Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Complications Related to Transarterial Treatment of Hepatocellular Carcinoma: A Comprehensive Review

  • Hyoung Nam Lee (Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital) ;
  • Dongho Hyun (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2022.06.20
  • Accepted : 2022.11.30
  • Published : 2023.03.01
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Abstract

Currently, various types of transarterial treatments are performed for hepatocellular carcinoma from the early to advanced stages. Its indications and efficacy have been widely investigated. However, procedure-related complications have not been updated in the literature, although new types of transarterial treatments, such as drug-eluting bead transarterial chemoembolization and transarterial radioembolization, are common in daily practice. Herein, a comprehensive literature review was carried out, and complications were organized according to the organs affected and treatment modalities.

Keywords

Acknowledgement

Authors deeply appreciate Prof. Suk Hyun Bae from Ilsan Paik Hospital for contribution on valuable case.

References

  1. Reig M, Forner A, Rimola J, Ferrer-Fabrega J, Burrel M, Garcia-Criado A, et al. BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update. J Hepatol 2022;76:681-693 https://doi.org/10.1016/j.jhep.2021.11.018
  2. Vogel A, Martinelli E; ESMO Guidelines Committee. Updated treatment recommendations for hepatocellular carcinoma (HCC) from the ESMO Clinical Practice Guidelines. Ann Oncol 2021;32:801-805 https://doi.org/10.1016/j.annonc.2021.02.014
  3. Korean Liver Cancer Association (KLCA), National Cancer Center (NCC) Korea. 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma. Korean J Radiol 2022;23:1126-1240 https://doi.org/10.3348/kjr.2022.0822
  4. Omata M, Cheng AL, Kokudo N, Kudo M, Lee JM, Jia J, et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int 2017;11:317-370 https://doi.org/10.1007/s12072-017-9799-9
  5. Park C, Kim JH, Kim PH, Kim SY, Gwon DI, Chu HH, et al. Imaging predictors of survival in patients with single small hepatocellular carcinoma treated with transarterial chemoembolization. Korean J Radiol 2021;22:213-224 https://doi.org/10.3348/kjr.2020.0325
  6. Doyon D, Mouzon A, Jourde AM, Regensberg C, Frileux C. [Hepatic, arterial embolization in patients with malignant liver tumours (author's transl)]. Ann Radiol (Paris) 1974;17:593-603. French
  7. Nouri YM, Kim JH, Yoon HK, Ko HK, Shin JH, Gwon DI. Update on transarterial chemoembolization with drug-eluting microspheres for hepatocellular carcinoma. Korean J Radiol 2019;20:34-49 https://doi.org/10.3348/kjr.2018.0088
  8. Sun J, Zhou G, Zhang Y, Zhou T, Nie C, Zhu T, et al. Comprehensive analysis of common safety profiles and their predictive factors in 520 records of liver cancer patients treated by drug-eluting beads transarterial chemoembolization. Medicine (Baltimore) 2018;97:e11131
  9. Yoon J, Lee S, Shin J, Kim SS, Kim GM, Won JY. LI-RADS version 2018 treatment response algorithm: diagnostic performance after transarterial radioembolization for hepatocellular carcinoma. Korean J Radiol 2021;22:1279-1288 https://doi.org/10.3348/kjr.2020.1159
  10. Kulik LM, Carr BI, Mulcahy MF, Lewandowski RJ, Atassi B, Ryu RK, et al. Safety and efficacy of 90Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis. Hepatology 2008;47:71-81 https://doi.org/10.1002/hep.21980
  11. Kokabi N, Camacho JC, Xing M, El-Rayes BF, Spivey JR, Knechtle SJ, et al. Open-label prospective study of the safety and efficacy of glass-based yttrium 90 radioembolization for infiltrative hepatocellular carcinoma with portal vein thrombosis. Cancer 2015;121:2164-2174 https://doi.org/10.1002/cncr.29275
  12. Sakamoto I, Aso N, Nagaoki K, Matsuoka Y, Uetani M, Ashizawa K, et al. Complications associated with transcatheter arterial embolization for hepatic tumors. Radiographics 1998;18:605-619 https://doi.org/10.1148/radiographics.18.3.9599386
  13. Tu J, Jia Z, Ying X, Zhang D, Li S, Tian F, et al. The incidence and outcome of major complication following conventional TAE/TACE for hepatocellular carcinoma. Medicine (Baltimore) 2016;95:e5606
  14. Clark TW. Complications of hepatic chemoembolization. Semin Intervent Radiol 2006;23:119-125 https://doi.org/10.1055/s-2006-941442
  15. Sueyoshi E, Hayashida T, Sakamoto I, Uetani M. Vascular complications of hepatic artery after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. AJR Am J Roentgenol 2010;195:245-251 https://doi.org/10.2214/AJR.08.2301
  16. Brown DB, Nikolic B, Covey AM, Nutting CW, Saad WE, Salem R, et al. Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy. J Vasc Interv Radiol 2012;23:287-294 https://doi.org/10.1016/j.jvir.2011.11.029
  17. Rmilah AA, Qrareya MN, Fleming C, Alkurashi AK, Nyberg S, Leise M, et al. Association of cirrhosis and other patient and procedural characteristics with postembolization syndrome after bland hepatic artery embolization for hepatic malignancy. AJR Am J Roentgenol 2022;218:1030-1039 https://doi.org/10.2214/AJR.21.26806
  18. Lammer J, Malagari K, Vogl T, Pilleul F, Denys A, Watkinson A, et al. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol 2010;33:41-52 https://doi.org/10.1007/s00270-009-9711-7
  19. Lee M, Chung JW, Lee KH, Won JY, Chun HJ, Lee HC, et al. Prospective multi-center Korean registry of transcatheter arterial chemoembolization with drug-eluting embolics for nodular hepatocellular carcinoma: a two-year outcome analysis. Korean J Radiol 2021;22:1658-1670 https://doi.org/10.3348/kjr.2020.1117
  20. Lee IJ, Lee JH, Lee YB, Kim YJ, Yoon JH, Yin YH, et al. Effectiveness of drug-eluting bead transarterial chemoembolization versus conventional transarterial chemoembolization for small hepatocellular carcinoma in Child-Pugh class A patients. Ther Adv Med Oncol 2019;11:1758835919866072
  21. Khalaf MH, Sundaram V, AbdelRazek Mohammed MA, Shah R, Khosla A, Jackson K, et al. A predictive model for postembolization syndrome after transarterial hepatic chemoembolization of hepatocellular carcinoma. Radiology 2019;290:254-261 https://doi.org/10.1148/radiol.2018180257
  22. Zhang L, Sun JH, Ji JS, Zhong BY, Zhou GH, Song JJ, et al. Imaging changes and clinical complications after drug-eluting bead versus conventional transarterial chemoembolization for unresectable hepatocellular carcinoma: multicenter study. AJR Am J Roentgenol 2021;217:933-943 https://doi.org/10.2214/AJR.20.24708
  23. Leung DA, Goin JE, Sickles C, Raskay BJ, Soulen MC. Determinants of postembolization syndrome after hepatic chemoembolization. J Vasc Interv Radiol 2001;12:321-326 https://doi.org/10.1016/S1051-0443(07)61911-3
  24. Yang H, Seon J, Sung PS, Oh JS, Lee HL, Jang B, et al. Dexamethasone prophylaxis to alleviate postembolization syndrome after transarterial chemoembolization for hepatocellular carcinoma: a randomized, double-blinded, placebo-controlled study. J Vasc Interv Radiol 2017;28:1503-1511.e2 https://doi.org/10.1016/j.jvir.2017.07.021
  25. Ogasawara S, Chiba T, Ooka Y, Kanogawa N, Motoyama T, Suzuki E, et al. A randomized placebo-controlled trial of prophylactic dexamethasone for transcatheter arterial chemoembolization. Hepatology 2018;67:575-585 https://doi.org/10.1002/hep.29403
  26. Lv N, Kong Y, Mu L, Pan T, Xie Q, Zhao M. Effect of perioperative parecoxib sodium on postoperative pain control for transcatheter arterial chemoembolization for inoperable hepatocellular carcinoma: a prospective randomized trial. Eur Radiol 2016;26:3492-3499 https://doi.org/10.1007/s00330-016-4207-8
  27. Alexander ES, Pantel AR, Carlin SD, Beckmann N, Mick R, Pryma DA, et al. Prospective study of systemic yttrium-90 elution during radioembolization of hepatic metastases. J Vasc Interv Radiol 2020;31:2007-2013.e1 https://doi.org/10.1016/j.jvir.2020.08.011
  28. Li X, Montazeri SA, Paz-Fumagalli R, Padula CA, Wang W, Mody K, et al. Prognostic significance of neutrophil to lymphocyte ratio dynamics in patients with hepatocellular carcinoma treated with radioembolization using glass microspheres. Eur J Nucl Med Mol Imaging 2021;48:2624-2634 https://doi.org/10.1007/s00259-020-05186-y
  29. Salem R, Lewandowski RJ, Atassi B, Gordon SC, Gates VL, Barakat O, et al. Treatment of unresectable hepatocellular carcinoma with use of 90Y microspheres (TheraSphere): safety, tumor response, and survival. J Vasc Interv Radiol 2005;16:1627-1639 https://doi.org/10.1097/01.RVI.0000184594.01661.81
  30. Carr BI. Hepatic arterial 90Yttrium glass microspheres (Therasphere) for unresectable hepatocellular carcinoma: interim safety and survival data on 65 patients. Liver Transpl 2004;10(2 Suppl 1):S107-S110 https://doi.org/10.1002/lt.20036
  31. Hsin IF, Hsu CY, Huang HC, Huang YH, Lin HC, Lee RC, et al. Liver failure after transarterial chemoembolization for patients with hepatocellular carcinoma and ascites: incidence, risk factors, and prognostic prediction. J Clin Gastroenterol 2011;45:556-562
  32. European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2018;69:182-236 https://doi.org/10.1016/j.jhep.2018.03.019
  33. Groupe d'Etude et de Traitement du Carcinome Hepatocellulaire. A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. N Engl J Med 1995;332:1256-1261 https://doi.org/10.1056/NEJM199505113321903
  34. Siriwardana RC, Niriella MA, Dassanayake AS, Liyanage CA, Upasena A, Sirigampala C, et al. Factors affecting post-embolization fever and liver failure after trans-arterial chemo-embolization in a cohort without background infective hepatitis- a prospective analysis. BMC Gastroenterol 2015;15:96
  35. Chung GE, Lee JH, Kim HY, Hwang SY, Kim JS, Chung JW, et al. Transarterial chemoembolization can be safely performed in patients with hepatocellular carcinoma invading the main portal vein and may improve the overall survival. Radiology 2011;258:627-634 https://doi.org/10.1148/radiol.10101058
  36. Min YW, Kim J, Kim S, Sung YK, Lee JH, Gwak GY, et al. Risk factors and a predictive model for acute hepatic failure after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. Liver Int 2013;33:197-202 https://doi.org/10.1111/liv.12023
  37. Lim L, Gibbs P, Yip D, Shapiro JD, Dowling R, Smith D, et al. Prospective study of treatment with selective internal radiation therapy spheres in patients with unresectable primary or secondary hepatic malignancies. Intern Med J 2005;35:222-227 https://doi.org/10.1111/j.1445-5994.2005.00789.x
  38. Sharma RA, Van Hazel GA, Morgan B, Berry DP, Blanshard K, Price D, et al. Radioembolization of liver metastases from colorectal cancer using yttrium-90 microspheres with concomitant systemic oxaliplatin, fluorouracil, and leucovorin chemotherapy. J Clin Oncol 2007;25:1099-1106 https://doi.org/10.1200/JCO.2006.08.7916
  39. Alsultan AA, Braat AJAT, Smits MLJ, Barentsz MW, Bastiaannet R, Bruijnen RCG, et al. Current status and future direction of hepatic radioembolisation. Clin Oncol (R Coll Radiol) 2021;33:106-116 https://doi.org/10.1016/j.clon.2020.12.003
  40. Denys A, Pracht M, Duran R, Guiu B, Adib S, Boubaker A, et al. How to prepare a patient for transarterial radioembolization? A practical guide. Cardiovasc Intervent Radiol 2015;38:794-805 https://doi.org/10.1007/s00270-015-1071-x
  41. Kwon JH, Kim GM, Han K, Won JY, Kim MD, Lee DY, et al. Safety and efficacy of transarterial radioembolization combined with chemoembolization for bilobar hepatocellular carcinoma: a single-center retrospective study. Cardiovasc Intervent Radiol 2018;41:459-465 https://doi.org/10.1007/s00270-017-1826-7
  42. Gil-Alzugaray B, Chopitea A, Inarrairaegui M, Bilbao JI, Rodriguez-Fraile M, Rodriguez J, et al. Prognostic factors and prevention of radioembolization-induced liver disease. Hepatology 2013;57:1078-1087 https://doi.org/10.1002/hep.26191
  43. Spina JC, Hume I, Pelaez A, Peralta O, Quadrelli M, Garcia Monaco R. Expected and unexpected imaging findings after 90Y transarterial radioembolization for liver tumors. Radiographics 2019;39:578-595 https://doi.org/10.1148/rg.2019180095
  44. Singh P, Anil G. Yttrium-90 radioembolization of liver tumors: what do the images tell us? Cancer Imaging 2014;13:645-657 https://doi.org/10.1102/1470-7330.2013.0057
  45. Sangro B, Martinez-Urbistondo D, Bester L, Bilbao JI, Coldwell DM, Flamen P, et al. Prevention and treatment of complications of selective internal radiation therapy: expert guidance and systematic review. Hepatology 2017;66:969-982 https://doi.org/10.1002/hep.29207
  46. Su YK, Mackey RV, Riaz A, Gates VL, Benson AB 3rd, Miller FH, et al. Long-term hepatotoxicity of yttrium-90 radioembolization as treatment of metastatic neuroendocrine tumor to the liver. J Vasc Interv Radiol 2017;28:1520-1526 https://doi.org/10.1016/j.jvir.2017.05.011
  47. Tomozawa Y, Jahangiri Y, Pathak P, Kolbeck KJ, Schenning RC, Kaufman JA, et al. Long-term toxicity after transarterial radioembolization with yttrium-90 using resin microspheres for neuroendocrine tumor liver metastases. J Vasc Interv Radiol 2018;29:858-865 https://doi.org/10.1016/j.jvir.2018.02.002
  48. Currie BM, Hoteit MA, Ben-Josef E, Nadolski GJ, Soulen MC. Radioembolization-induced chronic hepatotoxicity: a single-center cohort analysis. J Vasc Interv Radiol 2019;30:1915-1923 https://doi.org/10.1016/j.jvir.2019.06.003
  49. Guiu B, Deschamps F, Aho S, Munck F, Dromain C, Boige V, et al. Liver/biliary injuries following chemoembolisation of endocrine tumours and hepatocellular carcinoma: lipiodol vs. drug-eluting beads. J Hepatol 2012;56:609-617 https://doi.org/10.1016/j.jhep.2011.09.012
  50. Chung JW, Park JH, Han JK, Choi BI, Han MC, Lee HS, et al. Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization. Radiology 1996;198:33-40 https://doi.org/10.1148/radiology.198.1.8539401
  51. Joskin J, de Baere T, Auperin A, Tselikas L, Guiu B, Farouil G, et al. Predisposing factors of liver necrosis after transcatheter arterial chemoembolization in liver metastases from neuroendocrine tumor. Cardiovasc Intervent Radiol 2015;38:372-380 https://doi.org/10.1007/s00270-014-0914-1
  52. Arslan M, Degirmencioglu S. Liver abscesses after transcatheter arterial embolization. J Int Med Res 2019;47:1124-1130 https://doi.org/10.1177/0300060518816875
  53. Jia Z, Tu J, Cao C, Wang W, Zhou W, Ji J, et al. Liver abscess following transarterial chemoembolization for the treatment of hepatocellular carcinoma: a retrospective analysis of 23 cases. J Cancer Res Ther Ther 2018;14(Suppl S3):S628-S633 https://doi.org/10.4103/0973-1482.199385
  54. Ye T, Zhu P, Liu Z, Ren Q, Zheng C, Xia X. Liver abscess after drug-eluting bead chemoembolization in patients with metastatic hepatic tumors. Br J Radiol 2022;95:20211056
  55. Lv WF, Lu D, He YS, Xiao JK, Zhou CZ, Cheng DL. Liver abscess formation following transarterial chemoembolization: clinical features, risk factors, bacteria spectrum, and percutaneous catheter drainage. Medicine (Baltimore) 2016;95:e3503
  56. Song SY, Chung JW, Han JK, Lim HG, Koh YH, Park JH, et al. Liver abscess after transcatheter oily chemoembolization for hepatic tumors: incidence, predisposing factors, and clinical outcome. J Vasc Interv Radiol 2001;12:313-320 https://doi.org/10.1016/S1051-0443(07)61910-1
  57. Woo S, Chung JW, Hur S, Joo SM, Kim HC, Jae HJ, et al. Liver abscess after transarterial chemoembolization in patients with bilioenteric anastomosis: frequency and risk factors. AJR Am J Roentgenol 2013;200:1370-1377 https://doi.org/10.2214/AJR.12.9630
  58. Xia J, Ren Z, Ye S, Sharma D, Lin Z, Gan Y, et al. Study of severe and rare complications of transarterial chemoembolization (TACE) for liver cancer. Eur J Radiol 2006;59:407-412 https://doi.org/10.1016/j.ejrad.2006.03.002
  59. Chen C, Chen PJ, Yang PM, Huang GT, Lai MY, Tsang YM, et al. Clinical and microbiological features of liver abscess after transarterial embolization for hepatocellular carcinoma. Am J Gastroenterol 1997;92:2257-2259
  60. Zerem E, Hadzic A. Sonographically guided percutaneous catheter drainage versus needle aspiration in the management of pyogenic liver abscess. AJR Am J Roentgenol 2007;189:W138-W142 https://doi.org/10.2214/AJR.07.2173
  61. Yoshihara S, Yamana H, Akahane M, Kishimoto M, Nishioka Y, Noda T, et al. Association between prophylactic antibiotic use for transarterial chemoembolization and occurrence of liver abscess: a retrospective cohort study. Clin Microbiol Infect 2021;27:1514.e5-1514.e10 https://doi.org/10.1016/j.cmi.2021.01.014
  62. Lai EC, Lau WY. Spontaneous rupture of hepatocellular carcinoma: a systematic review. Arch Surg 2006;141:191-198 https://doi.org/10.1001/archsurg.141.2.191
  63. Singh Bhinder N, Zangan SM. Hepatocellular carcinoma rupture following transarterial chemoembolization. Semin Intervent Radiol 2015;32:49-53
  64. Seki A, Hori S, Shimono C. Management of vascular lake phenomenon on angiography during chemoembolization with superabsorbent polymer microspheres. Jpn J Radiol 2015;33:741-748 https://doi.org/10.1007/s11604-015-0486-2
  65. Kong J, Jiang X, Zhang Y, Wang W, Li Y, Shen X, et al. Clinical management of vascular lake during transarterial chemoembolization with CalliSpheres drug-eluting beads (DEBs) for the treatment of hepatocellular carcinoma. Transl Cancer Res 2020;9:2895-2903 https://doi.org/10.21037/tcr.2020.03.65
  66. Kim HC, Yang DM, Jin W, Park SJ. The various manifestations of ruptured hepatocellular carcinoma: CT imaging findings. Abdom Imaging 2008;33:633-642 https://doi.org/10.1007/s00261-007-9353-7
  67. Moris D, Chakedis J, Sun SH, Spolverato G, Tsilimigras DI, Ntanasis-Stathopoulos I, et al. Management, outcomes, and prognostic factors of ruptured hepatocellular carcinoma: a systematic review. J Surg Oncol 2018;117:341-353 https://doi.org/10.1002/jso.24869
  68. Aoki T, Kokudo N, Matsuyama Y, Izumi N, Ichida T, Kudo M, et al. Prognostic impact of spontaneous tumor rupture in patients with hepatocellular carcinoma: an analysis of 1160 cases from a nationwide survey. Ann Surg 2014;259:532-542 https://doi.org/10.1097/SLA.0b013e31828846de
  69. Miyayama S, Yamashiro M, Hashimoto M, Hashimoto N, Ikuno M, Okumura K, et al. Blood supply of the main bile duct from the caudate artery and medial subsegmental artery of the hepatic artery: evaluation using images obtained during transcatheter arterial chemoembolization for hepatocellular carcinoma. Hepatol Res 2013;43:1175-1181 https://doi.org/10.1111/hepr.12071
  70. Lee M, Chung JW, Lee KH, Won JY, Chun HJ, Lee HC, et al. Korean multicenter registry of transcatheter arterial chemoembolization with drug-eluting embolic agents for nodular hepatocellular carcinomas: six-month outcome analysis. J Vasc Interv Radiol 2017;28:502-512 https://doi.org/10.1016/j.jvir.2016.08.017
  71. Nakada S, Allard MA, Lewin M, Awad S, Dahbi N, Nitta H, et al. Ischemic cholangiopathy following transcatheter arterial chemoembolization for recurrent hepatocellular carcinoma after hepatectomy: an underestimated and devastating complication. J Gastrointest Surg 2020;24:2517-2525 https://doi.org/10.1007/s11605-019-04409-4
  72. Wang C, Yang Z, Xia J, Wang W, Chen W, Wang Q. Bronchobiliary fistula after multiple transcatheter arterial chemoembolizations for hepatocellular carcinoma: a case report. Mol Clin Oncol 2018;8:600-602 https://doi.org/10.3892/mco.2018.1574
  73. Ammirabile A, Rizzo DA, Pedicini V, Lanza E. Percutaneous treatment of bronchobiliary fistula: report of a successful transhepatic embolization and a decision-making strategy driven by systematic literature review. Cardiovasc Intervent Radiol 2021;44:1005-1016 https://doi.org/10.1007/s00270-021-02837-x
  74. Kim HC, Miyayama S, Choi JW, Kim GM, Chung JW. Hepatocellular carcinoma supplied by the inferior phrenic artery or cystic artery: anatomic and technical considerations. Radiographics 2023;43:e220076
  75. Chu HH, Kim HC, Chung JW, Lee JH, Yu SJ, Hur S, et al. Repeated intra-arterial therapy via the cystic artery for hepatocellular carcinoma. Cardiovasc Intervent Radiol 2014;37:1283-1291 https://doi.org/10.1007/s00270-013-0795-8
  76. Wagnetz U, Jaskolka J, Yang P, Jhaveri KS. Acute ischemic cholecystitis after transarterial chemoembolization of hepatocellular carcinoma: incidence and clinical outcome. J Comput Assist Tomogr 2010;34:348-353 https://doi.org/10.1097/RCT.0b013e3181caaea3
  77. Vesselle G, Petit I, Boucebci S, Rocher T, Velasco S, Tasu JP. Radioembolization with yttrium-90 microspheres work up: practical approach and literature review. Diagn Interv Imaging 2015;96:547-562 https://doi.org/10.1016/j.diii.2014.03.014
  78. Padia SA, Lewandowski RJ, Johnson GE, Sze DY, Ward TJ, Gaba RC, et al. Radioembolization of hepatic malignancies: background, quality improvement guidelines, and future directions. J Vasc Interv Radiol 2017;28:1-15 https://doi.org/10.1016/j.jvir.2016.09.024
  79. Ahmadzadehfar H, Biersack HJ, Ezziddin S. Radioembolization of liver tumors with yttrium-90 microspheres. Semin Nucl Med 2010;40:105-121 https://doi.org/10.1053/j.semnuclmed.2009.11.001
  80. Naymagon S, Warner RR, Patel K, Harpaz N, Machac J, Weintraub JL, et al. Gastroduodenal ulceration associated with radioembolization for the treatment of hepatic tumors: an institutional experience and review of the literature. Dig Dis Sci 2010;55:2450-2458 https://doi.org/10.1007/s10620-010-1156-y
  81. Carretero C, Munoz-Navas M, Betes M, Angos R, Subtil JC, Fernandez-Urien I, et al. Gastroduodenal injury after radioembolization of hepatic tumors. Am J Gastroenterol 2007;102:1216-1220 https://doi.org/10.1111/j.1572-0241.2007.01172.x
  82. Lopez-Benitez R, Radeleff BA, Barragan-Campos HM, Noeldge G, Grenacher L, Richter GM, et al. Acute pancreatitis after embolization of liver tumors: frequency and associated risk factors. Pancreatology 2007;7:53-62 https://doi.org/10.1159/000101878
  83. Wolbrink DRJ, Kolwijck E, Ten Oever J, Horvath KD, Bouwense SAW, Schouten JA. Management of infected pancreatic necrosis in the intensive care unit: a narrative review. Clin Microbiol Infect 2020;26:18-25 https://doi.org/10.1016/j.cmi.2019.06.017
  84. Gwon DI, Ko GY, Yoon HK, Sung KB, Lee JM, Ryu SJ, et al. Inferior phrenic artery: anatomy, variations, pathologic conditions, and interventional management. Radiographics 2007;27:687-705 https://doi.org/10.1148/rg.273065036
  85. Kim HC, Chung JW, Park JH, An S, Son KR, Seong NJ, et al. Transcatheter arterial chemoembolization for hepatocellular carcinoma: prospective assessment of the right inferior phrenic artery with C-arm CT. J Vasc Interv Radiol 2009;20:888-895 https://doi.org/10.1016/j.jvir.2009.03.036
  86. Kim HC, Kim YJ, Paeng JC, Chung JW. Yttrium-90 radioembolization of the right inferior phrenic artery in 20 patients with hepatocellular carcinoma. J Vasc Interv Radiol 2018;29:556-563 https://doi.org/10.1016/j.jvir.2017.10.010
  87. Wu GC, Chan ED, Chou YC, Yu CY, Hsieh TY, Hsieh CB, et al. Risk factors for the development of pulmonary oil embolism after transcatheter arterial chemoembolization of hepatic tumors. Anticancer Drugs 2014;25:976-981 https://doi.org/10.1097/CAD.0000000000000113
  88. Kishi K, Sonomura T, Satoh M, Nishida N, Terada M, Shioyama Y, et al. Acute toxicity of lipiodol infusion into the hepatic arteries of dogs. Invest Radiol 1994;29:882-889 https://doi.org/10.1097/00004424-199410000-00004
  89. Riaz A, Lewandowski RJ, Kulik LM, Mulcahy MF, Sato KT, Ryu RK, et al. Complications following radioembolization with yttrium-90 microspheres: a comprehensive literature review. J Vasc Interv Radiol 2009;20:1121-1130; quiz 1131 https://doi.org/10.1016/j.jvir.2009.05.030
  90. Kim S, Oh IJ, Park SY, Song JH, Seon HJ, Kim YH, et al. Corticosteroid therapy against treatment-related pulmonary toxicities in patients with lung cancer. J Thorac Dis 2014;6:1209-1217
  91. Shin SW, Do YS, Choo SW, Lieu WC, Cho SK, Park KB, et al. Diaphragmatic weakness after transcatheter arterial chemoembolization of inferior phrenic artery for treatment of hepatocellular carcinoma. Radiology 2006;241:581-588 https://doi.org/10.1148/radiol.2412051209
  92. Noh SY, Gwon DI, Park S, Yang WJ, Chu HH, Kim JW. Diaphragmatic weakness after transcatheter arterial chemoembolization of the right inferior phrenic artery for treatment of hepatocellular carcinoma: a comparison of outcomes after N-butyl cyanoacrylate versus gelatin sponge embolization. Acta Radiol 2022;63:48-58 https://doi.org/10.1177/0284185120981771
  93. Kim JS, Lee HN, Lee WH, Bae SH. Diaphragmatic perforation after transcatheter arterial chemoembolization of hepatocellular carcinoma via inferior phrenic artery: a case report. BMC Gastroenterol 2022;22:46
  94. Goh SK, Naazar A, Issa M, Starkey G, Ranatunga D, Lee E. Delayed diaphragmatic hernia and gastric fundus incarceration: a rare complication after transarterial chemoembolization. ANZ J Surg 2022;92:1882-1884 https://doi.org/10.1111/ans.17295
  95. Chu HJ, Lee CW, Yeh SJ, Tsai LK, Tang SC, Jeng JS. Cerebral lipiodol embolism in hepatocellular carcinoma patients treated with transarterial embolization/chemoembolization. PLoS One 2015;10:e0129367
  96. Pai YW, Hsieh PF, Tung H, Wu CY, Ching CT, Chang MH. Prognosis of cerebral lipiodol embolism caused by transarterial chemoembolization. Neurol Res 2016;38:857-863 https://doi.org/10.1080/01616412.2016.1201928
  97. Park SI, Lee DY, Won JY, Lee JT. Extrahepatic collateral supply of hepatocellular carcinoma by the intercostal arteries. J Vasc Interv Radiol 2003;14:461-468 https://doi.org/10.1097/01.RVI.0000064856.87207.1E
  98. Kim HC, Chung JW, Lee IJ, An S, Seong NJ, Son KR, et al. Intercostal artery supplying hepatocellular carcinoma: demonstration of a tumor feeder by C-arm CT and multidetector row CT. Cardiovasc Intervent Radiol 2011;34:87-91 https://doi.org/10.1007/s00270-010-9883-1
  99. Kim JH, Yeon JE, Jong YK, Seo WK, Cha IH, Seo TS, et al. Spinal cord injury subsequent to transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. Dig Liver Dis 2010;42:67-70 https://doi.org/10.1016/j.dld.2009.05.007
  100. Bazine A, Fetohi M, Berri MA, Essaadi I, Elbakraoui K, Ichou M, et al. Spinal cord ischemia secondary to transcatheter arterial chemoembolization for hepatocellular carcinoma. Case Rep Gastroenterol 2014;8:264-269 https://doi.org/10.1159/000368075
  101. Arora R, Soulen MC, Haskal ZJ. Cutaneous complications of hepatic chemoembolization via extrahepatic collaterals. J Vasc Interv Radiol 1999;10:1351-1356 https://doi.org/10.1016/S1051-0443(99)70242-3
  102. Wang DS, Louie JD, Kothary N, Shah RP, Sze DY. Prophylactic topically applied ice to prevent cutaneous complications of nontarget chemoembolization and radioembolization. J Vasc Interv Radiol 2013;24:596-600 https://doi.org/10.1016/j.jvir.2012.12.020