Interventional Oncology Treatments

Catheter-directed Chemoembolization or Radioembolization

Catheter-directed Chemoembolization/Radioembolization is a tool we use to deliver drugs or radioactive beads to a tumor(s) in your liver. This helps deliver chemotherapy medication or radioactivity directly, sparing the affects of the chemotherapy or radiation to the rest of your body.

Certain types of tumors/cancers cannot be effectively treated with usual chemotherapy medications, or they stop responding to the medications that previously worked. Some liver tumors may be better treated by putting chemotherapy medication on a special plastic miniscule bead, or by using special miniscule beads that already contain a tiny amount of radiation. These beads can then be placed through the arteries that go to the liver (and tumors) using a small catheter (microcatheter), and delivering them directly into the tumor so that they can “kill” the cancer cells.

What happens during microcatheter-directed radioembolization/chemoembolization?

You will have already discussed the treatment options with the physician doing the procedure. Prior to this procedure, you may also have a conventional angiogram (to map out the blood vessels) and possibly an embolization procedure to close off arteries that go to sensitive areas we don’t want radiation to affect.

Prior to your procedure, we’ll take you to a preparation area where our nurses will start an IV in your arm and give you any medication that may be required prior to your procedure. We may give you medicines to protect your kidneys, antibiotics to help prevent infection, and anti-nausea medications. You may have a Foley catheter (tube) placed into your bladder.

When it’s time to begin, we’ll take you to a special room that is similar to an operating room. We often use conscious sedation, or moderate anesthesia. In this case, you’ll remain slightly awake throughout the procedure. We will monitor your pulse, blood pressure, and your breathing throughout the procedure.

During the procedure, you’ll lie on your back on a table and we’ll clean the area where the catheter (a thin, hollow tube) will enter your body using a special solution to minimize infection. We’ll place sterile drapes over your body and an interventionalist will apply a local anesthetic so you don’t feel any pain.

Your interventionalist will make a small incision in your arm, groin, or upper thigh to insert the catheter. We’ll use an iodine-based contrast material (dye) to make the blood vessels stand out by taking special x-ray pictures and by looking at a special TV monitor (fluoroscopy). Using an x-ray “map” to guide us, we’ll advance the catheter through the blood vessels until it reaches the blood vessel we want to put the treatment solution through. Often we use another smaller catheter (microcatheter) that can reach the smallest of blood vessels. When the microcatheter reaches its target, we’ll slowly and carefully administer the special beads, watching continuously to make sure they all go to the right place.

You will most often stay in the hospital for one night. At the end of the procedure, your interventionalist will withdraw the catheter and either apply pressure or place a special device in the blood vessel to stop the blood from leaking out. Finally, we’ll put a bandage over the incision.

After your procedure, your interventionalist will review the results of your radioembolization/chemoembolization with you and your physician so he or she can discuss the next steps with you. We may ask you to return so the interventionalist can check how well you have done after your procedure, and to see if you need any other procedures to make you better.