Trans-Arterial Chemo Embolisation (DC Bead) of Metastases from a Choroid Melanoma

Jakub Wiskirchen, MD, Gunnar Tepe, MD, and Philippe L. Pereira, MD
Department for Diagnostic and Interventional Radiology University Hospital Tübingen, Germany

Patient History

Female patient (66 y) suffering from a choroid melanoma. The CT scans (Figs 1 and 2) showed multiple hypovascular metastases. Thus, initially we were asked to perform a chemoperfusion of the liver.

However, an initial angiography shaved presented the metastases to be hypervascular and it was decided to perform an arterial chemoembolisation.

Fig Fig 2

Procedure

After obtaining a survey angiography (Fig 3) using a 4Fr C2 Cobra™ (Cook®) catheter, the feeder of the metastases was catheterised with the help of a 2.7Fr microcatheter (Progreat™, Terumo®), and a total of 2ml DC Bead™ (Biocompatibles) loaded with 50mg epirubicin (Pfizer) were introduced (Fig 4 and 5).

Fig 3 Fig 4

Outcome

In the control angiography following embolisation the previously hypervascular metastases no longer opacified (Fig 6).

Fig 5 Fig 6

DC Bead Sizes and Label Colours

Bead size & label colour Volume
of
beads		 Product code Time to >90% loading Time to 98% loading
100-300µm 2ml DC2V103 5 mins 20 mins
300-500µm 2ml DC2V305 10 mins 40 mins
500-700µm 2ml DC2V507 20 mins 75 mins
700-900µm 2ml DC2V709 30 mins 100 mins

 

Regulatory Notices

Worldwide (excluding USA and Canada)

DC Bead® is CE marked and is indicated for the treatment of malignant hypervascular tumours and loading with doxorubicin drug. DC Bead® is also indicated for loading with irinotecan for the treatment of metastatic colorectal cancer (mCRC). For full prescribing information please refer to DC Bead instructions for use.

USA

DC Bead is not currently available for sale or distribution in the USA. DC Bead has not been submitted for approval to the FDA.

Canada

DC Bead® with doxorubicin is indicated for trans-arterial chemoembolization (TACE) of unresectable hepatocellular carcinoma (HCC). DC Bead are also intended to be loaded with irinotecan for the purpose of embolization of vessels supplying malignant colorectal cancer metastasised to the liver (mCRC), and delivery of a local, controlled, sustained dose of irinotecan to the mCRC. For full prescribing information please refer to DC Bead Canada Instructions for Use 

Tawain

DC Bead is approved by the Department of Health and is intended to be loaded with Mayne (Hospira) doxorubicin HCI for the purpose of embolisation of vessels supplying malignant hypervascularised tumour(s), and delivery of a local, controlled, sustained dose of doxorubicin.  DC Bead is also indicated for the embolisation of nidus vessels without medication.  Approved size ranges in Taiwan are 300-500µm and 500-700µm.