Next-Generation Flexible Embolic Systems: Targeted Transarterial Chemoembolization Strategies for Hepatocellular Carcinoma.

Transarterial chemoembolization (TACE) remains the gold standard for treating intermediate-stage hepatocellular carcinoma (HCC), yet faces great challenges in overcoming tumor heterogeneity, hypoxia-induced angiogenesis, and metastatic progression. The development of advanced flexible embolization materials marks a revolutionary leap in interventional therapy, offering opportunities to revolutionize embolization precision, drug delivery kinetics, and tumor microenvironment modulation. This comprehensive review systematically examines the paradigm shift toward next-generation TACE technology, emphasizing the limitations of conventional approaches and innovations in flexible embolic agents. A detailed discussion of next-generation nano-flexible embolic systems is presented, emphasizing their unique coagulation dynamics, real-time imaging capabilities, and therapeutic precision. The review delves into groundbreaking TACE strategies integrating hypoxia modulation, energy conversion therapeutics, and sophisticated tumor microenvironment engineering. Clinical translation aspects are thoroughly explored, including large-scale trial outcomes, vascular recanalization dynamics, and patient-specific treatment optimization. Looking forward, key frontiers in the field is identified: intelligent nanocomposite systems, synergistic combination therapies, and precision medicine approaches tailored to individual tumor biology. This work not only objectively evaluates current progress but also charts future research priorities, aiming to transform TACE from a palliative intervention to a precision medicine platform and ultimately reshaping the landscape of HCC treatment and patient care.