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CardioVascular and Interventional Radiology

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01-06-2010 | Clinical Investigation

The March of Extrahepatic Collaterals: Analysis of Blood Supply to Hepatocellular Carcinoma Located in the Bare Area of the Liver After Chemoembolization

Authors: Shiro Miyayama, Masashi Yamashiro, Miho Okuda, Yuichi Yoshie, Yoshiko Nakashima, Hiroshi Ikeno, Nobuaki Orito, Osamu Matsui

Published in: CardioVascular and Interventional Radiology | Issue 3/2010

Abstract

The purpose of this study was to evaluate changes in vascular supply to hepatocellular carcinoma (HCC) located in the bare area of the liver in patients who were mainly treated with chemoembolization. Twenty-six patients with HCC showing a mean diameter of 3.1 ± 1.4 cm (mean ± standard deviation) were mainly treated with chemoembolization. All patients underwent 2.7 ± 2.3 chemoembolization sessions over 40.1 ± 25.2 months. Tumor feeding branches demonstrated in each chemoembolization session were retrospectively evaluated. Initially, 18 tumors (59.2%) were supplied by the hepatic artery (H) and 8 (30.8%) by both the hepatic and the extrahepatic arteries (H + C). Fourteen tumors (53.8%) recurred at the posterior aspect of the tumor and were supplied by H (n = 4), H + C (n = 5), and extrahepatic collaterals (C) (n = 5). Several tumors recurred despite repeated chemoembolization, and these were supplied by H (n = 1), H + C (n = 7), and C (n = 2) at the second recurrence, by H (n = 1), H + C (n = 2), and C (n = 3) at the third, by H + C (n = 2) and C (n = 2) at the fourth, by H + C (n = 2) and C (n = 2) at the fifth, and by H (n = 1) and C (n = 1) at the sixth. One tumor was supplied by H at the seventh and by H + C at the eighth recurrence. As the number of local recurrences increased, the feeding vessel shifted from H to C. Especially, the right inferior phrenic artery (IPA) and renal capsular artery (RCA) supplied the tumor early, while the small right RCAs, adrenal arteries, and intercostal and lumbar artery supplied late recurrences in turns. In conclusion, HCCs located in the bare area are frequently supplied by extrahepatic vessels initially, while recurrence after chemoembolization is mainly due to extrahepatic blood supply. The right IPA and RCA are common feeding vessels demonstrated early, while other extrahepatic collateral supply from the retroperitoneal circulation occurs in turns during the later course.

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Title: The March of Extrahepatic Collaterals: Analysis of Blood Supply to Hepatocellular Carcinoma Located in the Bare Area of the Liver After Chemoembolization
Authors: Shiro Miyayama
Masashi Yamashiro
Miho Okuda
Yuichi Yoshie
Yoshiko Nakashima
Hiroshi Ikeno
Nobuaki Orito
Osamu Matsui
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 3/2010
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-009-9697-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The March of Extrahepatic Collaterals: Analysis of Blood Supply to Hepatocellular Carcinoma Located in the Bare Area of the Liver After Chemoembolization

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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