Arterial hepatic embolization of unresectable hepatocellular carcinoma using a cyanoacrylate/lipiodol mixture

Purpose: A survival analysis in 16 patients with unresectable hepatocellular carcinoma (HCC) undergoing transcatheter arterial embolization (TAE) using a combination of lipiodol and N-butyl-2-cyanoacrylate (5:1) was performed in a retrospective study. Methods: A combination of lipiodol and N-butyl-2-cyanoacrylate (5:1) was used for TAE. All patients had disease compatible with Okuda stages I and II. Results: Twenty-four embolizations were done; five patients had more than one embolization. Median alpha-fetoprotein levels declined from 116 to 48.6 ng/ml. A median of 0.3 ml cyanoacrylate was administered per patient. Median survival was 8.5 months (range 2-49 months). After a median follow-up of 4 years, 12 patients have died (75%). Okuda stage I and II patients had a median survival time of 34.4 and 5.5 months respectively. Few side effects (19%) were seen. Conclusion: We conclude that the TAE procedure used [lipiodol and N-butyl-2-cyanoacrylate (5:1)] is safe and produced only few side effects, thus constituting a valuable therapeutic option for patients with Okuda stage I and II HCC.