Download PDF
Semin intervent Radiol 2018; 35(01): 069-080
DOI: 10.1055/s-0038-1636523
How I Do It
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Intra- and Extrahepatic Collaterals: Pitfalls and Pathways for Locoregional Therapy

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

Publication History

Publication Date:
05 April 2018 (online)

Also available at
    Permissions and Reprints

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.

 

  • References

  • 1 Brown DB, Chapman WC, Cook RD. , et al. Chemoembolization of hepatocellular carcinoma: patient status at presentation and outcome over 15 years at a single center. AJR Am J Roentgenol 2008; 190 (03) 608-615
    CrossrefPubMedGoogle Scholar
  • 2 Ho AS, Picus J, Darcy MD. , et al. Long-term outcome after chemoembolization and embolization of hepatic metastatic lesions from neuroendocrine tumors. AJR Am J Roentgenol 2007; 188 (05) 1201-1207
    CrossrefPubMedGoogle Scholar
  • 3 Sharma KV, Gould JE, Harbour JW. , et al. Hepatic arterial chemoembolization for management of metastatic melanoma. AJR Am J Roentgenol 2008; 190 (01) 99-104
    CrossrefPubMedGoogle Scholar
  • 4 Stuart JE, Tan B, Myerson RJ. , et al. Salvage radioembolization of liver-dominant metastases with a resin-based microsphere: initial outcomes. J Vasc Interv Radiol 2008; 19 (10) 1427-1433
    CrossrefPubMedGoogle Scholar
  • 5 Kim HC, Chung JW, Lee W, Jae HJ, Park JH. Recognizing extrahepatic collateral vessels that supply hepatocellular carcinoma to avoid complications of transcatheter arterial chemoembolization. Radiographics 2005; 25 (01) (Suppl. 01) S25-S39
    CrossrefPubMedGoogle Scholar
  • 6 Piao DX, Ohtsuka A, Murakami T. Typology of abdominal arteries, with special reference to inferior phrenic arteries and their esophageal branches. Acta Med Okayama 1998; 52 (04) 189-196
    PubMedGoogle Scholar
  • 7 Chung JW, Park JH, Han JK, Choi BI, Kim TK, Han MC. Transcatheter oily chemoembolization of the inferior phrenic artery in hepatocellular carcinoma: the safety and potential therapeutic role. J Vasc Interv Radiol 1998; 9 (03) 495-500
    CrossrefPubMedGoogle Scholar
  • 8 Kim HC, Chung JW, Kim WH. , et al. Chemoembolization of the left inferior phrenic artery in patients with hepatocellular carcinoma: 9-year single-center experience. AJR Am J Roentgenol 2010; 194 (04) 1124-1130
    CrossrefPubMedGoogle Scholar
  • 9 Lee DH, Chung JW, Kim HC. , et al. Development of diaphragmatic weakness after transcatheter arterial chemoembolization of the right inferior phrenic artery: frequency and determinant factors. J Vasc Interv Radiol 2009; 20 (04) 484-489
    CrossrefPubMedGoogle Scholar
  • 10 Brennan DD, Farrelly C, Cooney R, Norris S, McEniff N. Abdominal rash after transarterial chemoembolization via the right inferior phrenic artery. J Vasc Interv Radiol 2005; 16 (09) 1269
    CrossrefPubMedGoogle Scholar
  • 11 Hefel L, Schwabegger A, Ninković M. , et al. Internal mammary vessels: anatomical and clinical considerations. Br J Plast Surg 1995; 48 (08) 527-532
    CrossrefPubMedGoogle Scholar
  • 12 Kim SH, Kim HC, Hur S. , et al. Chemoembolization via the left internal mammary artery supplying hepatocellular carcinoma. J Vasc Interv Radiol 2014; 25 (09) 1389-97.e1
    CrossrefPubMedGoogle Scholar
  • 13 Kim HC, Chung JW, Choi SH. , et al. Hepatocellular carcinoma with internal mammary artery supply: feasibility and efficacy of transarterial chemoembolization and factors affecting patient prognosis. J Vasc Interv Radiol 2007; 18 (05) 611-619 , quiz 620
    CrossrefPubMedGoogle Scholar
  • 14 Kim JH, Chung JW, Han JK, Park JH, Choi BI, Han MC. Transcatheter arterial embolization of the internal mammary artery in hepatocellular carcinoma. J Vasc Interv Radiol 1995; 6 (01) 71-74 , discussion 75–77
    CrossrefPubMedGoogle Scholar
  • 15 Lee JH, Chon CY, Ahn SH. , et al. An ischemic skin lesion after chemoembolization of the right internal mammary artery in a patient with hepatocellular carcinoma. Yonsei Med J 2001; 42 (01) 137-141
    CrossrefPubMedGoogle Scholar
  • 16 Arora R, Soulen MC, Haskal ZJ. Cutaneous complications of hepatic chemoembolization via extrahepatic collaterals. J Vasc Interv Radiol 1999; 10 (10) 1351-1356
    CrossrefPubMedGoogle Scholar
  • 17 Memis A, Oran I, Calli C, Yuzer Y, Mentes A. Transcatheter arterial embolization of internal mammary artery in a hepatocellular carcinoma with abdominal wall invasion. Eur J Radiol 1998; 28 (02) 160-163
    CrossrefPubMedGoogle Scholar
  • 18 Park SI, Lee DY, Won JY, Lee JT. Extrahepatic collateral supply of hepatocellular carcinoma by the intercostal arteries. J Vasc Interv Radiol 2003; 14 (04) 461-468
    CrossrefPubMedGoogle Scholar
  • 19 Kim HC, Chung JW, Lee IJ. , et al. Intercostal artery supplying hepatocellular carcinoma: demonstration of a tumor feeder by C-arm CT and multidetector row CT. Cardiovasc Intervent Radiol 2011; 34 (01) 87-91
    CrossrefPubMedGoogle Scholar
  • 20 Li Z, Cai Z, Dai S, Deng H, Li Z, Ji F. Cutaneous necrosis associated with transcatheter arterial chemoembolization of the intercostal artery. J Vasc Interv Radiol 2014; 25 (07) 1141-1148.e1
    CrossrefPubMedGoogle Scholar
  • 21 Chung JW, Park JH, Han JK. , et al. Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization. Radiology 1996; 198 (01) 33-40
    CrossrefPubMedGoogle Scholar
  • 22 Chou CT, Huang YC, Lee CW, Lee KW, Chen YL, Chen RC. Efficacy of transarterial chemoembolization for hepatocellular carcinoma in interlobar watershed zone of liver: comparison of unilateral and bilateral chemoembolization. J Vasc Interv Radiol 2012; 23 (08) 1036-1042
    CrossrefPubMedGoogle Scholar
  • 23 Kothary N, Takehana C, Mueller K. , et al. Watershed hepatocellular carcinomas: the risk of incomplete response following transhepatic arterial chemoembolization. J Vasc Interv Radiol 2015; 26 (08) 1122-1129
    CrossrefPubMedGoogle Scholar
  • 24 Wang DS, Louie JD, Kothary N, Shah RP, Sze DY. Prophylactic topically applied ice to prevent cutaneous complications of nontarget chemoembolization and radioembolization. J Vasc Interv Radiol 2013; 24 (04) 596-600
    CrossrefPubMedGoogle Scholar
  • 25 Kim DE, Yoon HK, Ko GY, Kwon JS, Song HY, Sung KB. Hepatic falciform artery: is prophylactic embolization needed before short-term hepatic arterial chemoinfusion?. AJR Am J Roentgenol 1999; 172 (06) 1597-1599
    CrossrefPubMedGoogle Scholar
  • 26 Yamagami T, Nakamura T, Iida S, Kato T, Nishimura T. Embolization of the right gastric artery before hepatic arterial infusion chemotherapy to prevent gastric mucosal lesions: approach through the hepatic artery versus the left gastric artery. AJR Am J Roentgenol 2002; 179 (06) 1605-1610
    CrossrefPubMedGoogle Scholar
  • 27 Hamoui N, Minocha J, Memon K. , et al. Prophylactic embolization of the gastroduodenal and right gastric arteries is not routinely necessary before radioembolization with glass microspheres. J Vasc Interv Radiol 2013; 24 (11) 1743-1745
    CrossrefPubMedGoogle Scholar
  • 28 Sebben GA, Rocha SL, Sebben MA, Parussolo Filho PR, Gonçalves BH. Variations of hepatic artery: anatomical study on cadavers. Rev Col Bras Cir 2013; 40 (03) 221-226
    CrossrefPubMedGoogle Scholar
  • 29 Abdelmaksoud MH, Louie JD, Kothary N. , et al. Embolization of parasitized extrahepatic arteries to reestablish intrahepatic arterial supply to tumors before yttrium-90 radioembolization. J Vasc Interv Radiol 2011; 22 (10) 1355-1362
    CrossrefPubMedGoogle Scholar