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First Usage of Combined HCC Treatment with Balloon-Occluded TACE and MW Ablation

Clinical Case 

66-year-old female patient with stabilized NASH HCC in the right lobe after two sessions of DEM-TACE. Tumor size 6.4 x 6.6 x 6.8 cm in the segments 6 and 7. Tumor board decision was to try balloon occluded DEM-TACE to achieve better tumor uptake (Occlusafe®, Terumo; LifePearl® microspheres 200μm 1 syringe, Terumo, 75mg doxorubicin).

Balloon - TACE

Product used: Occlusafe® + LifePearl® microspheres 200 μm 2 ml + 75mg doxorubicin

Pre-procedural CT phases


After local anesthesia of the skin and subcutaneous tissue, a 5F Simmons hydrophilic catheter was placed through the 6 F introducer in the celiac trunk. Angiography confirmed the lesion and feeding arteries were proximally catheterized by micro-balloon catheter. The balloon of the catheter was inflated in this feeder and the microspheres loaded with 75 mg of doxorubicin were injected with a good stasis at the end of the procedure.

1-Month Follow-up CT

Tumor size decreased to 4.5 x 4.2 cm.

Follow Up/ Conclusion

Balloon-occluded DEM-TACE with Occlusafe® was well tolerated by the patient and she was discharged at day 1. No alteration of liver function was observed. Grade 1 abdominal pain was present five days after the TACE. The MRI performed 1 month after the procedure had showed a complete devascularization of the tumoral nodule (complete response according to mRECIST) and patient was down-staged and assigned to MW ablation procedure.​

Microwave Ablation in 2 months after Balloon-Occluded TACE procedure

The patient underwent a percutaneous MW ablation session by US-guided insertion of one TATOpro 14G antenna under general anesthesia setting power at 40 watts and time at 5 minutes. To ablate the entire lesion, the antenna was then repositioned 4 times using the same parameters.

CT control on the second day after the treatment:

1-Month follow-up after MW Ablation: control CT with contrast

The contrast CT was performed 1 month after the procedure and showed the complete response to the treatment (according to mRECIST).


The use of LifePearl® microspheres loaded with doxorubicin in combination with Occlusafe® (Balloon occluded DEM-TACE) allowed a safe downstage to MWA with TATO. The use of these 3 products provided a good clinical efficacy with a final complete response. Next follow ups at 3 and 6 months.

Occlusafe is not available for sale in all countries. Please contact your Terumo local sales representative for more information. Occlusafe has not been approved by the FDA and is therefore not
available for sale in the U.S.A. Distributed by; Terumo Europe NV. 
LifePearl® microspheres are indicated for embolization of blood vessels supplying primary-hypervascular tumors or metastases in the liver. Note: LifePearl® microspheres can be loaded with
chemotherapeutic drugs (Doxorubicin, Idarubicin, Epirubicin ans Irinotecan). When used for drug loading, drug loading should be done under a physician’s direction, choice and responsibility, based on
type and dose of drug most beneficial to the patient. Lifepearl® microspheres are not available for sale in all countries. This information is provided only in respect to markets where this product is
approved or cleared. The use of the LifePearl® microspheres device in combination with drugs is not cleared or approved in the U.S.A. by the Food and Drug Administration. Lifepearl® microspheres are
not approved in Canada. Please contact your Terumo local sales representative for more information. LifePearl® microspheres are manufactured by MicroVention and exclusively distributed by Terumo
Europe NV in EMEA region. MicroVention is a registered trademark of MicroVention, Inc. LifePearl® microspheres are a registered trademark of Terumo, Inc. Scientifi c and clinical data related to this
document are on fi le at MicroVention, Inc. Refer to Instructions for Use for additional information. © 2019 MicroVention. CE0297 - Manufacturer MicroVention Europe - 30 bis, rue du Vieil Abreuvoir
78100 Saint-Germain-en-Laye FRANCE - Tel: +33(0)1 39 21 77 46 - Fax: +33(0)1 39 21 16 01.
TATO and TATOpro are a trademark of Biomedical srl. TATO and TATOpro are manufactured by Biomedical and exclusively distributed by Terumo Europe NV in EMEA region.
Please contact your local Terumo sales representative for more information.

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