Emergency transcatheter arterial embolization for bleeding of hepatocellular carcinoma spontaneous rupture

Objective: To evaluate the efficacy of emergency transcatheter arterial embolization (TAE) for spontaneous rupture of hepatocellular carcinoma (HCC). Methods: The authors retrospectively reviewed 16 cases of spontaneous ruptured HCC which had been treated in our hospital between 1997 and 2005. Emergency TAE was performed in the 16 patients, with 6 cases complicated by hypovolaemic. Results: Bleeding from the ruptured HCC was stopped at the end of the procedure in 16 patients who had undergone successful embolization. The time from the onset of clinical symptom to TAE been completed was 1.5-5 hours (mean, 3.6 hours). The shortest time was 1.5 hours in 3 patients. Following the achievement of hemostasis by TAE, transcatheter arterial chemoembolization (TACE) 2-6 times for each case with average 3.7 and CT guided percutaneous ethanol injection (CT-PEI) 5-9 times for every case with arerage 6.8 were performed in 12 cases. 3 cases were given up for further treatment. The liver transplantation was carried out in 1 case 3 days after TAE. The average survival time was 14.3 months. Conclusions: Emergency TAE is safe and effective for bleeding due to spontaneous rupture in HCC and would achieve better result by adding TACE and CT-PEI. Liver transplantation is one of the options for the patients with poor liver function. The combination of all methods above can prolong patients survival time. (authors)