Case Study: Application of Vispearl® Radiopaque Drug-Eluting Embolic Microspheres in Hepatocellular Carcinoma by Professor Deng Jiran’s Team at Zigong Municipal First People's Hospital

The latest "Guidelines for the Diagnosis and Treatment of Primary Liver Cancer 2024" currently recommend transarterial chemoembolization (TACE) as the preferred treatment for patients with CNLC IIa, IIIa, and some IIIb stages. The foreign BCLC staging guidelines also recommend TACE as the preferred treatment for patients with BCLC stage B.

HuiHe Healthcare's Vispreal® Drug-Eluting Microspheres with Visibility Feature Have Unique Small Particle Sizes of 40μm-90μm to Meet Various Clinical Needs. The visibility of Vispearl® not only allows the drug-eluting microspheres to be traceable during the procedure, but also enables immediate postoperative evaluation of embolization effects, and localization of tumor lesions throughout the follow-up, which is more in line with the concept of precise TACE.

This case will share the application of Professor Deng Jiran's team from Zigong First People's Hospital in liver cancer.

Basic Information:65-Year-Old Male

History of Present Illness:DiscoveryHBV infection for over 20 years, hepatic space-occupying lesions found during physical examination 10 days ago. More than 20 years ago at admission, the patient was found to have HBV infection during a physical examination, with no specific discomfort, and no diagnosis or treatment was given. Ten days ago, the patient was examined outside the hospital.AFP>1000ng/mlAbdominal Color Doppler Ultrasound:Solid Nodule in the Left Lobe of the Liver, nature to be determined.

Past Medical History:History of gout, history of smoking.

Laboratory Tests:Hepatitis B Small Three Positive,AFP 1646ng/ml, AST 53U/L; Coagulation indices are normal.

Admission Diagnosis：Space-occupying Lesion of the Liver

Surgical Strategy：Liver TACE Procedure

The three tumors are all located in the left lobe of the liver. The right femoral artery was chosen for puncture and catheterization. Celiac angiography showed a nodular tumor blush in the lateral segment of the left hepatic lobe. Superselective angiography of the left hepatic artery with a microcatheter revealed three nodular tumor blushes.

After super-selectively catheterizing the blood-supplying arteries of three tumors in the left lobe of the liver with a microcatheter and confirming by angiography, Vipearl was used.Drug-eluting microspheres (40-90μm/1.0g) loaded with 80mg of pirarubicin for tumor embolization treatment, followed by the use of blank microspheres (300-500μm).Proximal Tumor Vascular Embolization Treatment.Post-embolization angiography showed occlusion of tumor vessels and disappearance of tumor staining.

Postoperative Follow-up: The patient's AFP decreased from 1646 ng/ml (one week before surgery) to 16.09 ng/ml (one month after surgery), ALT decreased from 55 U/L (one week before surgery) to 34 U/L (one month after surgery), and AST decreased from 55 U/L (one week before surgery) to 40 U/L (one month after surgery). A plain CT scan one month after surgery showed tumor shrinkage (the largest nodule reduced from 2.8 cm to 2.3 cm) and denser high-density shadows within the tumor compared to before.

CT Image One Month Post-Operation

Professor Deng Jiran stated: In the clinical practice of this case series, Vispreal^®Drug-eluting beads with imaging capabilities have been proven to have excellent safety and efficacy. Their core advantage lies in the unique imaging function, which allows operators to clearly and intuitively assess the distribution and filling degree of the beads within the tumor lesion through real-time imaging.

In terms of efficacy, sufficient tumor packing provides a guarantee for the sustained release of local drug concentration, laying a solid foundation for anti-tumor effects. In terms of safety, in addition to improved operational safety, this study particularly observed that, compared with some traditional embolic materials, patients using Vispreal® experienced less fluctuation in liver function indicators post-surgery and had a lower risk of severe liver function damage. This suggests minimal damage to normal liver tissue and better patient tolerance. In summary, Vispreal® visualized drug-loaded microspheres, with their "visualizable" embolization and excellent safety, provide a powerful tool for achieving precise interventional treatment of liver cancer.