Semin intervent Radiol 2018; 35(01): 069-080
DOI: 10.1055/s-0038-1636523
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Intra- and Extrahepatic Collaterals: Pitfalls and Pathways for Locoregional Therapy

James Su
Vanderbilt University School of Medicine, Nashville, Tennessee
,
Suraj Kapoor
Vanderbilt University School of Medicine, Nashville, Tennessee
,
Daniel B. Brown
Department of Radiology and Radiologic Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
› Author Affiliations
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Publication History

Publication Date:
05 April 2018 (online)

Intra-arterial interventions are increasingly performed for several other primary and metastatic liver tumors including hepatocellular carcinoma (HCC), cholangiocarcinoma, neuroendocrine tumor, colorectal cancer, uveal melanoma, and other less common entities.[1] [2] [3] [4] Understanding common patterns of extrahepatic collateral supply to metastases is vital in patients with bulky disease, especially following multiple treatment sessions with resulting arteriopathy with tumors in anatomically relevant locations. With the advent of radioembolization and the recognized risk of radiation-induced ulcer, insight into other intrahepatic pathways is also valuable to identify less common sources of tumor supply and to avoid nontarget infusion of the stomach or skin via accessory supply to the right gastric or falciform arteries, respectively. In this review, we describe common patterns originating from outside the liver or from the hepatic arteries.