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Safety and efficacy of transarterial embolization of hepatocellular adenomas.

ABSTRACT: BACKGROUND:Hepatocellular adenoma (HCA) larger than 5 cm in diameter has an increased risk of haemorrhage and malignant transformation, and is considered an indication for resection. As an alternative to resection, transarterial embolization (TAE) may play a role in prevention of complications of HCA, but its safety and efficacy are largely unknown. The aim of this study was to assess outcomes and postembolization effects of selective TAE in the management of HCA. METHODS:This retrospective, multicentre cohort study included patients aged at least 18 years, diagnosed with HCA and treated with TAE. Patient characteristics, 30-day complications, tumour size before and after TAE, symptoms before and after TAE, and need for secondary interventions were analysed. RESULTS:Overall, 59 patients with a median age of 33.5 years were included from six centres; 57 of the 59 patients were women. Median tumour size at time of TAE was 76 mm. Six of 59 patients (10 per cent) had a major complication (cyst formation or sepsis), which could be resolved with minimal therapy, but prolonged hospital stay. Thirty-four patients (58 per cent) were symptomatic at presentation. There were no significant differences in symptoms before TAE and symptoms evaluated in the short term (within 3 months) after TAE (P = 0·134). First follow-up imaging was performed a median of 5·5 months after TAE and showed a reduction in size to a median of 48 mm (P < 0·001). CONCLUSION:TAE is safe, can lead to adequate size reduction of HCA and, offers an alternative to resection in selected patients.

SUBMITTER: van Rosmalen BV

PROVIDER: S-EPMC6771810 | biostudies-other | 2019 Sep

REPOSITORIES: biostudies-other

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Safety and efficacy of transarterial embolization of hepatocellular adenomas.

van Rosmalen B V BV Klompenhouwer A J AJ de Graeff J Jaap JJ Haring M P D MPD de Meijer V E VE Rifai L L Dokmak S S Rawashdeh A A Abu Hilal M M de Jong M C MC Dejong C H C CHC Doukas M M de Man R A RA IJzermans J N M JNM van Delden O M OM Verheij J J van Gulik T M TM

The British journal of surgery 20190717 10

<h4>Background</h4>Hepatocellular adenoma (HCA) larger than 5 cm in diameter has an increased risk of haemorrhage and malignant transformation, and is considered an indication for resection. As an alternative to resection, transarterial embolization (TAE) may play a role in prevention of complications of HCA, but its safety and efficacy are largely unknown. The aim of this study was to assess outcomes and postembolization effects of selective TAE in the management of HCA.<h4>Methods</h4>This ret ...[more]

PMID: 31313827

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Project description:ObjectiveThe study objective was to evaluate the safety and efficacy of transcatheter arterial "embolization" (TAE) in the treatment of chronic "musculoskeletal pain" refractory to standard therapy.MethodsPubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched for original research articles evaluating TAE in patients with musculoskeletal conditions from database inception to January 21, 2020. Search terms employed were as follows: "embolization", "pain", "knee osteoarthritis", joint replacement, epicondylitis, tenderness, inflammation, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), microspheres, Embozene, geniculate artery, neovascularity, transcatheter, embolic, imipenem/cilastatin sodium, angiogenesis, and "musculoskeletal". Studies involving particle "embolization" for painful musculoskeletal conditions were included. Studies of TAE for hemarthrosis or malignancy-related "musculoskeletal pain" were excluded.ResultsThe primary search yielded 1,099 sources; 7 articles and 4 abstracts were included for data extraction. All were cohorts or case series, with low risk of bias and moderate to poor level of evidence. Heterogeneity between studies was high, precluding meta-analysis. The reviewed studies reported the safety and efficacy of TAE for the treatment of "knee osteoarthritis"; adhesive capsulitis of the shoulder; tendinopathy/enthesopathy of the knee, shoulder, elbow, and ankle; and cervical myalgia. All TAEs were reported as technically successful without major complications or subsequent serious adverse events, including no reported osteonecrosis, cutaneous ulceration, limb ischemia, cartilage degeneration, or myotendinous injury. TAE significantly reduced pain and improved function for all of the treated conditions, with durable response up to 24 months post procedure.ConclusionTAE appears to be a safe and effective treatment for some types of chronic refractory "musculoskeletal pain". Randomized placebo-controlled studies are necessary to confirm these findings.

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Safety and efficacy of transarterial embolization of hepatocellular adenomas.

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Safety and efficacy of transarterial embolization of hepatocellular adenomas.

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