This course deals with a 66 year old male with liver metastases from well differentiated neuroendocrine tumor from the small bowel. He has been referred for intra arterial therapy to the liver because of flush and diarrhea associated with slow growing of a predominant tumor burden to the liver. Lipiodol-TACE (Trans Arterial Chemo Embolisation) will be demonstrated in this case which target selectively the left liver (Previous TACE has target right posterior liver segment).

Objectives:

• To acquire the technical aspects of the TACE procedure (Arterial puncture, catheterization.
• To know the hepatic arterial anatomy, and its main variations.
• To know flow rates and volume for hepatic angiography, including DSA and cone beam CT.
• To understand how to use the 3D CNCT angiography for vascular navigation including computed guided vascular navigation.
• To know how to use and were to place the micro-catheter for Lipiodol-TACE.
• To know how to prepare Lipiodol/doxorubicin emulsion in order to improve Lipiodol uptake.
• To understand the benefit of post embolization imaging with cone beam CT.

• 3D angio   10:15 / 09:40 / 11:10
• Arterial anatomy   02:45 / 06:30
• Arterial puncture   01:15
• Catheterization   02:35
• Computer guided vascular navigation   15:39 / 12:50 / 17:00
• Drug   18:13 / 23:50
• Embolic material   21:10
• Inferior phrenic artery   06:56
• Lipiodol emulsion  18:13 / 23:50
• Micro-catheter   11:35 / 15:00
• Papaverine   04:35
• Portography   02:50 / 05:50 / 04:11
• Power injector flow rates   07:36 / 10:20 / 05:40

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