Balloon-Occlusion TACE for Treatment of HCC Complicated by Arterio-Portal and Arterio-Hepatic Venous Shunts

Maria del Pilar Bayona Molano,

Abstract

      Trans-arterial chemoembolization is a well-supported treatment option for patients with hepatocellular carcinoma who are not surgical or transplant candidates. The efficacy relies on the ability catheterize the arteries directly feeding a tumor and inject chemo-embolic particles directly into the tumor under fluoroscopic guidance. In the presence of a vascular anomaly such as an arterio-portal or arteriohepatic shunts, the flow dynamics within the tumor are altered and may compromise conventional or drug-eluting bead trans-arterial chemoembolization. We present the case of a patient with hepatocellular carcinoma complicated by arterio-portal and arterio-hepatic vein shunts who was treated with a modified trans-arterial chemoembolization utilizing balloon-occlusion.