Background: Transarterial embolization (TAE) is an established therapeutic option for non-variceal gastrointestinal bleeding (GIB), but standardized criteria for patient selection and predictors of treatment outcomes remain limited. This study aimed to evaluate clinical outcomes after TAE and identify factors associated with treatment failure and 30-day mortality. Methods: We retrospectively reviewed all TAE procedures performed for nonvariceal GIB at Semmelweis University between May 2022 and July 2025. Clinical, laboratory, and procedural parameters were collected, including bleeding location, comorbidity burden, antithrombotic therapy, transfusion requirements, vasopressor or inotropic support, and embolization technique. Predictors of clinical failure (rebleeding within 30 days) and 30-day mortality were assessed using multivariable logistic regression. Results: A total of 111 embolizations were performed in 100 patients. Technical success was 100%, and clinical success was achieved in 82% of patients. The 30-day all-cause mortality rate was 26%, with disease-specific mortality at 15%. Complications occurred in 4% of cases. Vasopressor or inotropic therapy and antithrombotic use were independent predictors of clinical failure. Vasopressor requirement and higher Charlson Comorbidity Index (CCI) scores were significantly associated with 30-day mortality. Empiric embolization was associated with a lower likelihood of rebleeding but did not influence mortality. Conclusions: TAE provided high technical success and favorable overall outcomes with a low complication rate in the management of nonvariceal GIB. Vasopressor requirement was the strongest predictor of both rebleeding and mortality, likely reflecting the underlying severity of shock physiology rather than the direct effects of vasopressor therapy. These results highlight the need for further prospective studies to guide management strategies in hemodynamically unstable patients requiring vasopressor support.

Introduction: In recent years several new techniques have emerged to induce hypertrophy of the future liver remnant prior to major hepatectomies. We aimed to summarize our initial experience with Double-vein Embolization as the first center in Hungary. Methods: Between March 2023 and August 2024 a total of 16 Double-vein Embolization procedures were performed in Semmelweis University. Future liver remnant volume was calculated based on computed tomography scans obtained within 4 weeks prior and 2-3 weeks after the procedure. Tc-99m mebrofenin hepatobiliary scintigraphy results were available for 12/16 patients. Results: Technical success rate was 100 %. No major complication was observed. Successful resection rate was 93.8 %. One patient died due to post-hepatectomy liver failure. Future liver remnant volume and ratio increased significantly after the procedure compared to baseline (433.1 f 163.8 cm3 vs. 603.5 f 201.8 cm3, p < 0.0001 and 27.2 f 6.5 % vs. 37 f 8.8 %, p < 0.0001, respectively). Future liver remnant clearance improved significantly 1 and 2 weeks after the procedure (1.68 f 0.58 %/min/m2 vs. 2.44 f 0.64 %/min/m2 and 2.39 f 0.31 %/min/m2, respectively). Mean function gain was 50.6 % after one week and 60.1% after two weeks, respectively. Discussion: Volumetric and functional outcomes in the present study are comparable with results reported in the literature. Our findings provide further evidence that Double-vein Embolization is a safe procedure that offers sufficient volumetric and functional gain in most candidates for liver resection. However, further studies are needed to define the exact place of this new technique in clinical practice.

We present a case demonstrating the potential of radioembolization with Ho-166-labelled microparticles as an effective bridging therapy for hepatocellular carcinoma (HCC) in a 70-year-old male patient with liver cirrhosis awaiting liver transplantation. The patient received a calculated dose of 3 GBq of Ho-166 microspheres, which were selectively administered intra-arterially to the target area during the radioembolization procedure. Post-treatment dosimetry revealed an average tumor absorbed dose of 332 Gy. Contrast-enhanced CT scan performed one month later revealed a necrotic, non-enhancing area at the tumor site, indicating a complete response. The patient successfully underwent liver transplantation 2.5 months after radioembolization. This case suggests that Ho-166 radioembolization is a promising locoregional therapy for HCC, particularly for patients requiring a bridging approach to transplantation.

Thermal ablation has become an increasingly recognized alternative or adjunct to surgery for the management of colorectal liver metastases (CRLMs), particularly for lesions ≤3 cm and those located in anatomically challenging regions. Furthermore, advanced liver-regenerative strategies—such as double-vein embolization (DVE)—provide a safe and effective means of inducing hypertrophy of the future liver remnant (FLR) in patients who are candidates for extended hepatectomy. We present the case of a 38-year-old woman diagnosed with bilobar CRLMs during pregnancy. She underwent systemic chemotherapy during and after gestation, followed by ultrasound-guided microwave ablation of a deep segment 2 lesion and extended DVE to induce FLR hypertrophy. These interventions enabled a successful extended right hemihepatectomy and subsequent resection of the primary tumor. This case highlights the expanding role of interventional radiology in managing bilobar metastatic liver disease and supports the use of thermal ablation combined with regenerative strategies as a safe, parenchyma-sparing approach.

Background/Objectives: Transarterial radioembolization (TARE) plays an increasing role in the treatment of hepatocellular carcinoma (HCC). Several isotope platforms have been introduced; however, comparative data remain limited. We aimed to compare outcomes following Holmium-166 (Ho-166) and Yttrium-90 (Y-90) TARE in HCC patients. Methods: We retrospectively analyzed a prospectively maintained cohort of HCC patients treated with Ho-166 or Y-90 TARE between 2022 and 2024. Tumor burden and treatment response were assessed using contrast-enhanced CT or MRI. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method and further evaluated using multivariable Cox regression analyses adjusted for baseline confounders. Results: A total of 73 patients were analyzed, including 39 treated with Y-90 and 34 with Ho-166 TARE. Median follow-up duration was 20.9 months. No significant differences in OS or PFS were observed between treatment groups. Response outcomes, including objective response rate, complete response rate, and duration of response, were also comparable between groups. In the overall cohort, median OS was not reached in Barcelona Clinic Liver Cancer (BCLC) A or B patients and was 12.9 months in BCLC C patients. Median PFS was 20.1, 11.7, and 6.1 months in BCLC A, B, and C patients, respectively. Conclusions: Ho-166 and Y-90 TARE achieved favorable outcomes across different BCLC stages without significant differences in survival, treatment response, or duration of response between the two platforms. These findings further support the role of TARE in the management of patients with HCC.

"Addendum to: Successful treatment of a therapy-resistant, giant liver hemangioma with repeated bleomycin TACE: A case report" published on 06 May 2025 by Akadémiai Kiadó.