Complications of transarterial radioembolization in hepatic malignancies: Pathophysiological insights and management paradigms.

Hepatic malignancies remain among the most prevalent and lethal oncologic entities worldwide, characterized by aggressive biological behavior and dismal prognosis. Hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM) represent the predominant hepatic neoplasms, for which conventional therapies demonstrate limited efficacy in unresectable advanced-stage disease. Transarterial radioembolization (TARE), alternatively termed selective internal radiation therapy (SIRT) using yttrium-90 (Y) labeled microspheres, has emerged as an innovative hybrid modality integrating interventional radiology with intratumoral radiotherapy. While offering distinct advantages including minimally invasive implementation, demonstrated tumor response, and abbreviated hospitalization, postprocedural complications may substantially compromise therapeutic outcomes and quality of life. Consequently, prevention and management of TARE-associated complications have become critical components of perioperative care. This comprehensive review systematically analyzes the spectrum of potential post-TARE complications while elucidating contemporary prevention strategies and therapeutic algorithms grounded in pathophysiological mechanisms.