This information will help you prepare for your hepatic embolization procedure at Memorial Sloan Kettering Cancer Center (MSKCC).
The hepatic artery is the main source of blood for most liver tumors. A hepatic embolization involves injecting tiny particles through a small catheter (a thin, flexible tube), threaded into the hepatic artery. These particles kill the tumor by blocking the flow of blood that the tumor needs to survive.
Hepatic embolization procedures are performed in the Radiology Department. The specific area is called Interventional Radiology (IR).
Before Your Procedure
Ask about your medications
You may need to stop taking some of your medications before your procedure. We have included some common examples below.
- If you take medication to thin your blood, ask the doctor performing your hepatic embolization what to do. Some examples are aspirin, warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), cilostazol (Pletal®), prasugrel (Effient®), and ticlopidine (Ticlid®). These medications might be used to treat blood clots or to prevent a heart attack or stroke.
- If you take insulin or other medications for diabetes, you may need to change the dose before your procedure. Ask the doctor performing your hepatic embolization what you should do the day before and the morning of your procedure.
- Do not take vitamin E 10 days before your procedure.
Tell us if you're sick
If you develop any illness (fever, cold, sore throat, or flu) before your procedure, please call a nurse in Interventional Radiology at (212) 639-2236. A nurse is available Monday through Friday, 9:00 am to 5:00 pm. After hours, during the weekend, and on holidays, call (212) 639-2000 and ask for the Interventional Radiology fellow on call.
2 Days Before Your Procedure
Do not take any nonsteroidal anti-inflammatory medications (NSAIDS) 2 days before your procedure. Please review the information in Common Medications Containing Aspirin and Nonsteroidal Anti-Inflammatory Drugs for examples of what not to take and what to take instead.
The Day Before Your Procedure
A staff member from the Interventional Radiology office will call you 2 business days before your procedure. He or she will tell you what time you should arrive at the hospital for your appointment. If you are scheduled for your procedure on a Monday, you will be called on the Thursday before. If you don't receive a call by
12:00 pm the business day before your procedure, please call (212) 639-5051.
If you need to cancel your procedure for any reason, please call the doctor who scheduled it for you.
Do not eat or drink anything after midnight the night before your surgery. This includes water, gum, and hard candy.
The Day of Your Procedure
Things to remember
- Do not eat or drink anything the morning of your surgery. This includes water, gum, and hard candy.
- Take your medications the morning of the procedure as instructed by your doctor.
- Do not apply cream or petroleum jelly (Vaseline®). You may use deodorant and light moisturizers.
- Remove any jewelry, including body piercings.
- Leave all valuables such as credit cards and jewelry at home.
- If you wear contact lenses, if possible, wear your glasses instead. If you don't have glasses please bring a case for your contacts.
- If you use a C-Pap or Bi-pap machine to sleep at night, if possible please bring your machine in. If you can't bring your machine we will give you one to use while you are in the hospital.
What to bring with you
- A list of the medications you take at home
- Medications for breathing problems (such as inhalers) or medications for chest pain or both
- A case for your glasses or contacts
- Your Health Care Proxy form, if you have completed one
Where to park
Parking at MSKCC is available in the garage on East 66th Street between First and York Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about a quarter of a block toward First Avenue, on the right (north) side of the street. A tunnel connects the garage to the hospital. There are also nearby commercial garages: 4 on East 69th Street between First and Second Avenues and 3 on East 65th Street between First and Second Avenues. For questions about pricing, call (212) 639-2338.
Where to go
Please arrive at the main building of MSKCC at 1275 York Avenue. Take the M elevator to the 2nd floor. Enter through the glass doors and check in at the desk.
What to expect
Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. Patients with the same or similar names may be having procedures on the same day.
After changing into a hospital gown, you will meet your nurse. He or she will place an intravenous (IV) catheter into a vein, usually in your hand or arm. At first, you will receive liquids through the IV, but it will be used later to give you medication to make you sleepy.
When it is time for your procedure, you will be brought into the procedure room and helped onto an exam table. You will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose. A member of our clinical team will help position you onto your back. Your groin will be cleaned, shaved, and covered with sterile drapes. A local anesthetic will be injected into the area where your doctor will be working. A catheter (thin, flexible tube) will be threaded through the artery in your groin up to the artery that supplies the blood to your liver. To make sure the catheter is in the right place, an angiogram will be performed. An angiogram is an X-ray test that uses contrast (special dye) to allow your doctor to locate your tumor and arteries. Once your tumor is located, the particles that block the artery will be injected into your artery. When the procedure is completed, your doctor will remove the catheter and close up your incision.
After Your Procedure
In the recovery room
In the recovery room your nurse will continue to monitor your pain, heart, breathing, and blood pressure. He or she will monitor your puncture site for any bleeding. Depending on how the hole in your artery was closed, you may have to remain flat on your back in bed with your legs straight for up to 4 hours. While you are in the recovery room, tell your nurse if your dressing feels wet or warm. Once your anesthesia has worn off, you will be taken to your hospital room. Most patients stay in the hospital for 3 days.
Do not swim, sit in a hot tub, or take a bath for 1 week after your procedure. Unless your nurse or doctor tells you not to, you can start showering 24 hours after your procedure. Remove the bandage and wash the procedure area with soap and water. Gently dry the area with a clean towel. You may want to place a clean Band-Aid® over the area if there is any drainage.
Make an appointment to see your doctor 6 weeks after your procedure.
After being discharged from the hospital, some patients develop side effects from treatment, including:
To help decrease your pain, resume to your normal diet slowly. Start by drinking only clear liquids. Call your doctor if any of your symptoms worsen.
Call Your Doctor or Nurse If You Have:
- Pain, nausea or vomiting that is uncontrolled or worse than it was before your procedure
- Redness, swelling, or drainage around the needle marks on your back
- A temperature of 101° F (38.3° C) or higher
- Any symptoms that are worrying you