Clinical usefulness of the triaxial system in super-selective transcatheter arterial chemoembolization for...

Transcatheter arterial chemoembolization (TACE) has been widely performed for inoperable hepatocellular carcinoma (HCC). Super-selective TACE is preferable to non-selective therapy and it is important to advance the catheter tip as close to the tumor as possible in the feeding artery. A new microcatheter with a 1.9-Fr non-tapered tip has recently become available and this new microcatheter can be inserted into a 2.7-Fr. microcatheter. It is called the triple co-axial (triaxial) system.

To evaluate the clinical usefulness of super-selective TACE for HCC using the triaxial system.

We evaluated 63 HCCs that underwent super-selective TACE. Requirements for inclusion in this study were: (a) HCCs 3 cm or less in diameter; (b) TACE performed by a single operator; and (c) no additional treatment in the absence of local progression. All patients were followed for more than 1 year after TACE. The median follow-up period for surviving patients was 20 months (range, 17-31 months). The conventional system was used in 35 HCCs (control group), and the triaxial system was used in 28 (triaxial group). We reviewed angiographies at TACE and follow-up CT, and then evaluated local tumor status in the two groups.

Local tumor control rates at 3, 6, and 18 months were 64%, 36%, and 29%, respectively, in the triaxial group, and 40%, 14%, and 8.6%, respectively, in the control group (P = 0.0086). There were no major complications in either group.

The triaxial system appears to be useful for super-selective TACE and may contribute to achieving higher local control rates for HCC.