Hepatic artery embolization with Embosphere microspheres and Lipiodol for the treatment of massive bleeding due to ruptured primary liver cancer: clinical results in 25 cases

Objective: To evaluate hepatic artery embolization (HAE) with Embosphere microspheres (as an embolic agent) and Lipiodol in treating massive bleeding due to ruptured primary liver cancer. Methods: Emergency HAE with Embosphere microspheres and Lipiodol was performed in 25 patients with massive bleeding due to ruptured primary liver cancer. The clinical results were analyzed. Results: All the 25 cases had active massive bleeding due to ruptured primary liver cancer. After HAE with Embosphere microspheres and Lipiodol, successful hemostasis was obtained in 24 cases with an effective rate of 95%. After the treatment the mean arterial pressure rose from preoperative (63.5 ± 16.8) mmHg to postoperative (83.5 ± 18.2) mmHg, the difference was statistically significant (P < 0.05). The preoperative serum ALT and TBIL were (141.3 ± 77.8) u/L and (21.3 ± 7.1) μmol/L respectively. Five days after HAE the serum ALT and TBIL were (170.1 ± 98.6) u/L and (24.0 ± 9.1) μmol/L respectively. The differences were not significant (P > 0.05). The survival rates at one, 3, 6 and 12 months after HAE were 92%(23/25), 84%(21/25), 72%(18/25) and 48%(12/25) respectively. Conclusion: For the treatment of massive bleeding due to ruptured primary liver cancer, HAE with Embosphere microspheres and Lipiodol is very effective and less invasive, and it is very helpful for the subsequent therapies. (authors)