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Treatment of liver metastases with percutaneous embolization (coiling) or chemoembolization (634355) | University Hospital Mainz - BookingHealth
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After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.<\/p>\n\n<p style=\"text-align:justify\"><strong>Chemoembolization <\/strong>begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.<\/p>\n\n<p style=\"text-align:justify\">When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.<\/p>\n\n<p style=\"text-align:justify\">Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.<\/p>\n\n<p style=\"text-align:justify\">After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.<\/p>\n\n<p style=\"text-align:justify\"><strong>After the first procedure<\/strong>, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li style=\"text-align: justify;\">Medical records<\/li>\n\t<li style=\"text-align: justify;\">Abdominal ultrasound (if available)<\/li>\n\t<li style=\"text-align: justify;\">MRI\/CT scan of the abdomen (if available)<\/li>\n\t<li style=\"text-align: justify;\">Biopsy results (if available)<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the clinic<\/li>\n\t<li>clinical history taking<\/li>\n\t<li>review of medical records<\/li>\n\t<li>physical examination<\/li>\n\t<li>laboratory tests:\n\t<ul>\n\t\t<li>complete blood count<\/li>\n\t\t<li>general urine analysis<\/li>\n\t\t<li>biochemical analysis of blood<\/li>\n\t\t<li>TSH-basal, fT3, fT4<\/li>\n\t\t<li>tumor markers (AFP, CEA, \u0421\u0410-19-9)<\/li>\n\t\t<li>inflammation indicators (CRP, ESR)<\/li>\n\t\t<li>indicators of blood coagulation<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>abdominal ultrasound\u200b scan<\/li>\n\t<li>CT\/MRI of abdomen<\/li>\n\t<li>preoperative care<\/li>\n\t<li>percutaneous embolization (coiling)&nbsp;or chemoembolization<\/li>\n\t<li>symptomatic treatment<\/li>\n\t<li>cost of essential medicines<\/li>\n\t<li>nursing services<\/li>\n\t<li>elaboration of further recommendations<\/li>\n<\/ul>\n<div class=\"program_indications_for_surgery\"><h4>Indications<\/h4><ul>\n\t<li>Inoperable liver metastases<\/li>\n\t<li>Poor response&nbsp;to systemic chemotherapy<\/li>\n<\/ul>\n\n<p><strong>Treatment is not indicated<\/strong> in:<\/p>\n\n<ul>\n\t<li>Presence of extrahepatic metastases<\/li>\n\t<li>Affection of more than 70% of the liver<\/div><div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align:justify\"><strong>During the first visit<\/strong>, the doctor will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.<\/p>\n\n<p style=\"text-align:justify\"><strong>Chemoembolization <\/strong>begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.<\/p>\n\n<p style=\"text-align:justify\">When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.<\/p>\n\n<p style=\"text-align:justify\">Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.<\/p>\n\n<p style=\"text-align:justify\">After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.<\/p>\n\n<p style=\"text-align:justify\"><strong>After the first procedure<\/strong>, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. 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Treatment of liver metastases with percutaneous embolization (coiling) or chemoembolization in University Hospital Mainz

University Hospital Mainz

Mainz, Germany
Program id # 634355
Doctor photo
Prof. Dr. med. Christoph Düber
Department of Adult and Pediatric Diagnostic, Interventional Radiology
Specialized in: adult and pediatric diagnostic, interventional radiology

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • review of medical records
  • physical examination
  • laboratory tests:
    • complete blood count
    • general urine analysis
    • biochemical analysis of blood
    • TSH-basal, fT3, fT4
    • tumor markers (AFP, CEA, СА-19-9)
    • inflammation indicators (CRP, ESR)
    • indicators of blood coagulation
  • abdominal ultrasound​ scan
  • CT/MRI of abdomen
  • preoperative care
  • percutaneous embolization (coiling) or chemoembolization
  • symptomatic treatment
  • cost of essential medicines
  • nursing services
  • elaboration of further recommendations

Indications

  • Inoperable liver metastases
  • Poor response to systemic chemotherapy

Treatment is not indicated in:

  • Presence of extrahepatic metastases
  • Affection of more than 70% of the liver

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.

Chemoembolization begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.

When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.

Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.

After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.

After the first procedure, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.

Required documents

  • Medical records
  • Abdominal ultrasound (if available)
  • MRI/CT scan of the abdomen (if available)
  • Biopsy results (if available)

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About the department

The Department of Adult and Pediatric Diagnostic, Interventional Radiology at the University Hospital Mainz offers the full range of services in these medical fields. Patient care is provided both on an outpatient and inpatient basis. The department has all the modern imaging methods for the most accurate diagnostics and interventional therapy. The highly qualified doctors with extensive clinical experience and high rates of successful treatment take care of patient health. The department is headed by Prof. Dr. med. Christoph Düber.

The service range of the department includes:

  • Diagnostic radiology
    • Conventional X-ray studies
    • Functional diagnostics
      • Contrast-enhanced examinations of the gastrointestinal tract 
      • Joint examination (arthrography in combination with MRI or CT)
      • Spinal cord examination (myelography)
      • Venous examination (phlebography)
      • Bile duct examination
    • Ultrasound diagnostics (in accordance with the requirements of the German Society for Ultrasound in Medicine)
    • Breast imaging diagnostics and minimally invasive biopsy
      • Full-field digital mammography with a minimum radiation dose 
      • Tomosynthesis
      • Magnetic resonance imaging (MRI)
      • High resolution ultrasound with color duplex sonography (3D and 4D)
      • Needle biopsy and stereotactic vacuum biopsy
      • Galactography
      • Preoperative marking and intraoperative radiography
      • Second opinion and consultation on diagnostics
    • Computed tomography (CT)
    • Combined PET-CT method
    • Magnetic resonance imaging (MRI)
      • MRI of the musculoskeletal system (joints, ligaments, muscles, tendons, bones)
      • MRI of the central nervous system (brain and spinal cord)
      • MRI of the abdominal cavity and retroperitoneal space (liver, spleen, pancreas, kidney)
      • MRI of the pelvic organs (bladder, rectum, genital organs)
      • MRI of the heart and blood vessels
    • Angiography
  • Interventional radiology
    • Patency restoration of the narrowed or occluded blood vessels of the legs and arms, head and neck, internal organs (for example, liver, kidneys, intestines or lungs) using a balloon catheter, a stent or thrombolysis
    • Treatment of thoracic and abdominal aortic aneurysms (EVAR) and aneurysms of other arteries
    • Treatment of vascular dissections and vascular lesions
    • Blood vessel closure (embolization) in bleeding and tumors
    • Uterine artery embolization for the treatment of uterine myomas
    • Puncture (tissue sampling)
    • Drainage placement to eliminate abscesses and fluid accumulations
    • Local ablation therapy of tumors using radiofrequency ablation, irreversible electroporation and microwave ablation (in particular, in tumors of the liver, lungs, bones and other organs)
    • Percutaneous transhepatic gallbladder drainage
    • Stenting in esophageal and intestinal stenosis
    • Installation of feeding tubes in the stomach and intestines (gastrostomy, jejunostomy)
    • Transjugular intrahepatic portosystemic shunting
    • Pain therapy (for example, solar plexus block)
    • Vertebroplasty for the treatment of pathological vertebral fractures
    • Prostate artery embolization
    • Transarterial chemotherapy for the treatment of liver cancer and liver metastases
    • Internal selective radiation therapy and radioembolization for the treatment of liver cancer and liver metastases
  • Pediatric radiology
    • Ultrasound examinations
    • Computed tomography (CT)
    • Magnetic resonance imaging (MRI)
    • X-ray examinations
  • Other diagnostic and therapeutic options in radiology

Curriculum vitae

  • 1976 -1982 Study of Human Medicine at the Johannes Gutenberg University Mainz, Fellow of the German Foundation Studienstiftung des Deutschen Volkes.
  • 02.28.1984 Doctoral dissertation defense (summa cum laude), Johannes Gutenberg University Mainz.

Professional and Academic Training

  • 1982 - 1984 Research Assistant, Institute of Pathology at the University of Mainz (Head: Prof. Dr. V. Thoenes).
  • 1984 - 1989 Research Assistant, Department of Adult and Pediatric Diagnostic, Interventional Radiology, University Hospital Mainz (Head: Prof. Dr. M. Thelen).
  • 06.03.1989 Medical Specialist in Radiology.
  • 1991 - 2000 Senior Physician, Department of Adult and Pediatric Diagnostic, Interventional Radiology, University Hospital Mainz (Head: Prof. Dr. M. Thelen).
  • 04.11.1993 Habilitation in Radiology.
  • 01.11.2000 C4 Professor in Clinical Radiology, Department of Clinical Medicine at the University of Heidelberg, as well as Head of the Institute for Clinical Radiology at the University Hospital Mannheim.
  • 01.05.2005 W3 Professor in Diagnostic and Interventional Radiology at the Johannes Gutenberg University Mainz and Head of the Department of Adult and Pediatric Diagnostic, Interventional Radiology, University Hospital Mainz.

Photo of the doctor: (c) Universitätsmedizin der Johannes Gutenberg-Universität Mainz 


About hospital

The University Hospital Mainz is one of the best maximum care medical facilities in Germany and an internationally recognized scientific center. There are more than 60 departments and institutes, which represent all fields of modern medicine. The hospital serves more than 68,000 inpatients and more than 273,000 outpatients annually, which testifies to the excellent reputation of this medical institution.

The key to the successful clinical practice is also a highly qualified medical staff, which consists of 7.800 employees from various fields. The doctors of the hospital are convinced that each clinical case requires an individual approach, therefore, they devote much time to consultations and communication with patients. The main goal of all hospital employees is to provide an optimal medical care based on the use of the state-of-art diagnostic and therapeutic measures, as well as the introduction of the latest scientific achievements into the medical practice.

The best interns and assistant physicians are trained here. The world-famous leading physicians of the hospital share their long experience and professional skills. Naturally, an integral part of the university hospital work is research, thanks to which many innovative possibilities in the field of diagnostics and therapy have been developed.

Photo: (c) depositphotos

Accommodation in hospital

Patients rooms

The patients of the University Hospital Mainz live in bright, spacious and comfortable rooms. The patient rooms are equipped with modern electronically adjustable beds, which at the touch of a button automatically assume a specified position. Also, there is a TV and a telephone in the patient rooms. To use them, it is necessary to get a prepaid card (in vending machines at the entrance to the hospital). The use of a TV is free, but the patient will need headphones. Telephone calls are made for a fixed fee, which will be withdrawn from the prepaid card at discharge from the hospital. Also, each patient room is equipped with an ensuite bathroom with shower, washbasin and toilet.

Meals and Menus

The patients of the hospital are offered a tasty and balanced three meals a day: breakfast, lunch and dinner. The menu also includes vegetarian and dietary dishes. In addition, for both patients and their visitors there are available cafeterias and bakeries, where one can buy baked goods, snacks, hot and cold drinks.

Further details

Standard rooms include:

Shower
Toilet
TV