Balloon-occluded Infusion of Fragmented Gelatin Particles of Transarterial Embolization for Hypervascular Hepatic Metastases: A Prospective Trial

Abstract

Background/aim: Balloon-occluded infusion of fragmented gelatin particles of transarterial embolization (BOIG-TAE) is a chemotherapy-free technique combining selective balloon occlusion with gelatin particle embolization.

Patients and methods: This prospective, single-arm study (June 2022-June 2025) enrolled patients with hypervascular hepatic metastases refractory or intolerant to standard systemic therapy, with safety as the primary endpoint and preliminary efficacy and hepatic function as secondary endpoints. Adverse events were evaluated using Society of Interventional Radiology (SIR) criteria. Tumor response was independently assessed two months after treatment using modified Response Evaluation Criteria in Solid Tumors (mRECIST) and hepatic function was monitored using Child-Pugh and albumin-bilirubin (ALBI) scores.

Results: Six patients were enrolled (median age, 77 years; 4 male patients). One patient experienced transient abdominal pain lasting one week (SIR grade C); no other major complications occurred. Transient elevations in aspartate aminotransferase and alanine aminotransferase occurred in all patients and resolved within one month. No biliary or renal complications were recorded. The objective response rate at two months was 66.7% (4/6) and Child-Pugh and ALBI scores remained stable during follow-up.

Conclusion: BOIG-TAE may be feasible and generally well tolerated in selected patients, with potential for short-term tumor control while preserving hepatic function.

Keywords: Metastasis; TAE; transarterial embolization.