We report the case of a 71-year-old female patient with previous history of rectal cancer. The primary cancer was resected and three cycles of chemotherapy were completed. Excision of metastatic lesions was also performed from the left liver lobe. Due to the presence of new liver lesions on the right lobe, intra-operative microwave ablation was decided. Three hours post ablation the patient bled massively and angiography revealed extravasation from a peripheral branch of the right hepatic artery. Successful embolization was performed; however, the patient died 5 days later on liver failure. We would like to present the case and discuss the technical options and the key points to help avoiding similar complications in the future.
Tanaka K, Shimada H, Nagano Y, Endo I, Sekido H, Togo S: Outcome after hepatic resection versus combined resection and microwave ablation for multiple bipolar colorectal metastases to the liver. Surgery 139, 263–273 (2006)
Togo S. , 'Outcome after hepatic resection versus combined resection and microwave ablation for multiple bipolar colorectal metastases to the liver ' (2006 ) 139 Surgery : 263 -273 .
Erce C, Parks RW: Interstitial ablative techniques for hepatic tumours. Br J Surg 90, 272–289 (2003)
Parks R.W. , 'Interstitial ablative techniques for hepatic tumours ' (2003 ) 90 Br J Surg : 272 -289 .
Gillams AR, Lees WR: Five-year survival following radiofrequency ablation of small, solitary, hepatic colorectal metastases. J Vasc Intervent Radiol 19, 712–717 (2008)
Lees W.R. , 'Five-year survival following radiofrequency ablation of small, solitary, hepatic colorectal metastases ' (2008 ) 19 J Vasc Intervent Radiol : 712 -717 .
Flanders VL, Gevrais DA: Ablation of liver metastases: Current status. J Vasc Interv Radiol 21, S214–S222 (2010)
Gevrais D.A. , 'Ablation of liver metastases: Current status ' (2010 ) 21 J Vasc Interv Radiol : S214 -S222 .
Ong SL, Gravante G, Metcalfe MS, Strickland AD, Dennison AR, Lloyd DM: Efficacy and safety of microwave ablation for primary and secondary liver malignancies: A systematic review. Eur Gastrenterol Hepatol 21, 599–605 (2009)
Lloyd D.M. , 'Efficacy and safety of microwave ablation for primary and secondary liver malignancies: A systematic review ' (2009 ) 21 Eur Gastrenterol Hepatol : 599 -605 .
Bertot LC, Sato M, Tateishi R, Yoshida H, Koike K: Mortality and complication rates of percutaneous ablative techniques for treatment of liver tumors: A systematic review. Eur Radiol 21, 2584–2596 (2003)
Koike K. , 'Mortality and complication rates of percutaneous ablative techniques for treatment of liver tumors: A systematic review ' (2003 ) 21 Eur Radiol : 2584 -2596 .
Livraghi T, Meloni F, Solbiati L, Zanus G; Collaborative Italian Group using AMICA system: Complications of microwave ablation for liver tumors: Results of a multicenter study. Cardiovasc Intervent Radiol 35, 868–874 (2012)
Zanus G. , 'Complications of microwave ablation for liver tumors: Results of a multicenter study ' (2012 ) 35 Cardiovasc Intervent Radiol : 868 -874 .
Livraghi T, Solbiati L, Meloni MF, Gazelle GS, Halpern EF, Goldberg SN: Treatment of focal liver tumors with percutaneous radiofrequency ablation: Complications encountered in a multicenter study. Radiology 226, 441–451 (2003)
Goldberg S.N. , 'Treatment of focal liver tumors with percutaneous radiofrequency ablation: Complications encountered in a multicenter study ' (2003 ) 226 Radiology : 441 -451 .
Liang P, Wang Y, Yu X, Dong B: Malignant liver tumors: Treatment with percutaneous microwave ablation: Complications among cohort of 1136 patients. Radiology 251, 933–940 (2009)
Dong B. , 'Malignant liver tumors: Treatment with percutaneous microwave ablation: Complications among cohort of 1136 patients ' (2009 ) 251 Radiology : 933 -940 .
Martin RC, Scoggins CR, McMasters KM: Safety and efficacy of microwave ablation of hepatic tumors: A prospective review of a 5-year experience. Ann Surg Oncol 17, 171–178 (2010)
McMasters K.M. , 'Safety and efficacy of microwave ablation of hepatic tumors: A prospective review of a 5-year experience ' (2010 ) 17 Ann Surg Oncol : 171 -178 .
Jones C, Badger SA, Ellis G: The role of microwave ablation in the management of hepatic colorectal metastases. Surgeon 9, 33–37 (2011)
Ellis G. , 'The role of microwave ablation in the management of hepatic colorectal metastases ' (2011 ) 9 Surgeon : 33 -37 .
Rees M, Tekkis PP, Welsh FK, O’Rourke T, John TG: Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: A multifactorial model of 929 patients. Ann Surg 247, 125–135 (2008)
John T.G. , 'Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: A multifactorial model of 929 patients ' (2008 ) 247 Ann Surg : 125 -135 .
Simon CJ, Dupuy DE, Mayo-Smith WW: Microwave ablation: Principles and applications. Radiographics 25, S69–S83 (2005)
Mayo-Smith W.W. , 'Microwave ablation: Principles and applications ' (2005 ) 25 Radiographics : S69 -S83 .
McWilliams JP, Yamamoto S, Raman SS, Loh CT, Lee EW, Liu DM, Kee ST: Percutaneous ablation of hepatocellular carcinoma: Current status. J Vasc Interv Radiol 21, S204–S213 (2010)
Kee S.T. , 'Percutaneous ablation of hepatocellular carcinoma: Current status ' (2010 ) 21 J Vasc Interv Radiol : S204 -S213 .
Hartmann E, Németh A, Juharosi Gy, Lénárd Zs, Deák PÁ, Kozma V, Nagy P, Gerlei Zs, Fehérvári I, Nemes B, Görög D, Fazakas J, Kóbori L, Doros A: Downstaging of hepatocellular carcinoma with radiofrequency ablation on the Hungarian liver transplantation waiting list — Early results and learned lesson. IMAS 1, 41–45 (2009)
Doros A. , 'Downstaging of hepatocellular carcinoma with radiofrequency ablation on the Hungarian liver transplantation waiting list — Early results and learned lesson ' (2009 ) 1 IMAS : 41 -45 .
Kozma V, Végső Gy, Deák PÁ, Hartmann E, Németh A, Török Sz, Langer R, Doros A: Radiofrequency ablation of an intercalyceal neoplasm in a transplanted kidney using percutaneous nephrostomy for cooling — Safety and early result. IMAS 2, 37–41 (2010)
Doros A. , 'Radiofrequency ablation of an intercalyceal neoplasm in a transplanted kidney using percutaneous nephrostomy for cooling — Safety and early result ' (2010 ) 2 IMAS : 37 -41 .