Hepatic artery embolisation aims to block the blood supply to a carcinoid tumour that has spread to the liver.
The tumour can’t survive without a blood supply. Blocking the blood supply also stops the tumour releasing its hormones into the blood system.
Doctors might give a chemotherapy drug directly to the liver at the same time. This is called chemoembolisation or trans arterial chemoembolisation (TACE).
Why you have it
Your doctor might recommend hepatic artery embolisation if:
- you have a carcinoid tumour that has only spread to your liver
- you can’t have surgery to remove the liver tumour
- your tumour is producing a lot of hormones
- other drug treatments have not controlled your carcinoid symptoms
- there is one main tumour rather than several small ones
Hepatic embolisation can help to shrink carcinoid tumours in the liver. It can also reduce the amount of hormones the tumour makes. It helps to control symptoms for most people.
You can have the same treatment again when the tumour grows back.
How you have it
You have this treatment in the x-ray (radiology) department of the hospital. The doctor who does this procedure is called an interventional radiologist.
You can’t eat for 4 hours before the procedure. But you can usually drink water for up to 2 hours beforehand.
Your doctor puts a drug to make you drowsy (sedation) into a small tube in your arm (cannula). Then they inject a local anaesthetic into your groin to numb the area. They can then make a small cut (incision) into your groin. They gently push a thin tube into the main blood vessel (the femoral artery).
Watching on a scan, the doctor guides the tube into the main blood vessel of the liver (the hepatic artery). They inject a substance such as a gel or tiny beads to block the blood vessels. They might put a chemotherapy drug into the tube first. Or they might inject tiny beads that are already loaded with chemotherapy.
You have to lay flat for about 4 hours after the procedure. This is to reduce the risk of bleeding from the femoral artery.
You usually stay in hospital for 1 or 2 nights after the treatment.
The side effects of hepatic artery embolisation can include:
- flu-like symptoms
- feeling sick
- feeling hot
- pain around your liver (the upper right side of your tummy) or shoulders
These side effects usually last for a few days after you’ve had the treatment. Your doctor can give you anti sickness drugs and painkillers if you need them.
Tiredness (fatigue) is another common side effect. It usually lasts around 2 weeks.
Rarely, some people have more serious side effects from this treatment. These include:
- infection or a liver abscess - you have antibiotics before and after the procedure to reduce this risk
- bleeding - your doctor and nurses monitor you regularly, so they can deal with it straight away if it happens
- kidney damage - you may have fluids through a drip before the procedure to reduce this risk
- liver failure - you have blood tests before and after the procedure to check how well your liver and kidneys are working