Arterial patency after repeated hepatic artery bland particle embolization

To evaluate hepatic arterial patency after serial bland particle embolization procedures in patients with hepatocellular carcinoma (HCC).

All patients with HCC who underwent five or more hepatic artery bland embolization procedures with permanent particulate and spherical embolic agents between September 1996 and December 2007 were retrospectively reviewed. Data analyzed included patient demographics, vessels embolized, embolic agent used, and duration of arterial patency.

Forty-three patients were identified who underwent five or more bland embolization procedures in the same arterial distribution. Of the 43 patients examined, 83% (n = 36) showed no change in the hepatic arterial tree after repeated bland embolization (mean treatment period of 48 months +/- 23). Six patients (13%) exhibited occlusion of a fifth-order or more distal vessel after an average of 5 embolizations +/- 2 over a period of 34 months +/- 27. A single case of vascular occlusion of a fourth-order vessel was observed after five embolizations over a period of 52 months.

Repeated bland embolization of the hepatic arteries in HCC preserves patency of the hepatic arterial vasculature despite the fact that embolization is carried out to complete stasis.