Transcatheter arterial chemoembolisation (TACE)

 

TACE provides treatment for liver tumours by direct delivery of a chemo-embolic material (DC Beads loaded with Doxorubicin) to the tumour site(s). These tiny beads are lodged directly into the blood supply feeding these tumours, both blocking the vessel, as well as allowing the beads to elute chemo directly to the tumour. TACE can be performed on tumours local to the liver, or on malignant colorectal cancer which has spread to the liver.

Before the Procedure

Fasting: Do not eat or drink 4 hours prior to your procedure time.

Allergies: Please tell Intra staff at the time of booking if you have any food or medication allergies, or previous reactions to X-ray contrast (dye). 

Diabetes: If you are diabetic, please tell Intra staff at the time of booking. You may need to discuss your insulin/diabetes medication with your doctor.

Anticoagulation (blood thinners): If you are taking any blood thinners (e.g. Warfarin, Clexane, Pradaxa, Rivaroxban), please make this known to Intra staff at the time of booking. You will need to stop this medication temporarily 2-5 days before the procedure, but this will be advised via your interventional radiologist, Intra nurse, or the admin team.

Other regular medications: Continue taking these.

During the Procedure

TACE is performed by an interventional radiologist. During the procedure you will be sedated but awake.

The area around your groin or wrist will be painted with an antiseptic solution, and a sterile drape will then be placed over your body, to ensure sterility is maintained. Local anaesthetic will be injected around the artery in your groin, or at your wrist. This will sting for approximately 30 seconds, but after this, you should not feel any pain. If at any time you feel pain, or discomfort, please inform the doctor immediately, and more pain relief can be given via your IV line, as well as more local anaesthetic.

Using ultrasound guidance, the artery in the groin, or wrist will be accessed, and a small hollow tube (sheath) will be inserted into the artery. Using contrast dye and fluoroscopy, angiograms in your liver will take place. Wires and catheters will be used to gain access to the tumour(s).

Once access to the tumour(s) has been gained, DC Beads with Doxorubicin will be injected directly to the area. A device will then be used to close the hole made in the artery in your groin, or alternatively, if the artery in the wrist was used for the procedure, a pressure device will be applied around the wrist.

This treatment may require a repeat treatment however, this varies from individual to individual, and will be further discussed with your medical team at a later date.

After the procedure

The interventional radiologist will discuss the outcome of the procedure with you.

If the procedure was performed via the artery in your groin, you can sit up after one hour. If the procedure was performed via your wrist, you can sit up immediately.

You will be able to eat and drink once the sedation has worn off.

Once you are discharged home:

  • Someone must drive you home or accompany you in a taxi. Please arrange for accompanied transport in advance.
  • Due to the sedation or effects of the general anaesthetic, you may feel lethargic afterwards with reduced concentration. For this reason, for 24 hours after your procedure please:
    • Do not drive.
    • Do not drink alcohol.
    • Do not make any legal decisions or sign legal documents.
  • Do not do activity requiring strength, concentration, or full alertness for the rest of the day.

Before you leave, a nurse will give you discharge instructions to follow at home.

What are the risks?

As with any procedure, there are potential risks involved. Your interventional radiologist will explain the procedure, discuss possible risks and answer any questions you may have. You will then be asked to sign the consent form. This will occur on the day of your procedure.