Ovarian cancer is the most common malignant tumor of the female reproductive system, and about 70% to 80% of patients are already at an advanced stage when diagnosed. Arterial chemoembolization is to insert a small tube about 2mm thick from the femoral artery into the nutrient vessel of the tumor through interventional techniques, and to concentrate the chemotherapeutic drugs into the tumor area, so that the local concentration of chemotherapeutic drugs is hundreds of times higher than that of intravenous chemotherapy, thus producing a strong effect of killing tumor cells. After that, the tumor’s nutrient artery is then embolized with embolization agent to further cause ischemic necrosis of the tumor. Arterial chemoembolization opens up a minimally invasive, high-efficiency, and low-toxicity treatment method for advanced ovarian cancer, which shrinks and downgrades the tumor after treatment, creating opportunities for surgical resection. Physicians should be familiar with the nutritional arteries of ovarian cancer. Ovarian blood supply mainly comes from the ovarian branch of uterine artery and ovarian artery, and the visceral branch of internal iliac artery and inferior mesenteric artery can also participate in blood supply of advanced ovarian cancer through anastomotic branches, which need to be super-selectively cannulated branch by branch during interventional procedures. Chemotherapy drug selection Paclitaxel + platinum (TC) regimen is the first choice for standard first-line chemotherapy. However, there are significant differences in the efficiency of TC regimens for different pathologic subtypes of ovarian cancer, with 70%-80% for plasmacytosis and only 26%-42% for mucinous cancer, and even lower for other subtypes. In addition, multiple use of the same chemotherapy regimen can lead to serious side effects such as persistent peripheral neurotoxicity, and tumor cells are also prone to drug resistance. Therefore, choosing different drugs for sequential chemotherapy is more beneficial to patient survival and quality of life. For stage III and IV ovarian cancer treated with TC regimen in sequential chemotherapy with gemcitabine + oxaliplatin (GEMOX) regimen or gemcitabine + carboplatin (GC) regimen, the toxic side effects of chemotherapy are relatively less. Patients with ovarian mucinous carcinoma resistant to the TC regimen can choose the oxaliplatin + fluorouracil or oxaliplatin + capecitabine regimens. In contrast, the irinotecan + cisplatin regimen is more effective for ovarian clear cell carcinoma that is primary, recurrent, or resistant to the TC regimen. Embolization agent choice Usually there are gelatin sponges and granular microspheres. Generally, after gelatin sponge embolization of the target vessel, the embolized vessel will be recanalized by the absorption of gelatin sponge in about half a month. Drug microspheres and radioactive microspheres can persistently embolize and may improve the efficacy. However, after embolization of target vessels by microspheres, neovascularization and collateral vessels open to form a new tumor-nourishing vascular network, so that some tumors without necrosis continue to grow, and the embolized vascular trunk can no longer be intubated for chemotherapy, which makes future treatment very difficult, so the timing of using microspheres needs to be carefully grasped. Follow-up monitoring Commonly used markers for ovarian cancer include CA125, CA19-9, carcinoembryonic antigen (CEA), human epithelial protein 4 (HE4), etc. In most cases, abnormal markers in the same patient can be used as a basis for assessing the disease during chemotherapy or before and after recurrence; however, the marker profile of some patients will change during this period, as shown by changes in the type or number of markers, which is related to the tumor heterogeneity, metastatic sites, tumor stem cells, drug resistance, and other factors. Therefore, combined testing of multiple tumor markers should be performed regularly on patients during chemotherapy and follow-up to evaluate the efficacy and detect recurrence and to guide the selection of chemotherapy regimens.