Dual-balloon infusion microcatheter for selective drug-eluting bead transarterial chemoembolization: initial
Wayne L Monsky1, Siddharth A Padia, Andrew Hal Hardy
1Division of Interventional Radiology, Department of Radiology, University of Washington Medical Center, Seattle, WA, USA. wmonsky@uw.edu.
Diagnostic and Interventional Radiology (Ankara, Turkey)
|November 4, 2017
Summary
This study shows that using a dual-balloon microcatheter for drug-eluting bead transarterial chemoembolization (DEB-TACE) is feasible and safe for treating liver cancer. This technique allows access to difficult-to-reach arteries, improving treatment options.
Area of Science:
- Interventional Radiology
- Hepatobiliary Oncology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer with limited treatment options.
- Transarterial chemoembolization (TACE) is a standard treatment for unresectable HCC.
- Drug-eluting bead TACE (DEB-TACE) offers targeted delivery of chemotherapy.
- Accessing segmental and subsegmental arteries for DEB-TACE can be challenging with standard microcatheters.
Purpose of the Study:
- To evaluate the feasibility and safety of a dual-balloon infusion microcatheter for segmental/subsegmental DEB-TACE.
- To assess the technical success rate of this novel microcatheter system.
- To determine the oncologic outcomes and safety profile of the procedure.
Main Methods:
- A 16-month prospective study involving 21 patients with HCC undergoing DEB-TACE.
- Utilized a dual-balloon anti-reflux microcatheter (IsoFlow™) for segmental/subsegmental arterial access.
- Assessed technical success, tumor response using modified RECIST, and safety (arterial/hepatic injury, complications, liver toxicity).
- Follow-up imaging included CT or MRI at 1, 3, 6, 9, and 12 months.
Main Results:
- The dual-balloon microcatheter successfully enabled DEB-TACE in 26 procedures where standard microcatheters failed due to tortuous or atretic arteries.
- Radiologic response showed 32% complete response, 19% partial response, 34% stable disease, and 15% progressive disease.
- No procedural complications or hepatic/arterial injuries were reported.
- Median time to progression for targeted tumors was 7 months.
Conclusions:
- DEB-TACE using the dual-balloon anti-reflux infusion microcatheter is a feasible and safe technique.
- This microcatheter system expands treatment options for HCC by facilitating access to challenging arterial segments.
- The procedure demonstrates a favorable safety profile and promising tumor response rates.
