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Complications of Intra-Arterial Regional Liver Therapy

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Cancer Regional Therapy

Abstract

Multiple complications have been described after or during intra-arterial regional liver treatments. These complications are caused either by the angiographic/surgical procedure itself (i.e., arterial thrombosis), by the embolic/infusion effect (i.e., post-embolization syndrome and chemical hepatitis), by nontarget embolization/infusion to normal liver parenchyma (i.e., radioembolization-induced liver disease and biliary sclerosis), by nontarget embolization/infusion to extrahepatic sites (i.e., gastroduodenal ulceration), and by device malfunction in the case of intra-arterial infusion pump. The most common complications resulting from transarterial chemoembolization (TACE) and transarterial embolization (TAE) are post-embolization syndrome, arterial injuries, nontarget embolization, biliary ischemia and bilomas, and liver abscesses. Radioembolization is also associated with nontarget embolization and post-embolization syndrome, and with radiation-specific complications, such as radioembolization-induced liver disease (REILD) and radiation pneumonitis. Finally, hepatic artery infusion (HAI) treatments may be complicated by gastroduodenal toxicity, chemical hepatitis, biliary sclerosis, and pump/catheter malfunction.

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Authors and Affiliations

  1. Memorial Sloan Kettering Cancer Center, Hepatopancreatobiliary Service, Department of Surgery, New York, NY, USA

    Gaya Spolverato & Michael D’Angelica

  2. Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY, USA

    Amy Robin Deipolyi

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  1. City Of Hope National Medical Center, Duarte, CA, USA

    Yuman Fong

  2. Medical College of Wisconsin, Milwaukee, WI, USA

    T. Clark Gamblin

  3. City Of Hope National Medical Center, Duarte, CA, USA

    Ernest S. Han

  4. City Of Hope National Medical Center, Duarte, CA, USA

    Byrne Lee

  5. Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA

    Jonathan S. Zager

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Spolverato, G., Deipolyi, A.R., D’Angelica, M. (2020). Complications of Intra-Arterial Regional Liver Therapy. In: Fong, Y., Gamblin, T., Han, E., Lee, B., Zager, J. (eds) Cancer Regional Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-28891-4_28

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