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Transarterial chemoembolization (TACE) is a minimally invasive procedure performed in interventional radiology to kill cancer cells. TACE is the current standard of care for patients with intermediate-stage hepatocellular carcinoma (HCC) and relatively preserved liver function. Multiple randomized clinical trials demonstrated a survival benefit of TACE, and the treatment has been incorporated into multiple clinical guidelines as standard care for patients with unresectable HCC. In this article, efficacy, technique, indications and contraindications, along with nursing consideration for the preprocedure workup, procedural techniques, and postprocedure management for patients undergoing TACE for nonresectable HCC are reviewed. [ABSTRACT FROM AUTHOR]

To assess the incidence and predictive factors of abdominal pain following transarterial hepatic chemoembolization (TACE) in patients with hepatocellular carcinoma. In this single-center retrospective cohort study, abdominal pain was defined as a score of 4 or more within 72 h after TACE and requiring additional drug intervention. Patient, tumor characteristics, and technical factors associated with severe pain were identified using the decision tree and binary logistic regression model. Of 220 patients who were included in the study, 126 (57.3%) had abdominal pain after 206 of 420 TACE procedures (49.0%). A predictive model built based on the logistic regression identified the drug-eluting bead TACE (DEB-TACE) (odds ratio [OR] = 3.340; 95% confidence interval [CI] 2.169–5.141), the number of tumors (OR = 2.235; 95% CI 1.060–4.713), embolization of both hepatic lobes (OR = 2.310; 95% CI 1.109–4.813), and concomitant extrahepatic artery embolism (OR = 2.654; 95% CI 1.227–5.739) as the independent predictors of severe abdominal pain. Similarly, the decision tree confirmed the DEB-TACE as the strongest predictor of subsequent performance, followed by the history of hepatectomy and the embolization in the right or both lobes. The area under the receiver operating characteristic curve (AUC) of the classification prediction effect of the two models was 0.706 for the logistic regression and 0.676 for the decision tree. Internal validation results show that the accuracy of logistic regression model prediction was 71.4%. The model suggests that DEB-TACE and multiple treatment sites are predictors of abdominal pain after TACE in patients with hepatocellular carcinoma. It may help improve nursing management practices. • Almost half of the patients with HCC experienced abdominal pain after TACE. • Both analytical models identified similar predictors regarding such abdominal pain. • Effective symptom care is an important aspect in dealing with PES including abdominal pain. [ABSTRACT FROM AUTHOR]

Summary: Renal artery embolization (angio-infarction) of a large renal cell carcinoma, prior to excision, is an acceptable surgical option. It may reduce the tumour''s size and vascularity. However, postembolization syndrome, as characterized by flank pain, fever, nausea, and/or vomiting, is a potential complication of such an approach. The flank pain of this syndrome may be resistant to conventional opioid therapy. Here we report the successful use of a unilateral paravertabral block for the control of the unilateral flank pain of postembolization syndrome secondary to renal artery embolization. [Copyright &y& Elsevier]