Hepatic neoplasms: effects of transcatheter arterial embolization on coagulation and fibrinolysis

Forty-eight patients with hepatic malignancy (47 with hepatocellular carcinoma, one with metastatic colon carcinoma), who underwent transcatheter arterial embolization (TAE) for treatment of hepatic neoplasms, were investigated to determine the effects of TAE on coagulation and fibrinolysis. TAE was followed by a significant decrease in the platelet count (P less than .001); a prolongation of prothrombin time (P less than .001); an early increase in levels of fibrinopeptide A (P less than .01), fibrinopeptide B beta-15-42 (P less than .001), and fibrin(ogen) degradation products (P less than .001); and a delayed increase in the fibrinogen level (P less than .001), without a significant prolongation of the activated partial thromboplastin time. In the three patients who developed disseminated intravascular coagulation (DIC) after TAE, a reduction of both the platelet count and fibrinogen level occurred significantly earlier and in a more severe form than in the other patients without DIC; this reduction preceded the onset of the characteristic symptoms of DIC. Data suggested that close monitoring of platelet count and fibrinogen level is important for early detection of DIC following TAE.