Adverse effects of irreversible electroporation of malignant liver tumors under CT fluoroscopic guidance: a single-center experience

Abstract

PURPOSE We aimed to describe the frequency of adverse events after computed tomography (CT) fluoros-copy-guided irreversible electroporation (IRE) of malignant hepatic tumors and their risk factors.METHODSWe retrospectively analyzed 85 IRE ablation procedures of 114 malignant liver tumors (52 prima-ry and 62 secondary) not suitable for resection or thermal ablation in 56 patients (42 men and 14 women; median age, 61 years) with regard to mortality and treatment-related complications. Complications were evaluated according to the standardized grading system of the Society of In-terventional Radiology. Factors influencing the occurrence of major and minor complications were investigated.RESULTSNo IRE-related death occurred. Major complications occurred in 7.1% of IRE procedures (6/85), while minor complications occurred in 18.8% (16/85). The most frequent major complication was postablative abscess (4.7%, 4/85) which affected patients with bilioenteric anastomosis significant-ly more often than patients without this condition (43% vs. 1.3%, P = 0.010). Bilioenteric anastomo-sis was additionally identified as a risk factor for major complications in general (P = 0.002). Minor complications mainly consisted of hemorrhage and portal vein branch thrombosis.CONCLUSIONThe current study suggests that CT fluoroscopy-guided IRE ablation of malignant liver tumors may be a relatively low-risk procedure. However, patients with bilioenteric anastomosis seem to have an increased risk of postablative abscess formation.