Embolization Procedure for Hepatic Tumor

The embolization procedure has been described previously [23 (link),25 (link),26 (link),27 (link)]. The procedures were performed under aseptic conditions with prophylactic antibiotics. The animals were maintained under general anesthesia. A C-arm unit (Pulsera BV, Philips Medical Systems Inc., Best, The Netherlands) was used for angiography. The femoral artery was accessed through a surgical cut-down and catheterized with a 3 F vascular sheath, after which a 2.4 F microcatheter (Progreat, Terumo, Irvine, CA, USA) and microwire (Transcend 0.018”, Stryker Inc., Kalamazoo, MI, USA) were advanced into the common hepatic artery. Angiography was performed. The tumor was visualized as a region of hypervascular blush in the liver. The hepatic artery supplying the tumor was catheterized as selectively as possible and embolized using the DEE loaded with liposomal sorafenib or regorafenib under fluoroscopic visualization until vascular stasis was achieved. Post TACE, the femoral artery was ligated. Post procedure, the animals were monitored daily for signs of discomfort. Doses of Buprenorphine ranging from 0.01 to 0.05 mg/Kg and a 5 mg/Kg dose of Enrofloxacin were administered intramuscularly or subcutaneously if needed.