Skip to main content
SIR 2025 Event Main banner
BSCI - Consideration Cases Ad 1
Merit/DPSSME Siege
Back

SIR 2025

Interventional Oncology

Educational Exhibit

Session: Educational Exhibit Presentations - Interventional Oncology

Beyond the Target: Innovative Management of Non-Target Embolization in Hepatocellular Carcinoma Treatments

Monday, March 31, 2025
5:30 PM – 5:35 PM CT
Location: Music City Center, 209 ABC
Learning Objectives: To detail medical and interventional management of adverse effects involved with non-target radioembolization during trans-arterial radioembolization (TARE) of hepatocellular carcinoma (HCC).

Background: Yttrium-90 (Y90) radioembolization is a well-recognized and studied therapy for HCC in patients who are not candidates for surgery or liver transplant. It provides targeted radiation to tumors which results in lower radiation doses to surrounding tissues. Despite its precision, non-target embolization can affect adjacent organs, leading to complications like gastric ulceration, pancreatitis, cholecystitis, and radiation pneumonitis.

Clinical Findings/Procedure Details: This presentation will cover the range of complications arising from non-target radioembolization and offer a detailed review of management strategies based on current literature. Complications such as gastric ulceration due to gastric artery involvement, pancreatitis from pancreatic embolization, and cholecystitis due to gallbladder embolization will be discussed. We will explore the benefits and drawbacks of conservative versus aggressive treatment approaches for each condition. For example, conservative management of gastric ulcers with proton pump inhibitors may be preferable in some cases over surgical intervention. Similarly, corticosteroid therapy may effectively treat radiation pneumonitis, while biliary injuries might require endoscopic or surgical management. We will also review case examples illustrating different management outcomes. Special attention will be given to the decision-making process involved in treating these complications, as well as the morbidity and mortality associated with both aggressive and conservative approaches.

Conclusion and/or Teaching Points: Trans-arterial radioembolization is a cornerstone therapy for HCC, but non-target embolization remains a challenging complication. Since non-target embolization can lead to serious adverse events, understanding management of these complications is crucial for decreasing further morbidity and mortality for the patient.