Scholarlink

Background <p>Ruptured hepatocellular carcinoma (r-HCC) is a life-threatening complication requiring urgent hemostasis. Transarterial embolization (TAE) is the first-line treatment, but the optimal embolic agent remains debated. This study reports on the use of a low-viscosity EVOH copolymer (Squid Peri12) in the emergency management of r-HCC.</p> Methods <p>Four patients presenting with r-HCC underwent emergency TAE using Squid Peri12. Diagnosis of rupture was based on clinical symptoms and characteristic imaging findings, including hemoperitoneum. TAE was performed via superselective catheterization using a DMSO-compatible microcatheter, with slow injection under fluoroscopic guidance. Tumor response was assessed using modified RECIST and volumetric analysis at 1, 3, and 6&#xa0;months.</p> Results <p>Technical success was achieved in all cases, with immediate bleeding control and no procedure-related complications. Portal vein patency was preserved, and all patients were discharged within 3–5&#xa0;days. At follow-up, all patients showed sustained devascularization and tumor shrinkage, with an average volume reduction exceeding 60% at 6&#xa0;months. Two patients became eligible for curative-intent surgery after marked radiologic and biologic response, including one with AFP decline from 3500 to 27&#xa0;ng/mL. A third declined surgery despite downstaging, and one demonstrated complete radiologic response without additional treatment.</p> Conclusion <p>TAE with low-viscosity EVOH was safe and effective in the acute setting of r-HCC, achieving rapid hemostasis and consistent tumor regression. These findings support further prospective evaluation of non-adhesive liquid embolics beyond emergent indications, including their potential oncologic role in unresectable HCC.</p> Level of Evidence <p>Level 4, Case Series.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Transarterial embolization with a low-viscosity ethylene vinyl alcohol (EVOH) copolymer for ruptured hepatocellular carcinoma: an oncologic role beyond hemostasis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年11月6日

查看全文
  • Claudio Sallemi,
  • Maria Parmigiani,
  • Marco Garatti,
  • Massimo Graffeo

摘要

Background

Ruptured hepatocellular carcinoma (r-HCC) is a life-threatening complication requiring urgent hemostasis. Transarterial embolization (TAE) is the first-line treatment, but the optimal embolic agent remains debated. This study reports on the use of a low-viscosity EVOH copolymer (Squid Peri12) in the emergency management of r-HCC.

Methods

Four patients presenting with r-HCC underwent emergency TAE using Squid Peri12. Diagnosis of rupture was based on clinical symptoms and characteristic imaging findings, including hemoperitoneum. TAE was performed via superselective catheterization using a DMSO-compatible microcatheter, with slow injection under fluoroscopic guidance. Tumor response was assessed using modified RECIST and volumetric analysis at 1, 3, and 6 months.

Results

Technical success was achieved in all cases, with immediate bleeding control and no procedure-related complications. Portal vein patency was preserved, and all patients were discharged within 3–5 days. At follow-up, all patients showed sustained devascularization and tumor shrinkage, with an average volume reduction exceeding 60% at 6 months. Two patients became eligible for curative-intent surgery after marked radiologic and biologic response, including one with AFP decline from 3500 to 27 ng/mL. A third declined surgery despite downstaging, and one demonstrated complete radiologic response without additional treatment.

Conclusion

TAE with low-viscosity EVOH was safe and effective in the acute setting of r-HCC, achieving rapid hemostasis and consistent tumor regression. These findings support further prospective evaluation of non-adhesive liquid embolics beyond emergent indications, including their potential oncologic role in unresectable HCC.

Level of Evidence

Level 4, Case Series.