Practical Pearls for DEB-TACE

Nadine Abi-Jaoudeh, MD, University of California, Irvine, shares her top tips for utilizing drug-eluting bead transarterial chemoembolization (DEB-TACE). Dr Abi-Jaoudeh notes that currently, it is unclear whether there is any advantage with DEB-TACE when compared to bland embolization.

Transcript:

My name is Nadine Abi-Jaoudeh. I'm an interventional radiologist and I work at the University of California, Irvine.

Pearl number 1 is, for now until we have better technology and drugs, do conventional TACE. And the reason is because there's been a lot of randomized controlled trials that have shown if you use a single drug with any embolization, it doesn't really confer an advantage, especially with the drugs we have right now, compared to bland embolization. Try to use conventional TACE, and do multiple drugs until we figure out how to put multiple drugs in the beads or until we get better drugs for the beads.

If you can get your hands on idarubicin. Otherwise use epirubicin, not doxorubicin. That's pearl number 2.

Pearl number 3 is really make sure that you cover the whole lesion and take your time to treat slowly. Because vessels and tumors are very chaotic, they open and close. By taking your time, you allow any vessels that were previously spasmed or closed to open up.

Don't use it for neuroendocrine tumors because there's been a lot of biliary complications so avoid definitely with that. And do cone-beam CT to make sure that you have full coverage.