CONTRAINDICATIONS

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Absolute contraindications

  • Factors related to liver cirrhosis: ■
    • Decompensated cirrhosis (Child-Pugh B, score >8)
      • jaundice, clinical hepatic encephalopathy, and refractory ascites and/or hepatorenal syndrome ■
    • Impaired portal-vein blood flow
      • Portal-vein thrombus, hepatofugal blood flow
  • Factors related to HCC:
    • Extensive tumour involving the entirety of both lobes of the liver
    • Tumourous portal vein thrombosis
  • Technical contraindication to hepatic intra-arterial treatment:
    • Renal insufficiency (creatinine ≥2 mg/dl or creatinine clearance <30 ml/min)

Relative contraindications

  • Factors related to liver cirrhosis:
    • Oesophageal varices at high risk of bleeding
  • Factors related to HCC:
    • Large tumour (>10cm)
  • Others factors:
    • Severe comorbidities that compromise organ function
    • Incompetent papilla with aerobilia (owing to biliary stenting or surgery)
    • Biliary dilatation