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Transarterial chemoembolization or TACE is a procedure that is used for the treatment of liver cancers. In this procedure, chemotherapy is injected into the hepatic (liver) artery that supplies the liver tumor, and additional material is injected to block (embolize) the small branches of the hepatic artery. Primary liver cancer, also known as hepatoma or hepatocellular carcinoma (HCC) gets its blood exclusively from the hepatic artery. Making use of this fact, investigators have delivered chemotherapy agents selectively through the hepatic artery directly to the HCC tumor. The theoretical advantage is that higher concentrations of the agents can be delivered to the tumors without subjecting the patients to the systemic toxicity of the agents.
An interventional radiologist (one who does therapeutic procedures) usually carries out this procedure. Some patients may undergo repeat sessions at six- to 12-week intervals. This procedure is done with the help of fluoroscopy (type of x-ray) imaging. A catheter (long, narrow tube) is inserted into the femoral artery in the groin and is threaded into the aorta (the main artery of the body). From the aorta, the catheter is advanced into the hepatic artery. Once the branches of the hepatic artery that feed the liver cancer are identified, the chemotherapy is infused. Then comes the additional step of blocking (embolizing) the small blood vessels with different types of compounds, such as gelfoam or even small metal coils. The whole procedure takes one to two hours, and then the catheter is removed.
Thus, TACE has the advantages of exposing the tumor to high concentrations of chemotherapy and confining the agents locally since they are not carried away by the blood stream. At the same time, this technique deprives the tumor of its needed blood supply, which can result in the damage or death of the tumor cells.