Numerical zero‐dimensional hepatic artery hemodynamics model for balloon‐occluded transarterial chemoembolization.

Abstract: Balloon‐occluded transarterial chemoembolization (B‐TACE) is a valuable treatment option for patients with inoperable malignant tumors in the liver. Balloon‐occluded transarterial chemoembolization consists of the transcatheter infusion of an anticancer drug mixture and embolic agents. Contrary to conventional TACE, B‐TACE is performed via an artery‐occluding microballoon catheter, which makes the blood flow to redistribute due to the intra‐ and extrahepatic arterial collateral circulation. Several recent studies have stressed the importance of the redistribution of blood flow in enhancing the treatment outcome. In the present study, the geometries of a representative hepatic artery and the communicating arcades (CAs) are modeled. An in silico zero‐dimensional hemodynamic model is created by characterizing the geometry and the boundary conditions and then is validated in vitro. The role of CAs is assessed by combining 2 cancer scenarios and 2 catheter locations. The importance of the diameter of the CAs is also studied. Results show that occluding a main artery leads to collateral circulation and CAs start to play a role in blood‐flow redistribution. In summary, numerical zero‐dimensional simulations permit a fast and reliable approach for exploring the blood‐flow redistribution caused by the occlusion of a main artery, and this approach could be used during B‐TACE planning. [ABSTRACT FROM AUTHOR]