High-Volume Dilution of Drug-Eluting Beads Reduces Severe Pain After DEB-TACE: A Single-Center Retrospective Study

Background: Abdominal pain is the most frequent consequence of postembolization syndrome (PES) after drug-eluting bead transarterial chemoembolization (DEB-TACE). The analgesic impact of an easily modifiable intraprocedural factor-microsphere suspension dilution, remains unclear. We evaluated whether high-fold dilution during DEB-TACE reduces early postprocedural pain and severe pain risk without compromising short-term response and safety. Methods: This single-center retrospective cohort study included 362 patients with hepatocellular carcinoma who underwent DEB-TACE. The patients were divided into conventional dilution (Group A, n = 103), 30-50-fold dilution (Group B, n = 127), and > 50-fold dilution (Group C, n = 132). The outcomes included a maximum visual analog scale (VAS) pain score within 72 hours and moderate-to-severe (VAS score ≥ 4) and severe (VAS score ≥ 7) pain scores. Associations were tested through Spearman correlation and trend tests. Univariable and multivariable logistic regression were used to estimate adjusted odds ratios (ORs) for severe pain. Short-term tumor response was also assessed according to mRECIST at 1-3 months after the index procedure. Results: = 0.015). Conclusion: High-fold microsphere suspension dilution during DEB-TACE was associated with reduced early postprocedural abdominal pain without compromising short-term laboratory safety.