Trans Arterial Chemo Embolization

Transarterial chemoembolization or TACE combines the local delivery of chemotherapy with a procedure called embolization to treat cancer, most often of the liver. It is a non-surgical and minimally invasive procedure performed in radiology, usually by an interventional radiologist.In TACE, anti-cancer drugs are injected directly into the blood vessel feeding the cancerous tumor. In addition, synthetic materials called embolic agents are placed inside the blood vessels that supply blood to the tumor, trapping chemotherapy in the tumor and blocking blood flow to the tumor.

TACE is most beneficial for patients whose disease is primarily confined to the liver, whether the tumor started in the liver or has spread (metastasized) from another organ to the liver. .

• Hepatoma or hepatocellular carcinoma (primary liver cancer)
• Cholangiocarcinoma (primary cancer of the bile ducts in the liver)
• Metastasis (spread) to the liver
• Colon cancer
• Breast Cancer
• Carcinoid tumors and other neuroendocrine tumors
• Islet cell tumor of the pancreas
• Eye melanoma
• sarcoma
• Other vascular primary tumors in the body
• Depending on the number and type of tumor, your TACE specialist doctor in Jaipur may use TACE or combine it with other treatment options, such as surgery, chemotherapy, radiation therapy, or ablation.

Several days before the procedure, you will have an office consultation with the interventional radiologist who will perform your procedure.

Before your procedure, your doctor may test your blood to check your kidney function and to determine whether your blood clots normally..

Tell your doctor about all medicines you take, including herbal supplements. List any allergies, especially to local anesthetic, general anesthesia, or contrast ingredients. Your doctor may tell you to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood thinners before your procedure.

Women should always tell their doctor and technologist if they are pregnant. Doctors will not perform many tests during pregnancy to protect the fetus from exposure to radiation. If an X-ray is necessary, the doctor will take precautions to reduce the risk of radiation to the baby. See the Safety page in X-rays, Interventional Radiology, and Nuclear Medicine Procedures for more information about pregnancy and X-rays. .

You will receive specific instructions on how to prepare, including any changes you will need to make to your regular medication schedule.

If you want to receive a sedative during the procedure, the doctor may tell you not to eat or drink anything for four to eight hours before your exam. If you are seduced, have someone take you with you and take you home later.

In this procedure, X-ray equipment, a catheter, and embolic agents are used.This exam usually uses a radiographic table, one or two X-ray tubes, and a video monitor. Fluoroscopy converts X-rays into video images. Doctors use it to visualize an d guide procedures. The video is made from the X-ray machine and the detector mounted on the examination table. A catheter is a long, thin plastic tube much smaller than a “pencil lead”. Its diameter is about 1/8 inch.

Various materials called embolic agents are used to block or block blood vessels, but the most common are oil or plastic parti cles made from polyvinyl alcohol (PVA). This procedure may use other equipment, including an intravenous line (IV), ultrasound machines, and devices that monitor yo ur heartbeat and blood pressure.

• Image-guided, minimally invasive procedures such as TACE are often performed by a specially trained interventional radiologist in an interventional radiology suite or sometimes in the operating room.
• X-ray images will be taken to map the path of the blood vessels feeding the tumor. Contrast material can also be used to map the path.
• You may be given a drug called allopurinol, which can help protect the kidneys from byproducts produced by chemotherapy and dying tumor cells.
• Your doctor may provide medicines to help stop nausea and pain, and antibiotics to help prevent infection.
• You will lie on the process table.
• The doctor or nurse can hook you up to monitors that track your heart rate, blood pressure, oxygen level, and pulse.
• A nurse or technologist will insert an intravenous (IV) line into a vein in your arm or arm to administer a sedative. This procedure may use moderate sedation. It does not require a breathing tube. However, some patients may require general anesthesia.
• The doctor will make a very small skin incision at the site.
• Using X-ray guidance, the doctor inserts a thin catheter through the skin into an artery, either in the groin or wrist, and leads it to the liver. Contrast material is then injected through the catheter and another series of X-rays will be taken.
• Once the catheter is positioned in the branches of the artery feeding the tumor, anticancer drugs, and embolic agents are mixed together and injected.
• Additional X-rays will be taken to confirm that the entire tumor has been treated.
• When the procedure is complete, the doctor will remove the catheter and apply pressure to stop any bleeding. Sometimes, your doctor may use a closure device to seal the small hole in the artery. This will allow you to move around more quickly. No stitches are visible on the skin. The nurse will cover this small patch of skin with a dressing.
• You can expect to be in the recovery room for between two and six hours, depending on which artery was accessed and if a closure device was used.
• TACE is usually completed within 90 minutes.
• Who interprets the results and how do I get them?
• After the procedure is complete, the interventional radiologist in Jaipur will tell you if the procedure was successful.
• You will also be scheduled for additional CT or MRI exams and blood tests to determine the size of the tumor being treated.

TACE is not recommended in cases of severe liver or kidney dysfunction, abnormal blood clotting, prior surgery or bile duct stenting, or blockage of the bile ducts. In some cases—despite liver dysfunction—TACE may be used in small doses and in multiple procedures to try and reduce the effects on the normal liver.TACE is a treatment, not a cure. Liver improvement will be seen in about 70 percent of patients and depending on the type of liver cancer, this can improve survival rates and quality of life.