Chemoembolization of a Tumor (TACE)

Chemoembolization is a minimally invasive treatment for liver cancer that can be used for patients that are not surgical candidates, or when there is too much tumor to treat with Radiofrequency Ablation (RFA).

Chemoembolization works to attack the cancer in two ways. First, it delivers a very high concentration of chemotherapy directly into the tumor, without exposing the entire body to the effects of those drugs. Second, the procedure cuts off blood supply to the tumor, depriving it of oxygen and nutrients, and trapping the drugs at the tumor site to enable them to be more effective.

How do I prepare for the procedure?

You will be scheduled for a consultation with the Interventional Radiology Team. Bring a list of questions to ask your doctor. It is important that you understand exactly what procedure is planned, the risks, benefits and other options before your procedure.

What happens during the procedure?

Conscious sedation is provided just prior to starting the procedure. You will be connected to several types of monitoring equipment.
Patients lie flat on the x-ray table. The technologist will prepare the skin over the groin by cleaning it with an antiseptic solution and place sterile drapes and towels over you to create a sterile work space.
Lidocaine local anesthesia is injected into the skin overlying the common femoral artery in the groin. Contrast dye is injected to mix with the blood allowing the Interventional Radiologist to view the outlining of the arteries that connect to the organ to be treated.  You may be asked to hold still, and hold your breath for about 20 seconds when the pictures are taken.  When in place the Interventional Radiologist will inject the chemo agent directly into the tumor. The catheter is removed and pressure is applied over the artery until there is no bleeding (approximately 15min).

This procedure typically requires 1-2 hours.

What happens after the procedure?

Since conscious sedation medicine is administered and an artery was punctured, you will be required to stay a minimum of 5-6 hours after the end of the procedure.  The Interventional Radiologist also reserves the option to keep you overnight. While in recovery, patients are monitored closely for signs of bleeding from the groin and ensure that the effects of the sedation have worn off. Patients must have a responsible adult available to drive/escort you home from the hospital.

Going home:

Since the artery is a high pressure system, patients should refrain from lifting more than 10 lbs, refrain from strenuous activity or anything which causes abdominal distension for the following 48-72 hours. Any straining such as vomiting, coughing, forced bowel movements could dislodge the clot that forms to seal the artery and cause bleeding. If you note any signs of bleeding, such as bulging under the skin the size of a golf ball, put direct pressure to the area, call your doctor, and go to the nearest emergency room or call 911 for assistance.

Do not take a tub bath, go in a hot tub or submerge in water for 5 days. Leave the sterile dressing on for 24 hours, then shower and clean the area daily.  Place a clean Band-Aid over the site each day for 5 days. Report any signs of infection (redness, swelling, discharge and fever) to your doctor.

At home, you can eat normally, but you should continue drinking extra fluids for 1 to 2 days after your procedure.

Is there any follow up care?

Patients can expect blood work around 3 weeks post procedure and an office visit.

Long term follow up constitutes blood work and CT scans at 3 month intervals.

If you have any questions or need to reschedule an appointment please feel free to contact the Interventional Radiology Office at 802- 847-8359. Our business hours are Monday – Friday 8:30 a.m. to 5 p.m. Someone is available to take your call after hours for emergencies.

This information is provided by the Fletcher Allen Health Care, Department of Radiology, Division of Interventional Radiology and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider.