Featured products: Occlusafe® Temporary Occlusion Balloon Catheter, LifePearl® Drug Elutable Microspheres
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).
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.
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.
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.
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.
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