Bland Embolization as a Bridge to Transplantation
In the latest issue of JVIR, researchers from Duke evaluated the effectiveness of bland embolization as a bridge to transplantation in 117 patients with HCC that underwent treatment while within Milan criteria. Superselective embolization was performed in 128 of 181 procedures. PVA particles were the most common embolic used (132 of 181) with sizes ranging from 150-250 µm (n=111), 45-150 µm (n=16), and 250-355 µm (n=1). 40 µm embozene and 100-300 µm embospheres were also used in some procedures. Follow-up imaging was evaluated to determine if patients progressed beyond Milan criteria in an intent-to-transplant analysis. They found that post-embolization, 87% and 78% of patients still fell within Milan criteria at 6 and 12 months respectively. The median time to disease progression beyond Milan criteria was 22.6 months (95% confidence interval, 16.2-29 mo). 34 of 117 (29%) had eventual transplant at a median of 3.3 mo (range, 0.5 – 20.9 mo). The authors concluded that bland embolization has a comparable efficacy versus other embolotherapies as a bridging strategy to maintain HCC within Milan criteria.
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Hodavance MS, Vikingstad EM, Griffin AS, Pabon-Ramos WM, Berg CL, Suhocki PV, Kim CY. Effectiveness of transarterial embolization of hepatocellular carcinoma as a bridge to transplantation. J Vasc Interv Radiol 2016; 27:39-45.
Luke R. Wilkins