procedure. None had renal failure. Conclusion DEB-TACE for HCC is well tolerated with minimal complications in patients with pre-existing TIPS. Complications leading to prolonged in-hospital course are more often seen in patients who received lobar embolization.