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Supplemental Transcatheter Arterial Chemoembolization Through a Collateral Omental Artery: Treatment for Hepatocellular Carcinoma

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Abstract

Purpose: To evaluate the therapeutic efficacy and safety of supplemental transcatheter arterial chemoembolization (TACE) through the extrahepatic collateral omental artery (OA) for the treatment of hepatocellular carcinoma (HCC). Methods: We studied 21 patients with extrahepatic collaterals of the OA, among 1,512 patients with HCC who had undergone angiography. HCCs supplied by collateral OAs were located at: segment IV in seven, segment V in five, segment III in three, segment VI in three and segment VIII in three patients (Couinaud classification of segments). On preoperative CT scans, every HCC was abutting the liver surface. Adjacent omental infiltration or engorgement was noted in 11 patients. Celiac and hepatic arteriograms showed hypertrophy of the feeding OA in all patients. TACE of the OA was performed in 19 patients with an emulsion of iodized oil and doxorubicin hydrochloride. Embolization with gelatin sponge particles was added in five patients. Results: Collaterals of the OA to the HCC were found on the first to seventeenth sessions of TACE. On follow-up CT scans, five patients showed complete uptake of iodized oil in the tumor. Partial uptake of iodized oil was noted in 13 patients and no uptake in one patient. There was no serious complication that related to the omental embolization, such as omental or bowel ischemia. The cumulative survival rates from the time of the TACE of the OA were 81% at 6 months and 68% at 12 months. Conclusion: TACE of the OA is safe and has a potential therapeutic effect in the treatment of HCC.

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References

  1. N Yamanaka E Okamoto A Toyosaka et al. (1990) ArticleTitlePrognostic factors after hepatectomy for hepatocellular carcinoma. Cancer 65 1104–1110 Occurrence Handle2154320

    PubMed  Google Scholar 

  2. H Nakamura T Hashimoto H Oi S Sawada (1989) ArticleTitleTranscatheter oily chemoembolization of the hepatocellular carcinoma. Radiology 170 783–786 Occurrence Handle2536946

    PubMed  Google Scholar 

  3. H Uchida H Ohishi N Matsuo K Nishimine S Ohue Y Nishimura M Maeda T Yoshioka (1990) ArticleTitleTranscatheter hepatic segmental arterial embolization using lipiodol mixed with an anticancer drug and gelfoam particles for hepatocellular carcinoma. Cardiovasc Intervent Radiol 13 140–145

    Google Scholar 

  4. JH Park JK Han JW Chung MC Han ST Kim (1993) ArticleTitlePostoperative recurrence of hepatocellular carcinoma: Results of transcatheter arterial chemoembolization. Cardiovasc Intervent Radiol 16 21–24 Occurrence Handle8382109

    PubMed  Google Scholar 

  5. O Matsui M Kadoya J Yoshikawa T Gabata K Arai H Demachi S Miyayama T Takashima M Unoura K Kogayashi (1993) ArticleTitleSmall hepatocellular carcinoma: Treatment with subsegmental transcatheter arterial embolization. Radiology 188 79–83 Occurrence Handle8390073

    PubMed  Google Scholar 

  6. N Matuo M Kuzuki T Yoshioka et al. (1985) ArticleTitleCollateral embolization after hepatic arterial embolization to the hepatocellular carcinoma. Jpn Coll Angiol 25 365–372

    Google Scholar 

  7. T Kodama S Tamura M Samejima et al. (1989) ArticleTitleChanges of hepatic circulation after hepatic arterial embolization: An analysis of factors affecting the development of collaterals. Nippon Igaku Hoshasen Gakkai Zasshi 49 892–898

    Google Scholar 

  8. CS Soo VP Chuang S Wallace C Charnsangavej H Carrasco (1983) ArticleTitleTreatment of hepatic neoplasm through extrahepatic collaterals. Radiology 147 45–49 Occurrence Handle6828758

    PubMed  Google Scholar 

  9. Y Iwata J Endo T Saito T Iwata S Matsuyama Y Tanaka Y Otani S Tsukui K Goto S Ikeuchi (1996) ArticleTitleHepatic embolization through extrahepatic collateral pathways after hepatic arterial embolization for the hepatocellular carcinoma. Tokai J Exp Clin Med 21 177–183 Occurrence Handle9300978

    PubMed  Google Scholar 

  10. JW Chung JH Park JK Han BI Choi TK Kim MC Han (1998) ArticleTitleTranscatheter oily chemoembolization of the inferior phrenic artery in hepatocellular carcinoma: The safety and potential therapeutic role. J Vasc Interv Radiol 9 495–500 Occurrence Handle9618112

    PubMed  Google Scholar 

  11. G Duprat C Charnsangavej S Wallace H Carrasco () ArticleTitleInferior phrenic artery embolization in the treatment of hepatic neoplasms. Acta Radiol 29 427–429

    Google Scholar 

  12. JH Kim JW Chung JK Han JH Park BI Choi MC Han (1995) ArticleTitleTranscatheter arterial embolization of the internal mammary artery in hepatocellular carcinoma. J Vasc Interv Radiol 6 71–77 Occurrence Handle7703585

    PubMed  Google Scholar 

  13. SE Macaulay DM Coldwell (1995) ArticleTitleInternal mammary artery embolization for hepatic tumors. Cardiovasc Intervent Radiol 18 20–24

    Google Scholar 

  14. PN Kim IY Kim KS Lee (1994) ArticleTitleIntraperitoneal seeding from hepatoma. Abdom Imaging 19 309–312 Occurrence Handle8075551

    PubMed  Google Scholar 

  15. NW Skezas DG Spigos PM Dunne BG Langer (1991) ArticleTitleParasitization by hepatocellular carcinoma of branches of the superior mesenteric artery (letter). AJR Am J Roentgenol 157 1357–1358

    Google Scholar 

  16. C Couinaud (1954) ArticleTitleLobes et segments hepatiques. Notes sur l’architecture anatomique et chirurgicale du foie. Presse Med 62 709–712 Occurrence Handle13177441

    PubMed  Google Scholar 

  17. R Yamada K Kishi T Sonomura et al. (1990) ArticleTitleTranscatheter arterial embolization in unresectable hepatocellular carcinoma. Cardiovasc Intervent Radiol 13 134–139

    Google Scholar 

  18. Kumada Ikeda Saitoh H . S et al. (1991) ArticleTitleEffect of repeated transcatheterarterial embolization on the survival time in patient with hepatocellular carcinoma: An analysis by Cox proportional hazard model. Cancer 68 2150–2154 Occurrence Handle1655202

    PubMed  Google Scholar 

  19. N Nakao K Kamino K Miura et al. (1992) ArticleTitleTranscatheter arterial embolization in hepatocellular carcinoma: A long-term follow up. Radiat Med 10 13–18 Occurrence Handle1316626

    PubMed  Google Scholar 

  20. NA Michels (1953) ArticleTitleCollateral arterial pathways to the liver after ligation of the hepatic artery and removal of the celiac axis. Cancer 6 708–724 Occurrence Handle13059765

    PubMed  Google Scholar 

  21. C Charnsangavej VP Chuang S Wallace CS Soo T Bowers (1982) ArticleTitleAngiographic classification of hepatic arterial collaterals. Radiology 144 485–494 Occurrence Handle6285413

    PubMed  Google Scholar 

  22. H Segall (1923) ArticleTitleAn experimental anatomical investigation of blood and bile channels of the liver: with special reference to the compensatory arterial circulation of the liver in its relation to surgical ligation of the hepatic artery: Report of a case of arteriosclerotic aneurysm of the gastroduodenal artery. Surg Gynecol Obstet 37 152–178

    Google Scholar 

  23. KL Moore AF Dalley (1999) Peritoneum and peritoneal cavity. PJ Kelly (Eds) Clinically oriented anatomy, 4th edn Lippincott Williams & Wilkins Philadelphia 209–217

    Google Scholar 

  24. T Taranu H Varlam GM Marta DS Antohe (1998) ArticleTitleThe arterial system of the greater omentum. Rev Med Chir Soc Med Nat lasi 102 139–142

    Google Scholar 

  25. FF Jr Ruzicka P Rossi (1970) ArticleTitleNormal vascular anatomy of the abdominal viscera. Radiol Clin North Am 8 3–29 Occurrence Handle5423172

    PubMed  Google Scholar 

  26. R Warwick PL Williams (1973) The coeliac trunk. Gray’s anatomy, 35th edn WB Saunders Philadelphia 660–663

    Google Scholar 

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Acknowledgements

We thank Dr. Franklin J. Miller (Department of Radiology, University of Utah, SLC, UT) for his helpful suggestions.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, 120-752, Korea

    Jong Yun Won, Do Yun Lee, Jong Tae Lee, Sung Il Park, Myeong-Jin Kim, Hyung Sik Yoo, Sang-Hyun Suh & Sang Joon Park

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  1. Jong Yun Won
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  2. Do Yun Lee
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Correspondence to Jong Yun Won.

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Won, J., Lee, D., Lee, J. et al. Supplemental Transcatheter Arterial Chemoembolization Through a Collateral Omental Artery: Treatment for Hepatocellular Carcinoma . CVIR 26, 136–140 (2003). https://doi.org/10.1007/s00270-002-2629-y

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