Haq T U.
Transcatheter Chemo-Embolization for Hepatocellular Carcinoma and certain Hepatic Metastasis.
J Pak Med Assoc Jan ;54(3):142-5.

Hepatic artery embolization, in combination with chemotherapy was developed in Japan in early 80s for unresectable HCC. It is now fairly well established as primary treatment for non-resectable HCC. The rationale for transarterial chemo-embolization (TACE) is that these tumours especially the well-encapsulated lesions are mainly fed by the hepatic artery. By contrast the infiltrative tumours also have a supply from the portal vein. On the basis of many clinical studies it has been speculated that when iodized oil (Lipoidol Ultra-Fluid) is used to embolize HCC, the oil enters the sinusoids, where it is retained. Oil particles have been found in the portal vein following an arterial injection. The oil is mixed with the cytotoxic agent such as Cisplatinum, Doxorubicin, Epirubicin or Mitomycin C to form a covalent conjugate, which is then injected into the feeding artery. The conjugate remains in the tumour acting from both arterial and portal side and the cytotoxic agent is slowly released to exert the chemotherapeutic effect. This is a review article.

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