Assessment of a Novel Microcatheter for Reflux Control in Chemoembolization Procedures Using Drug-Eluting Beads
In a recent study, a new microcatheter called the SeQure reflux control microcatheter has shown potential in reducing non-target embolization during drug-eluting bead transarterial chemoembolization (DEB-TACE) for hepatocellular carcinoma (HCC), a common type of primary liver cancer.
The study, which included 23 patients with 37 HCC nodules, compared the reflux control ability of the SeQure microcatheter to a standard microcatheter. Of the 23 patients, 21 were male, and most had underlying liver cirrhosis, often due to multifactorial causes. Many also had comorbidities such as hypertension, type 2 diabetes, a history of tobacco smoking, cardiopathy, and a history of another neoplasm.
The SeQure microcatheter, developed by Guerbet, France, is designed to reduce non-target embolization during TACE procedures, including DEB-TACE. It incorporates a unique anti-reflux mechanism that helps prevent the backflow of embolic agents into non-target areas, allowing for more precise delivery of drug-eluting beads to the tumor site.
In the study, non-target embolization (NTE) was found in 20% of patients in the SeQure microcatheter group, compared to 85% in the standard microcatheter group. Notably, no complications linked to NTE were found in the SeQure microcatheter group, while it led to one case of ischemic cholangitis and another case of biloma in the standard microcatheter group.
Furthermore, the SeQure microcatheter may be efficient in reducing NTE and thus eventual adverse events in comparison to standard of care end-hole microcatheters. TACE is the recommended treatment for intermediate stage HCC when curative options are not available.
The study found that treatment by TACE was recommended for 12/23 (52%) of the patients who were classified as BCLC B, and for 10/23 (44%) with BCLC A and one patient (4%) with BCLC 0 as a bridge to liver transplantation. Five patients had undergone prior cTACE, six patients a prior surgical resection, four had percutaneous thermal ablation, and one had received previous systemic chemotherapy.
In DEB-TACE, calibrated beads are loaded with chemotherapeutics beforehand, providing a more consistent embolization and a more controlled and sustained delivery of the drug. The HCC was unifocal in 10/23 (44%) of the patients and de novo in 17/23 (74%).
Overall, the SeQure reflux control microcatheter offers a specific advantage over standard microcatheters by its anti-reflux design, which can lead to more targeted delivery of drug-eluting beads and potentially reduce non-target embolization during DEB-TACE for HCC. However, the actual clinical benefits would depend on the results of specific studies comparing these devices.
Liver cancer is the third most frequent cause of cancer-related death globally, and HCC is the most common type of primary liver cancers. As research continues, the SeQure microcatheter may play a significant role in improving the efficacy of TACE treatments for HCC, potentially reducing complications and improving patient tolerability.
Interventional radiology, with its advancements like the SeQure reflux control microcatheter, is playing a significant role in the science of medical-conditions such as liver cancer, specifically hepatocellular carcinoma. This new device, when used in procedures like drug-eluting bead transarterial chemoembolization (DEB-TACE), could potentially improve health-and-wellness outcomes by reducing non-target embolization and associated adverse events, as suggested by recent studies.
