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Bland Embolization in Patients with Unresectable Hepatocellular Carcinoma Using Precise, Tightly Size-Calibrated, Anti-Inflammatory Microparticles: First Clinical Experience and One-Year Follow-Up

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Abstract

The purpose of this study is to report on the feasibility, local response, and 1-year clinical outcome of bland transarterial embolization (TAE) with 40- and 100-μm Embozene microspheres in patients affected by unresectable hepatocellular carcinoma (HCC). Up to January 2009, 53 patients underwent superselective TAE for a total of 74 lesions. Diagnosis of HCC was based on multidetector computed tomography (MDCT), α-fetoprotein, and biopsy. MDCT was performed 24 after treatment and repeated at 1 month, 3 months, and then every 6 months. Local efficacy was defined according to RECIST criteria. Technical success was always achieved. Local results at 1-month, 3- to 6-month, and 6- to 12-month follow-up were 62%, 37%, and 16%, respectively, for stable disease and 35%, 56%, and 51%, respectively, for partial response. Complete response (no evidence of lesion) has been observed only at late follow-up (three lesions; 7%). To date, 20 of 53 patients have had at least 1 year of follow-up, with an overall survival rate of 96%. Hepatic progressive disease (i.e., new nodules) was observed in 14 of 20 patients due to underlying liver disease. Minor complications were observed in four patients. A major complication occurred in one patient, who died unexpectedly 24 h after TAE due to pulmonary embolism of necrotic pathologic tissue and passage of particles through a disrupted hepatic vein. Local results as well as 1-year clinical outcome after TAE with Embozene microspheres are veryly encouraging, however, further studies, a larger patient population, and a longer follow-up are mandatory to assess the real clinical impact.

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Authors and Affiliations

  1. Unit of Interventional Radiology, European Institute of Oncology, Via Ripamonti 435, 2041, Milan, Italy

    Guido Bonomo, Lorenzo Monfardini, Paolo Della Vigna, Gianluigi Orgera & Franco Orsi

  2. Radiology, Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Vittorio Pedicini & Dario Poretti

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  1. Guido Bonomo
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  2. Vittorio Pedicini
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  3. Lorenzo Monfardini
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  4. Paolo Della Vigna
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  6. Gianluigi Orgera
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Correspondence to Guido Bonomo.

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Bonomo, G., Pedicini, V., Monfardini, L. et al. Bland Embolization in Patients with Unresectable Hepatocellular Carcinoma Using Precise, Tightly Size-Calibrated, Anti-Inflammatory Microparticles: First Clinical Experience and One-Year Follow-Up. Cardiovasc Intervent Radiol 33, 552–559 (2010). https://doi.org/10.1007/s00270-009-9752-y

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  • DOI: https://doi.org/10.1007/s00270-009-9752-y

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