Hepatocellular carcinoma (HCC) is the fourth most common cancer and the third leading cause of cancer-related death worldwide. Transarterial chemoembolisation (TACE) is a minimally invasive endovascular treatment for HCC and mCRC tumours. Among the various treatment options, transarterial chemoembolisation (TACE) is an effective choice for patients with intermediate stage HCC.TACE is a widely accepted treatment option for inoperable or intermediate stage HCC worldwide.
Embolization – blockage of part or all of the radius of a blood vessel, stopping blood flow in vascular formations. Transarterial chemoembolization – TACE – combines local delivery of chemotherapy drug with embolization. This procedure is used to treat liver cancer (HCC and mCRC). The procedure is performed by an interventional radiologist.
HCC - (hepatocellular carcinoma) - adult hepatocellular carcinoma - is the most common type of liver cancer, accounting for about 75-80% of all cancers. cases of liver cancer.
Adult hepatocellular carcinoma develops from hepatocytes and is often associated with chronic liver disease. The disease starts with inflammation of the liver, which can be caused by viral hepatitis C or B infection, alcohol abuse, obesity and rare liver diseases. The inflammatory changes then progress to fibrosis and cirrhosis, which can develop into adult hepatocellular carcinoma.
Colorectal cancer, or “colorectal” cancer, is one of the 5 most common cancers in Lithuania. Like many other cancers, this cancer cancer cells cancer can detach from the tumour and travel to other organs of the body via blood vessels or the lymphatic system. This process is called metastasis. Cancer cells that have attached themselves to other organs multiply and form new tumours – metastases. Often colorectal cancer io metastases of colorectal cancer are found in the liver. M he liver metastases, an effective treatment approach may be TACE – local intra-arterial chemotherapy to the liver.
TACE Lithuania
In Lithuania, these procedures have been performed for more than ten years in university hospitals – LSMUL Kaunas Clinics, Klaipėda University Hospital, VU Hospital Santaros Clinics, and the National Cancer Institute.
In addition to the radiological features of HCC, it is important to assess the liver function and functional status of the patient when choosing a treatment for hepatocellular carcinoma (HCC). The Barcelona-Clinic Liver Cancer (BCLC) staging criteria are used for this purpose.According to these guidelines, TACE can be applied in Stage B. For stage B (intermediate), transarterial chemoembolisation is the recommended treatment. Many studies confirm TACE in the early and slightly advanced stages.
In BCLC stage 0 (very early HCC), TACE could be an alternative for patients who are not suitable for radiofrequency or microwave ablation or liver resection. For patients with stage A BCLC, the combined approach of TACE and thermal ablation provides better local tumour control than ablation alone. TACE can be used as a “bridging” therapy for patients awaiting liver transplantation. For patients with BCLC B, TACE offers a survival advantage compared to palliative treatment options.

Procedure
The TACE procedure is performed by interventional radiologists angiography operating theatre. Per microspheres are selectively injected through a special microcatheter into a blood vessel feeding the tumour in the groin, the surface of which is impregnated with a chemotherapeutic agent before the procedure.

Practice of TACE procedures
Anterventional angiographyangiography, angiography on the screen visible at contrast-filled tumourys. It is an extremely precise and safe method that only affects the tumour without damaging other organs and tissues, but also the rest of the healthy liver. The drug, which is absorbed on the surface of the microspheres, has a much longer effect on the scarred liver tissue compared to Other treatment methods. The microspheres enter the small blood vessels of the tumour, disrupting the blood supply and leading to ischaemia and necrosis of tumour cells.
TACE photo gallery
Products

RADIFOCUS intorducer
Introducers from TERUMO for transcutaneous insertion into a blood vessel to facilitate the interventional procedure

RADIFOCUS wire
TERUMO hydrophilic guidewire, coated with polyurethane, a hydrophilic polymer coating, for guiding the catheter to the desired location in the vascular system during procedures

RADIFOCUS catheter
Angiographic or diagnostic TERUMO catheter for angiographic procedures, used with a guidewire: delivers radioactive media and materials to selected sites in the vascular system

LIFE PEARL
TERUMO's LifePearl microspheres for drug release are PEG (polyethylene glycol) embolization microspheres that can be loaded with chemotherapeutic agents