Transarterial chemoembolization (TACE) is an image-guided, catheter-based therapy for hepatocellular carcinoma in which chemotherapy is delivered directly into the hepatic artery branches feeding the tumor, followed by embolization of those vessels. Because hepatocellular carcinoma derives most of its blood supply from the hepatic artery while normal liver parenchyma is fed predominantly by the portal vein, this approach concentrates treatment at the tumor while limiting systemic exposure.
Conventional TACE
Conventional TACE (cTACE) mixes a chemotherapeutic agent with ethiodized oil, which acts as both a drug carrier and an embolic that lodges in tumor vasculature. Particle embolization then completes arterial occlusion. cTACE has decades of clinical use and remains a reference standard for intermediate-stage hepatocellular carcinoma in many treatment algorithms.
Drug-eluting bead TACE
Drug-eluting bead TACE (DEB-TACE) loads the chemotherapeutic agent onto calibrated microspheres that release the drug in a slow, controlled manner after embolizing the target vessel. This produces more predictable pharmacokinetics, lower peak systemic drug concentrations, and a more standardized, reproducible procedure. Bead size selection allows the operator to tailor the depth of vascular penetration to tumor anatomy.
Key considerations
- Liquid embolic agents penetrate a malformation nidus or tumor bed and are suited to lesions that cannot be reached by discrete devices alone.
- Vascular plugs achieve rapid, single-device occlusion of larger high-flow vessels.
- Understanding collateral supply and non-target territories is fundamental to safe, effective embolization.
- Detachable coils allow controlled, retrievable positioning before final release, improving precision in aneurysm and vessel occlusion.
Patient selection and technique
Careful patient selection and imaging-based evaluation underpin good outcomes. Terminology that frequently arises includes nidus, superselective, microcatheter, non-target embolization. Superselective catheterization with microcatheters protects non-target liver tissue, and cone-beam CT is increasingly used to confirm tumor feeder coverage before delivery.
Device technologies
A range of embolization technologies supports contemporary transarterial therapy.
Explore the full Embolization portfolio for the devices used across these procedures.
Summary
Conventional and drug-eluting bead TACE are complementary options for hepatocellular carcinoma, and the choice between them rests on tumor burden, liver function, institutional experience, and multidisciplinary review. Sound patient selection, superselective technique, and well-matched embolic technology together support safe, effective care. INVAMED develops embolization technologies used by interventional radiologists worldwide.