criteria for liver transplantation. Other treated malignancies include neuroendocrine tumors, ocular melanoma, cholangiocarcinoma, and sarcoma. Transcatheter arterial chemoembolization plays a palliative role in patients with metastatic colon carcinoma. There is a possible benefit for liver-dominant metastases from other primary malignancies. Procedure TACE is an interventional radiology procedure performed in the angiography suite. The procedure involves gaining percutaneous transarterial access by the Seldinger technique to the hepatic artery with an arterial sheath, usually by puncturing the common femoral artery in the right groin and passing a catheter guided by a wire through the abdominal aorta, through the celiac trunk and common hepatic artery, and finally into the branch of the proper hepatic artery supplying the tumor. The interventional radiologist then performs a selective angiogram of the celiac trunk and possibly the superior mesenteric artery to identify the branches of the hepatic artery supplying the tumor(s) and threads smaller, more selective catheters into these branches. This is done to maximize the amount of the chemotherapeutic dose that is directed to the tumor and minimize the amount of the chemotherapeutic agent that could damage the normal liver tissue. When a blood vessel supplying the tumor has been selected, alternating doses of the chemotherapy dose and of embolic particles, or an infusion of embolic particles containing the chemotherapy agent, are injected through the catheter. The physician removes the catheter and access sheath, applying pressure to the entry site to prevent bleeding. The patient must lie stationary for several hours after the procedure to allow the punctured artery to heal. The clinician can apply pressure using a Femostop or close the artery using a vascular sealing device. The patient will often be kept overnight for observation and will likely be discharged the following day. The procedure is normally followed up with a CT scan several weeks later to check the response of the tumor to the procedure. Agents Lipiodol – mixed with chemotherapeutic agents (Lipiodol is nonocclusive, combined with Gelfoam, Ivalon, or other particles) Drug eluting particles – slow, sustained release of loaded drug locally with embolic effect leading to tumor ischemia Polyvinyl alcohol microspheres – loaded with doxorubicin Superabsorbent polymer microspheres – loaded with doxorubicin Gelatin microspheres – loaded with cisplatin EmboCept S - made up of Degradable Starch Microspheres (DSM). It can be mixed with low volume chemotherapeutic agents such as Doxorubicin and Mitomycin and high volume chemotherapeutic agents such as Cisplatin and