The Procedure

After disinfection and local anesthesia, the femoral vein which is located in the inguinal region is punctured. A small femoral sheath usually is placed in the vein through which different catheters or guide-wires can be inserted.
After visualising the venacava, a catheter is pushed forward into the tumor feeding vessels via the pulmonary artery. Inorder to prevent pain during the procedure analgetic drug-infusions are administered. Chemoembolization drug typically is composed of Mitomycin C as the chemotherapeutic agent and Lipidol and Spheres as the embolizing material. Additionally, other cytotoxic drugs could be be applied depending on tumor-response.
Affter the completion of the procedure, the catheters and the sheath-system are removed and a compression bandage is applied in order to prevent complications such as haematoma. After surveillance of 6 to 24 hours, in which complications might be detected and traeted, the patients is discharged. In order to evaluate response to treatment and to diagnose complications, a CT-Scan is performed 24 hours after the procedure. Treatment normally is repeated two to three times at intervals of four weeks, but some cases may require more sittings. The purpose is a symptomatic palliative therapy option.

Reduction in metastasis-size of a thyroid carcinoma after three cycles of Transpulmonary Chemoembolization ( 12 weeks after initial treatmanet). High lipiodol-uptake in the cancer-tissue.

 

Document Date: 2007/02/14   Author: Ahmed Koujan

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