Abstract
Transarterial chemoembolization has been widely used to treat unresectable hepatocellular carcinoma. Various complications have been reported, but they have not included acute myocardial infarction. Acute myocardial infarction results mainly from coronary artery occlusion by plaques that are vulnerable to rupture or from coronary spasm, embolization, or dissection of the coronary artery. It is associated with significant morbidity and mortality. We present a case report that describes a patient with hepatocellular carcinoma who underwent transarterial chemoembolization and died subsequently of acute myocardial infarction. To our knowledge, there has been no previous report of this complication induced by transarterial chemoembolization for hepatocellular carcinoma. This case illustrates the need to be aware of acute myocardial infarction when transarterial chemoembolization is planned for the treatment of hepatocellular carcinoma, especially in patients with underlying coronary artery disease.
Similar content being viewed by others
References
Bosch FX, Ribes J, Diaz M et al (2004) Primary liver cancer: worldwide incidence and trends. Gastroenterology 127(5; suppl 1):5–6
Bruix J, Sherman M (2005) Management of hepatocellular carcinoma. Hepatology 42(5):1208–1236
Yamada R, Sato M, Kawabata M et al (1983) Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 148(2):397–401
Liapi E, Georgiades C, Hong K et al (2007) Transcatheter arterial chemoembolization: current technique and future promise. Tech Vasc Interv Radiol 10(1):2–11
Lau WY, Yu SC, Lai EC et al (2006) Transarterial chemoembolization for hepatocellular carcinoma. J Am Coll Surg 202(1):155–168
Ahrar K, Gupta S (2003) Hepatic artery embolization for hepatocellular carcinoma: technique, patient selection, and outcomes. Surg Oncol Clin N Am 12(1):105–126
Kokudo N, Makuuchi M (2004) Current role of portal vein embolization/hepatic artery chemoembolization. Surg Clin North Am 84(2):643–657
Del Pozo AC, López P (2007) Management of hepatocellular carcinoma. Clin Liver Dis 11(2):305–321
Kothary N, Weintraub JL, Susman J et al (2007) Transarterial chemoembolization for primary hepatocellular carcinoma in patients at high risk. J Vasc Interv Radiol 18(12):1517–1526
Yen FS, Wu JC, Kuo BI et al (1995) Transcatheter arterial embolization for hepatocellular carcinoma with portal vein thrombosis. J Gastroenterol Hepatol 10(3):237–240
Chung JW, Park JH, Han JK et al (1996) Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization. Radiology 198(1):33–40
White HD, Chew DP (2008) Acute myocardial infarction. Lancet 372(9638):570–584
Calvo-Romero JM, Fernández-Soria-Pantoja R, Arrebola-Garcia JD et al (2001) Ischemic heart disease associated with vincristine and doxorubicin chemotherapy. Ann Pharmacother 35(11):1403–1405
McCord JM (1989) Oxygen-derived free radicals in postischemic tissue injury. N Engl J Med 312:159–163
Lu W, Li YH, He XF (2008) Necrosis and apoptosis in hepatocellular carcinoma following low-dose versus high-dose preoperative chemoembolization. Cardiovasc Interv Radiol 31(6):1133–1140
Kasugai H, Kojima J, Tatsuta M (1989) Treatment of hepatocellular carcinoma by transcatheter arterial embolization combined with intraarterial infusion of a mixture of cisplatin and ethiodized oil. Gastroenterology 97(4):965–971
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lai, YL., Chang, WC., Kuo, WH. et al. An Unusual Complication Following Transarterial Chemoembolization: Acute Myocardial Infarction. Cardiovasc Intervent Radiol 33, 196–200 (2010). https://doi.org/10.1007/s00270-009-9683-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-009-9683-7