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CardioVascular and Interventional Radiology

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01.02.2006 | CLINICAL INVESTIGATION

Extrahepatic Blood Supply to Hepatocellular Carcinoma: Angiographic Demonstration and Transcatheter Arterial Chemoembolization

verfasst von: Shiro Miyayama, Osamu Matsui, Keiichi Taki, Tetsuya Minami, Yasuji Ryu, Chiharu Ito, Koichi Nakamura, Dai Inoue, Kazuo Notsumata, Daisyu Toya, Nobuyoshi Tanaka, Takeshi Mitsui

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 1/2006

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Abstract

Purpose

To evaluate the incidence of each extrahepatic collateral pathway to hepatocellular carcinoma (HCC) and to assess technical success rates and complications of transcatheter arterial chemoembolization (TACE) through each collateral.

Methods

We retrospective evaluated extrahepatic collateral pathways to HCC on angiography in 386 procedures on 181 consecutive patients. One hundred and seventy patients had previously undergone TACE. TACE through extrahepatic collaterals using iodized oil and gelatin sponge particles was performed when a catheter was advanced into the tumor-feeding branch to avoid nontarget embolization.

Results

A single collateral was revealed in 275 TACE procedures, two were revealed in 74, and three or more were revealed in 34. Incidences of collateral source to HCC were 83% from the right inferior phrenic artery (IPA), 24% from the cystic artery, 13% from the omental artery, 12% from the right renal capsular artery (RCA) and left IPA, 8% from the right internal mammary artery (IMA) and right intercostal artery (ICA), and 7% from the right inferior adrenal artery (IAA). Technical success rates of TACE were 53% in the right ICA, 70% in the cystic artery, 74% in the omental artery, 93% in the left IPA, 96% in the right IPA, and 100% in the right RCA, right IMA, and right IAA. Complications included skin necrosis after TACE through the right IMA (n = 1), cholecystitis after TACE through the cystic artery (n = 1), and ulcer formation after TACE through the right gastric artery (n = 1), in addition to pleural effusion and basal atelectasis after TACE through the IPA and IMA.

Conclusion

Our study suggests that TACE through extrahepatic collaterals is possible with high success rates, and is also relatively safe.

Dodd GD III, Soulen MC, Kane RA, et al. (2000) Minimally invasive treatment of malignant hepatic tumors: At the threshold of a major breakthrough. Radiographics 20:9–27PubMed

Yamada Y, Sato M, Kawabata M, et al. (1983) Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 148:397–401PubMed

Uchida H, Ohishi H, Matsuo N, et al. (1990) Transcatheter hepatic segmental arterial embolization using lipiodol mixed with an anticancer drug and Gelfoam particles for hepatocellular carcinoma. Cardiovasc Intervent Radiol 13:140–145PubMedCrossRef

Matsui O, Kadoya M, Yoshikawa J, et al. (1993) Small hepatocellular carcinoma: Treatment with subsegmental transcatheter arterial embolization. Radiology 188:79–83PubMed

Charnsangavej C, Chuang VP, Wallace S, et al. (1982) Angiographic classification of hepatic arterial collaterals. Radiology 144:485–494PubMed

Michels NA (1953) Collateral arterial pathways to the liver after ligation of the hepatic artery and removal of the celiac axis. Cancer 6:708–724PubMedCrossRef

Koehler RE, Korobkin M, Lewis F (1975) Arteriographic demonstration of collateral arterial supply to the liver after hepatic artery ligation. Radiology 117:49–54PubMed

Miyayama S, Matsui O, Akakura Y, et al. (2001) Hepatocellular carcinoma with blood supply from omental branches: Treatment with transcatheter arterial embolization. J Vasc Interv Radiol 12:1285–1290PubMedCrossRef

Chung JW, Park JH, Han JK, et al. (1998) Transcatheter oily chemoembolization of the inferior phrenic artery in hepatocellular carcinoma: The safety and potential therapeutic role. J Vasc Interv Radiol 9:495–500PubMedCrossRef

10.

Hirota S, Matsumoto S, Fukuda T, et al. (1999) Solitary hepatocellular carcinoma fed by the cystic artery: Limitation of transcatheter arterial embolization. Cardiovasc Intervent Radiol 22:206–209PubMedCrossRef

11.

Tanigawa N, Sawada S, Okuda Y, et al. (1998) A case of small hepatocellular carcinoma supplied by the cystic artery. AJR Am J Roentgenol 170:675–676PubMed

12.

Park S II, Lee DY, Won JY, et al. (2003) Extrahepatic collateral supply of hepatocellular carcinoma by the intercostal arteries. J Vasc Interv Radiol 14:461–468PubMed

13.

Soo CS, Chuang VP, Wallace S, et al. (1983) Treatment of hepatic neoplasm through extrahepatic collaterals. Radiology 147:45–49PubMed

14.

Kim JH, Chung JW, Han JK, et al. (1995) Transcatheter arterial embolization of the internal mammary artery in hepatocellular carcinoma. J Vasc Interv Radiol 6:71–77PubMedCrossRef

15.

Duprat G, Charnsangavej C, Wallace S, et al. (1988) Inferior phrenic artery embolization in the treatment of hepatic neoplasms. Acta Radiol 29:427–429PubMedCrossRef

16.

Nakai M, Sato M, Kawai N, et al. (2001) Hepatocellular carcinoma: Involvement of the internal mammary artery. Radiology 219:147–152PubMed

17.

Kodama Y, Shimizu T, Endo H, et al. (2002) Spontaneous rupture of hepatocellular carcinoma supplied by the right renal capsular artery treated by transcatheter arterial embolization. Cardiovasc Intervent Radiol 25:137–140CrossRefPubMed

18.

Miyayama S, Matsui O, Nishida H, et al. (2003) Transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma fed by the cystic artery. J Vasc Interv Radiol 14:1155–1161PubMed

19.

Miyayama S, Matsui O, Taki K, et al. (2004) Transcatheter arterial chemoembolization for hepatocellular carcinoma fed by the reconstructed inferior phrenic artery: Anatomical and technical analysis. J Vasc Interv Radiol15:815–823PubMed

20.

Miyayama S, Matsui O, Akakura Y, et al. (2001) Use of a catheter with a large side hole for selective catheterization of the inferior phrenic artery. J Vasc Interv Radiol 12:497–499PubMedCrossRef

21.

Miyayama S, Matsui O, Taki K, et al. (2004) Combined use of an occlusion balloon catheter and a microcatheter for embolization of the unselectable right inferior phrenic artery supplying hepatocellular carcinoma. Cardiovasc Intervent Radiol 27:667–681

22.

Komatsu T, Matsui O, Kadoya M, et al. (1999) Cystic artery origin of the segment V hepatic artery. Cardiovasc Intervent Radiol 22:165–167CrossRefPubMed

23.

Tajima T, Honda H, Kroiwa T, et al. (2002) Pulmonary complications after hepatic artery chemoembolization or infusion via the inferior phrenic artery for primary liver cancer. J Vasc Interv Radiol 13:893–900PubMedCrossRef

24.

Chung JW, Park JH, Han JK, et al. (1996) Hepatic tumors: Predisposing factors for complications of transcatheter oily chemoembolization. Radiology 198:33–40PubMed

25.

Arora R, Soulen MC, Haskal ZJ (1999) Cutaneous complications of hepatic chemoembolization via extrahepatic collaterals. J Vasc Interv Radiol 10:1351–1356PubMedCrossRef

26.

Takayasu K, Moriyama N, Muramatsu Y, et al. (1985) Gallbladder infarction after hepatic artery embolization. AJR Am J Roentgenol 144:135–138PubMed

27.

Takeuchi Y, Arai Y, Inaba Y, et al. (1998). Extrahepatic arterial supply to the liver: Observation with a unified CT and angiography system during temporary balloon occlusion of the proper hepatic artery. Radiology 209:121–128PubMed

28.

Ishijima H, Koyama Y, Aoki J, et al. (1999) Use of a combined CT-angiography system for demonstration of correlative anatomy during embolotherapy for hepatocellular carcinoma. J Vasc Interv Radiol 10:811–815PubMedCrossRef

29.

Takayasu K, Muramatsu Y, Maeda T, et al. (2001) Targeted transarterial oily chemoembolization for small foci of hepatocellular carcinoma using a unified helical CT and angiography system: Analysis of factors affecting local recurrence and survival rates. AJR Am J Roentgenol 176:681–688PubMed

Titel: Extrahepatic Blood Supply to Hepatocellular Carcinoma: Angiographic Demonstration and Transcatheter Arterial Chemoembolization
verfasst von: Shiro Miyayama
Osamu Matsui
Keiichi Taki
Tetsuya Minami
Yasuji Ryu
Chiharu Ito
Koichi Nakamura
Dai Inoue
Kazuo Notsumata
Daisyu Toya
Nobuyoshi Tanaka
Takeshi Mitsui
Publikationsdatum: 01.02.2006
Verlag: Springer-Verlag
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 1/2006
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-004-0287-y

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Extrahepatic Blood Supply to Hepatocellular Carcinoma: Angiographic Demonstration and Transcatheter Arterial Chemoembolization