Intraarterial Therapies for the Management of Hepatocellular Carcinoma

SIMPLE SUMMARY: Hepatocellular carcinoma is the most common liver cancer, leading to approximately 700,000 deaths worldwide and 30,000 deaths in the United States every year. Transarterial therapies play a crucial role in the management of these patients, with significant development in techniques over the last couple of decades. The aim of this review is to discuss the different types of transarterial therapies with regards to the pre-procedure, procedural, and post-procedural patient management, along with giving a review of evidence from the literature. ABSTRACT: Image-guided locoregional therapies play a crucial role in the management of patients with hepatocellular carcinoma (HCC). Transarterial therapies consist of a group of catheter-based treatments where embolic agents are delivered directly into the tumor via their supplying arteries. Some of the transarterial therapies available include bland embolization (TAE), transarterial chemoembolization (TACE), drug-eluting beads–transarterial chemoembolization (DEB–TACE), selective internal radioembolization therapy (SIRT), and hepatic artery infusion (HAI). This article provides a review of pre-procedural, intra-procedural, and post-procedural aspects of each therapy, along with a review of the literature. Newer embolotherapy options and future directions are also briefly discussed.